Oncologic Disorders Flashcards by Jessica McGrane

What is the disease process of cancer?

Begins when a cell is transformed by genetic mutation of cellular DNA. Can involve any organ system.

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Define benign cells

Not cancerous; may grow but unable to spread.

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What characterizes malignant cancer?

Cells or processes that are characteristic of cancer.

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What is metastasis?

Abnormal cells invade surrounding tissue and gain access to lymph and blood vessels carrying them to other areas of the body.

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List some strong familial factors in cancer.

Genetic predisposition
Family history of cancer

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What is precision medicine in the context of cancer?

Development of biologic databases and technologic advances that identify unique characteristics of individuals.

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What is the approximate annual death toll from cancer in the U.S.?

Approximately 600,000 persons.

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Which organ systems have the highest incidence of cancer in men?

Lung
Prostate
Colorectal

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Which organ systems have the highest incidence of cancer in women?

Lung
Breast
Colorectal

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What is cell proliferation?

Genetically altered cells clone and proliferate abnormally;
Evade normal intra/extracellular processes

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What are characteristics of growth by benign tumors?

Grows by expansion, no infiltration of adjacent cells
Slow growth
No metastasis
Localized effects
Rare tissue damage
Death rare

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What are characteristics of growth of malignant tumors?

Grows at periphery, invades surrounding tissues
Variable growth rate
Uses blood and lymph channels to invade other areas
Generalized effects
Frequent tissue damage
Death

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What are the three phases of carcinogenesis?

Initiation
Promotion
Progression

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What is the initiation (apoptosis) stage of carcinogenesis?

Carcinogens cause mutations in cellular DNA. Normal cell cycle interrupted

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What is the promotion stage of carcinogenesis?

initiated cells are prompted to grow and survive. tumor suppressor gene - preneoplastic/benign lesions

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What is the progression stage of carcinogenesis?

proliferation and differentiation; angiogenesis

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What are common carcinogenic agents?

Viruses (HPV, HBV, EBV)
Bacteria (H. pylori)
Chemical agents (tobacco, asbestos)
Physical agents (sunlight, radiation)

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What lifestyle factors can contribute to cancer risk?

Diet
Obesity
Sedentary lifestyles
Hormonal agents

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What is the role of the immune system in cancer prevention?

T-cell lymphocytes & B-cell lymphocytes normally destroys cancer cells

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What is primary prevention in cancer?

Reducing risks through health promotion and risk reduction strategies.

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What is secondary prevention in cancer prevention?

screening and early detection activities

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What is tertiary prevention in cancer?

monitoring and preventing recurrence of primary cancer
screen for secondary malignancies in cancer survivors

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What are some warning signs of cancer?

Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in wart/mole
Nagging cough

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What is involved in the diagnosis of cancer?

Physical examination
Imaging studies (CT, MRI)
Laboratory tests
Pathologic analysis (biopsy)

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What does tumor staging involve?

* Size of the tumor * Existence of local invasion * Lymph node involvement * Distant metastasis

What does tumor grading involve?

define type of original tumor tissue and degree of differentiation (I-IV)

What is the goal of cancer management?

* Cure * Control * Palliation

What types of surgical treatment are available for cancer?

* Diagnostic surgery * Tumor removal * Prophylactic surgery * Palliative surgery * Reconstructive surgery

What is external beam radiation therapy (EBRT)?

Delivers tightly targeted radiation beams directed from outside the body.

What is Stereotactic Body Radiotherapy (SBRT)?

Higher doses of radiation over shorter time

What is brachytherapy?

* Placement of radioactive sources within or immediately next to the cancer site * Intense, highly targeted * Seeds, beads, ribbons placed in body cavities, interstitial tissues

What are common side effects of radiation therapy?

* Radiation dermatitis * Alopecia * Fatigue * Anorexia

What precautions are necessary for bracytherapy?

* Pregnant staff are not assigned * Restrict visits by children or pregnant women * Limit visits to 30 min/day * 6-Foot distance

What is chemotherapy designed to do?

Destroy cancer cells by interfering with cellular function and replication.

What are hypersensitivity reactions to chemotherapy?

Unexpected, adverse drug reactions associated with mild or progressively worsening signs and symptoms

List some chemotherapy toxicities.

* Gastrointestinal * Hematopoietic * Renal * Cardiopulmonary * Neurologic * Reproductive

Nursing management in chemotherapy

* Assessing fluid, electrolyte status * Assessing cognitive status * Modifying risks for infection, bleeding * Administering chemotherapy * Preventing nausea and vomiting * Managing fatigue * Protecting caregivers

What is hematopoietic stem cell transplantation (HSCT)?

Used to treat several malignant and nonmalignant diseases.

What is graft-versus-host disease (GVHD)?

Occurs when donor lymphocytes initiate an immune response against recipient's tissues.

What is the risk of developing breast cancer over a woman's lifetime?

About 12% or one in eight.

What are risk factors for breast cancer?

* Combination of genetic, hormonal, and environmental factors * Long-term smoking before first pregnancy * Night shift work

What are guidelines for early detection of breast cancer?

* MRI and yearly mammogram for high-risk women * Clinical breast exams twice a year starting at age 25 * Chemoprevention for women at high risk

What is the purpose of a percutaneous biopsy?

Obtains tissue by making a small puncture in the skin.

What is the purpose of excisional biopsy?

Removal of the entire mass plus margin surrounding tissue.

What does the TNM staging system represent?

* T: Tumor size * N: Lymph node involvement * M: Metastasis

What is an excisional biopsy?

Removal of entire mass plus margin surrounding tissue.

What is an incisional biopsy?

Surgical removal of a portion of mass to confirm diagnosis and aid in determining treatment.

What is wire needle localization?

Prior to surgery, wire placed under radiography to identify exact location of mass.

What does TNM stand for in breast cancer staging?

Tumor, nodes, metastasis.

What imaging studies are used in breast cancer diagnosis?

* Chest x-ray * CT * MRI * PET * Bone scan * Blood work.

What factors are associated with favorable prognosis for breast cancer?

Tumor size, spread to the lymph nodes, certain genes (ERBB2).

What is a modified radical mastectomy?

Removal of breast tissue, including the nipple–areola complex, plus a portion of the axillary lymph nodes dissection (ALND).

What is a total mastectomy?

Removal of the breast and nipple–areola complex but does not include ALND.

What is breast conservation treatment?

Excise only the tumor in the breast completely and obtain clear margins.

What is sentinel node biopsy?

Less invasive alternative to ALND, considered a standard of care for the treatment of early-stage breast cancer.

What types of radiation therapy are used in breast cancer management?

* External beam * Brachytherapy.

What are common forms of chemotherapy for breast cancer?

* Chemotherapy * Hormonal therapy.

What are selective estrogen receptor modulators (SERMs)?

Tamoxifen.

What are aromatase inhibitors used in breast cancer treatment?

* Anastrazole * Letrozole * Exemestane.

What precautions should be taken during chemotherapy administration?

* Dosage schedule * Minimize nausea and vomiting * Central Line only.

What is a potential complication of chemotherapy related to infection?

Neutropenic: abnormally low absolute neutrophil count (ANC).

When is the lowest point for Absolute Neutrophil Count in chemotherapy?

Immediately following chemotherapy

What are typical signs of infection in myelosuppressed patients?

May not occur; fever may be the only sign.

What is the temperature threshold for fever indicating potential infection?

One-time temperature of 38.3°C (101°F) or any temperature of ≥38°C (100.4°F) or ≥1 h.

What is hyperthermia treatment in cancer therapy?

Type of treatment in which body tissue is heated to as high as 113°F to help damage and kill cancer cells.

What are the methods of hyperthermia treatment?

* Local or regional * Microwaves * Radio waves * Ultrasound * Lasers.

What is involved in perfusion during hyperthermia treatment?

* Heating fluids such as blood or chemotherapy drugs and putting them into the body * Placing the entire body in a heated chamber or hot water bath or wrapping with heated blankets