Oncologic Nursing/Surgery Flashcards

(32 cards)

1
Q

Describe the normal cell life cycle.

A

Interphase
Mitosis - prophase, metaphase, anaphase, telophase
Cytokinesis

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2
Q

Define cancer.

A

Phenotypic end result of a whole series of changes that may have taken a long time to develop

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3
Q

How does cancer arise?

A

Accumulation of genetic mutations - eliminates normal cell constraints
Increased longevity of life allows more of these mutations to accumulate

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4
Q

What are some environmental causes of cancer?

A

Chemical carcinogens e.g. smoke, pesticides
Physical agents e.g. sunlight, radiation
Hormones e.g. neutering
Cancer-causing viruses e.g. papilloma virus, retroviruses (FeLV)

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5
Q

How can mutations in DNA cause deviation in normal cell cycle?

A

Sustained proliferative signalling
Evade growth suppressors
Resist cell death
Enable replicative immortality
Induce angiogenesis
Activate invasion and metastasis

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6
Q

Define neoplasia.

A

Formation of new abnormal growth that is not responsive to normal physiologic control mechanisms
May be benign or malignant

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7
Q

What are the 7 main goal types of chemotherapy?

A

Primary induction
Primary neoadjuvant
Adjuvant
Consolidation
Maintenance
Rescue or salvage
Palliative

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8
Q

Describe multimodal chemotherapy plans.

A

Maximal cell kill within range of tolerable host toxicity
Broader range of interaction between drugs and tumour cells
Slows development of tumour drug resistance
Preferably drugs with non-overlapping toxicities
Use drugs at optimal doses and schedules, at consistent intervals

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9
Q

Name some specific chemotherapy agents.

A

Alkylating agents
Antitumour antibiotics
Antimetabolites
Antimicrotubule agents
Corticosteroids
Platinum
L-Asparginase
Targeted agents

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10
Q

What is the CHOP protocol?

A

Cyclophosphamide
Hydroxydaunorubicin (Doxorubicin)
Oncovin (Vincristine)
Prednisolone
Discontinuous protocol

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11
Q

What are some possible side effects of the CHOP protocol?

A

All dividing cells affected by cytotoxic drugs
Bone marrow toxicity
GI toxicity

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12
Q

How do we administer chemotherapy?

A

Quiet area, IV catheter placement ‘clean stick’, double check dose and draw up drug
Bolus injection/infusion - check IV placement, connect syringe, administer

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13
Q

Describe haemopoietic tumours.

A

Leukaemia - in blood-forming tissues, acute and chronic
Lymphoma - in cells that make up part of immune system, B-cell and T-cell
Treated with chemotherapy

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14
Q

Describe osteosarcomas.

A

Typically distal radius/top of femur
Metastatic - usually has occurred by time of presentation
Surgery to remove affected limb
Chemotherapy, bisphosphonates, radiation therapy useful

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15
Q

Describe haemangiosarcomas.

A

Spleen, heart (blood vessels)
Treated with combination of surgery and chemotherapy

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16
Q

Describe soft tissue sarcomas.

A

Tumour of connective tissue

17
Q

Describe carcinomas.

A

Tissue that covers any body surface, line a body cavity or makes up an organ
‘Adeno’ = arises from a gland

18
Q

Describe squamous cell carcinomas.

A

Common in cats - mouth, nose, ears
Surgery to remove
Locally invasive
Radiation therapy/chemotherapy useful

19
Q

Describe mast cell tumours.

A

Most common malignant skin tumour in dogs
Manifests in many ways anywhere on the body
Range from almost benign to highly malignant with high rate of spread
In skin layers = hard and firm, under skin layers = mobile and soft
Cats can have splenic/GI presentation
Often need surgical removal - appropriate margins can be curative
Radiation therapy/chemotherapy useful

20
Q

Describe melanomas.

A

Sometimes pigmented black
Mouth, toes, skin
Surgery to improve quality of life - mass painful and can bleed
Immunotherapy to slow spread - melanoma vaccine

21
Q

Describe benign tumours.

A

Slow-growing, tend not to metastasise
Lipoma, haemangioma, adenoma

22
Q

Describe paraneoplastic syndrome and lymphoma.

A

Cancer-associated alterations not directly related to tumour or metastases
Lymphoma - e.g. hypercalcaemia, anaemia, neutrophilic leucocytosis, thrombocytopaenia

23
Q

What can PNS signify?

A

Occurrence may signify malignancy - can result in greater morbidity than tumour itself causes
Successful treatment of tumour leads to disappearance of many PNSs
Recurrence of PNS may signify return of tumour

24
Q

Describe tumour sensitivity to chemotherapy.

A

High sensitivity e.g. lymphoma, some leukaemias
Moderate sensitivity e.g. high grade sarcomas, mast cell tumours
Low sensitivity e.g. slow growing sarcomas, carcinomas, melanomas

25
What factors can affect treatment of a tumour?
Benign/malignant Staging and grading Chemotherapy/surgery best option Resectable/non-resectable Owner expectation e.g. disfiguring surgery, cost Patient temperament
26
What treatments can be used for cancers?
Chemotherapy Radiation therapy Cryotherapy Hyperthermic therapy Photodynamic therapy Immunotherapy Surgery
27
What surgical treatment options are available for tumours?
Complete excision, wide, radical Excisional biopsy Incisional biopsy Trucut biopsy FNA
28
What are the principles of staging a tumour?
TNM system T - primary tumour size N - level of lymph node involvement M - presence of metastasis
29
How can we stage a tumour?
Physical exam and history-taking Urinalysis Bloods - haem/biochem Thoracic radiographs Abdo u/s - aspirate liver, spleen, lymph nodes Imaging - echocardiogram, CT, MRI
30
How are tumours graded?
Histologic findings Appearance under microscope Mitotic index How well organised the cells are Evidence of cancer cells invading blood vessels Low, intermediate, high - important prognostic indicator
31
What specific nursing considerations should we have for oncologic patients?
May be hospitalised for long periods of time Can be anorexic May have impaired immune function Chemotherapy drugs - barrier nursing, excreted in urine/bodily fluids for 3-5 days Chemotherapy should be given with care using specific equipment
32