Oncological Screening Flashcards by Jenn Cantilli

what is similar ab the number 1 type of cancer in men and women

both are areas that are very affected by hormones

men - prostate
women - breast

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how do the most prevalent types of cancer compare between women and men

most common 2-5 are the same
2. lung and bronchus
3. colon and rectum
4. urinary bladder / uterine corpus
5. melanoma of skin

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what type of cancer has the highest mortality rate

lung and bronchus

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what are the 3 basic rules of cancer screening

review PMH
clinical presentation
associated s/sx

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what are 4 components of a risk factor assessment

age >50yo
ethnicity
family hx
environmental and lifestyle

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what age range has the highest incidence of cancer and cancer mortalities

> 65yo

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what 4 types of cancer have inc incidence in older adults

colon/rectum
ovarian
prostate
chronic leukemia

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what 2 types of cancer have inc incidence in a younger population

testicular
breast

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what are 3 known childhood cancers

acute leukemia
retinoblastoma
sarcoma

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what ethnicity has an inc risk? describe what that risk entails

African Americans

10x greater incidence than white
30% higher mortality
less responsive to cancer tx

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how does a hispanic ethnicity impact the risk

lower incidence of the more common cancers

inc incidence of cancers w infectious etiology
- stomach
- liver
- uterine
- cervical
- gallbladder

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how do you do a screen for a family hx

connected to 1st gen family members
- immediate family

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what cancers is a family hx important bc of their mutated gene etiology

breast
colon
ovarian

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how does a family hx of cancer impact the screening process

colonoscopy and mammograms screenings start at 50yo
- if known family hx, will come in to start screening 10yr prior to when family member was dx

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what are 5 risks for hereditary cancer syndrome

cancer in >2 family members
cancer in family <50yo
same type of cancer in family
different CA in 1 person in family
rare cancer in >1 family member

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what are modifiable risk factors that are linked to 80-90% of cancer cases (6)

obesity
diet
sedentary lifestyle
sexual practices
tobacco/alcohol/drug use
sun exposure / tanning beds

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what are occupational risk factors

ionizing radiation
agent orange
chemical agents

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what cancers have low survival rates (4)

pancreatic cancer
lung/bronchus
liver and intrahepatic duct
esophageal

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what are PT warning signs (3)

idiopathic prox weakness
- trendelenburg gait
- SOB
- STS and stair climbing
DTR changes
pain & night pain (intense &/or constant)

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how is DTR linked to cancer

DTR related to carcinomatous meningitis
- cancer cells to meninges of brain or SC resulting in neuromyopathy

will see DTRs and prox ms weakness

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what are 7 warning signs

C hanges in bowel/bladder habits
A sore doesn’t heal in 5wks
U nusual bleeding/discharge
T thickening lump in breast or other
I ndigestion or difficulty swallowing
O bvious changes in wart or mole
N agging cough or hoarseness

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what are 3 general types of cancer

carcinoma (85%) - epithelial
sarcoma - connective
bloodborne - blood and lymph

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what are ex of carcinomas (4)

skin
intestines
breast
lung

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what are ex of sarcomas (3)

bone
cartilage
ms

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what are ex of bloodborne (3)

leukemia multiple myeloma lymphoma

what are the most common sites for metastatic cancer (5)

integ pulm neuro msk (often bones) hepatic

what are s/sx of integument mets (4)

ABCDEs - Asymmetry - Border (irregular?) - Color (constant or shades?) - Diameter (small or large?) - Evolving clusters of moles bleeding from mole tenderness around a mole

what are 4 s/sx of MSK mets

bone pain pathologic fx hypercalcemia back and rib pain

how does bone pain present in a MSK met

deep dec WB tolerance not responsive to treatment

what does a pathologic fx seen w MSK mets mean

not bc of a trauma

why do you see hypercalcemia w MSK mets

if calcium coming out of bones, then going into blood if in blood, not keeping bones strong

treatment for a MSK met

surgery isn't necessarily the best option - could see PT for QOL and pain management

what are the most common sites for bone metastases (5)

skull pelvis prox femur posterior ribs spine (thoracic, then lumbar)

s/sx of neurological mets (12)

drowsiness HA n/v irritability confusion mental status changes vision changes numbness/tingling balance/coordination problems DTR changes - (+) Babinski - clonus tone changes paraneoplastic syndrome

what is paraneoplastic syndrome

group of rare disorders that are triggered by an abnormal immune response to a cancerous tumor

what cancers is paraneoplastic syndrome most common with (4)

ovarian breast lung hodgkins lymphoma

what are the types of paraneoplastic syndrome (4)

endocrine neurological musculoskeletal hematological

s/sx of pulmonary mets (4)

dyspnea wheezing - new onset productive cough pleural pain

how does a productive cough present in a pulmonary met

sputum - yellow, green, rust colored

how does pleural pain present in pulmonary mets

sharp chest pain that occurs while someone is breathing

s/sx of hepatic mets (6)

RUQ tenderness/pain - anatomic location of liver R shoulder pain (referred) jaundice ascites B CTS/TTS encephalopathy

how does jaundice present

yellow coloration best seen in eyes - if bad, could probably see across body

how does ascites present

distention of abdomen - d/t fluid buildup bc of disruption of flow in portal v as it leaves the liver makes it difficult for fluid to get back to heart and into circulation - buildup of fluid that then goes into abdomen

what is the significance of a bilateral presentation

likely a systemic issue

how does CTS and TTS present in hepatic mets

CTS - carpal tunnel syndrome TTS - tarsal tunnel syndrome may be bilateral

how does encephalopathy present

path relating to brain - confusion - cog impairments - neuropathies

why would hepatic mets lead to encephalopathy

liver being unable to transport ammonia out of body via portal v - ammonia is instead transported back into the brain causing encephalopathy

how does oncologic pain present

usually a late sign of cancer

what are 5 paths for oncologic pain

1. bone destruction 2. visceral obstruction (among organs) 3. nerve compression 4. skin/tissue distention 5. tissue inflammation, infection, necrosis

what are 4 cancer treatments

surgery radiation chemotherapy immunotherapy

how does surgery treat CA

completely remove

how does radiation treat CA

pinpoint area - kill it locally

how does chemo treat CA

systemic goal is to kill fast growing cells (which CA is) - does kill other good fast growing cells

how does immunotherapy treat CA

immune response to target a specific tumor

what are signs of side effects to look for in pts undergoing cancer treatment

infection fever thrombocytopenia - dec platelets >> inc bleed risk DVT dehydration electrolyte imbalance

what are 2 things to monitor in outpatient setting if pt undergoing cancer treatment

VS - identify how tolerating tx RPE - may be overly fatigued/tired - want to make sure working them at an appropriate level

what are 4 contraindications for aerobic ex

platelets <50k hemoglobin <10 WBC <3k absolute granulocytes <2500

metastatic pathway for lung CA in adults

brain bone mediastinum

metastatic pathway for colon CA in adults

bone belly liver lung

metastatic pathway for breast CA in adults

bone lung liver brain

metastatic pathway for prostate CA in adults

bone bladder colon

metastatic pathway for leukemia in children

doesn't "metastasize" by nature is everywhere

metastatic pathway for brain CA in children

local

metastatic pathway for sarcoma in children

local - tends to stay in that bone/cartilage area

what indicates a need for an immediate referral (5)

lumps and bumps - new or changed lymph node changes prox weakness w DTR changes bleeding - unexplained s/sx of mets

how would a lump present if cancerous? how would a non cancerous lump present?

hard and not movable - CA squishy and movable - lipoma

Oncological Screening Flashcards

(66 cards)