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Medical Conditions II > Oncology > Flashcards

Flashcards in Oncology Deck (58):
1

Cancer

indicates any of various types of growths that are uncontrolled by normal cellular mechanisms

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Malignant Neoplasm Synonyms

-Tumor
-malignancy
-carcinoma

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Types of Cancer

-Primary
-Secondary
-Carcinoma in situ

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Primary Cancer

-arising from cells local to the structure
-primary cell usually determines behavior of cancer

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Secondary Cancer

-arising from cells that have metastasized from other sites

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Carcinoma in Situ

-malignant cell changes in epithelial tissue that do not extend beyond the basement membrane (pre-invasive)

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Metaplasia

-Reversible change in cell

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Dysplasia

-permanent abnormal changes in cells

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Classifications of Neoplasms

-Epithelial
-Connective/Muscle Tissue
-Lymphoid
-Hematopoietic
-Miscellaneous (reproductive glands, placenta, thymus)

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Staging of Cancer

-distinct phase or period in development of disease
-what is the EXTENT of the disease?

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Grading of Neoplasms

-degree of malignancy and differentiation of malignant cells
-Grade I-IV
-less differentiated=worse
-what is the severity of the tumor?

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TNM System

-Classifies cancer based on Tumor size, lymph Node status, Metastases presence
-Tumor, Node, Metastases

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Grade I

well-differentiated cells

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Grade II

moderately-differentiated cells

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Grade III

poorly-differentiated cells

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Grade IV

Undifferentiated
(worst)

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Sources of Cancer (2)

-Endogenous
-Exogenous

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Endogenous Origin

-factors that are outside the patient's control
-familial pattern/genetic

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Exogenous Origin

-risk factors, within patient's control
-chemical agents, physical agents, drugs/EtOH, hormones
-inflammatory disease

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Risk Factor Examples

-Age
-Lifestyle (tobacco, diet, nutrition, sexual behaviors)
-Geography
-Ethnicity
-Stress

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What are oncogenes?

-gene that is likely to produce or is a marker of cancer

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What are tumor suppressor genes?

-genes that are good at minimizing tumor growth

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What are the mechanisms of the spread of cancer?

-Metastasis
-Invasion

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Invasion

-growth by direct or continuous extension of the tumor into neighboring tissue

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Metastasis

-growth of neoplastic cells at a remote or non-contiguous site in the body

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How do metastasis cells travel to new sites?

-bloodstream
-lymphatic system

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Angiogenesis

-creation of new circulation (for secondary tumor)

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Most common sites of metastasis

(L3B2)
-Lymphnodes, lungs, liver, bone, brain

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Other sites of metastasis

-skin, ovaries and adrenal glands

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Most metastases occur within ________

-3-5 years;
-but can occur 15-20 after original appearance of disease

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Common Manifestations of Cancer

-NVR
-Anorexia and weight loss
-Pain
-Fever
-Cancer related fatigue

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Primary Prevention

-decrease number of cases/prevalence of cancer
-risk reduction

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Secondary Prevention

-prevent morbidity and mortality of cancer
-early detection

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Tertiary Prevention

-managing symptoms, limiting complications, preventing disability disability
-palliative treatment

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CAUTION: clinical manifestations of cancer

C-change in bowel/bladder
A-a sore that doesn't heal in 6 weeks
U-unusual bleeding/discharge
T-thickening or lump in breast or elsewhere
I-indigestion or difficulty swallowing
O-obvious changes in wart or mole
N-nagging cough/hoarsness

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Diagnostics

-Biopsy, endoscopy (invasive)
-CT, MRI (radiologic/noninvasive)

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Types of Treatment

-Surgery
-Radiation
-Chemotherapy
-Biotherapy
-Immunotherapy
-Hormonal therapy

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Medical Management of Cancer Tx

-Medications other than chemo
-Alternative care
-Hospice

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PT management of cancer treatment

-positioning
-relaxation techniques
-biofeedback
-manual therapy

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Goals of Intervention

-cure the cancer
-control the cancer
-palliative care

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Progression of Cancer

-complete remission/response
-partial response
-no response
-survival

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Complete Remission/Response

-disappearance of clinically evident disease

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Partial Response

-more than 50% reduction in tumor size

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No Response

-no response to treatment

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Survival=

time from diagnosis to death

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Prognosis affected by:

-type, stage, grade of cancer
-type/effectiveness of therapy
-pt's general health status
-age

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Winningham Precautions:
Platelets

<50,000/ml

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Winningham Precautions:
Hb

<10g/ml

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Winningham Precautions:
Absolute Granulocytes

<500/ml

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Winningham Precautions

-precautions to aerobic exercise in chemotherapy patients

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Winningham Precautions:
WBC

< 3,000/ml ; 10,000 with fever (no exercise)

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Side effects of Chemo

fatigue,
GI,
anxiety/depression,
hepatotoxicity, hemorrhage,
bone marrow suppression,
anemia,
infection,
neutropenia,
thrombocytopenia,
muscle weakness,
decreased bone density,
rash,
neuropathies,
hair loss,
sterilization,
sexual dysfunction,
weight loss/gain

53

Side Effects of Radiation

fatigue,
radiation sickness,
immunosuppression,
decreased platelets/WBC,
infection,
fibrosis,
burns,
mucositis,
diarrhea,
edema,
hair loss,
ulceration,
CNS/PNS effects,
Malignancy

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Symptoms of Metastasis: Lung

-cough, pleural pain, SOB

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Symptoms of Metastasis: Liver

-abdominal pain, RUQ pain, malaise, fatigue, anorexia, weight loss, fever

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Symptoms of Metastasis: Bone

-deep pain worsening with activity, pathologic fractures

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Symptoms of Metastasis: Brain

-cognitive impairment, headache, reduced sensory/motor function

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Symptoms of Metastasis: Lymphnodes

-lymphedema