oncology + hematology Flashcards
(36 cards)
what is it
cancer
malignant neoplastic disorder, cells lose their normal growth-controlling mechanism (growth of cells is uncontrolled)
what is it + routes
metastasis
cancer cells move from orginal location to other sites
- local seeding = shed of cancer cells outside local area of tumor
- bloodborne metastasis = tumor cells enter blood (most common cause of spread)
- lymphatic spread = primar sites rich in lymphatics are more susxeptible to early mestatic spread
factors influencing cancer development
- chemical carcinogens: industrial chemcials, medicationsm alcohol, tobacco
- physical carcinogens: ionizing radiation (x-ray), ultraviolet radiation (sun, tanning bed, germicidal lights), chronic irritation, tissue trauma
- viral carcinogen: aka oncoviruses (hep B, human paillomavirus)
- helico bacter pylori - associated with an increased risk of gastric cancer
- lifestyle: obesity, smoking, diet (preservatives/contaminents/additives/alcohol/nitrates)
- genetic predisposition
- advancing age
- immunosuppression
1 - 4
tumor grades
- cells differ slightly from normal cells, well differentiated (mild dysplasia)
- cell more abnormal, moderately differenctiated
- cells are very abnormal, poorly differentiated (anaplasia)
0 to 4
cancer stages
stage 0: carcinoma in situ
stage 1: tumor lumuted to tissue of origin, localized growth
stage 2: limited local spread
stage 3: extensive local/regional spread
stage 4: distant metastasis
CAUTION-US
cancer warning signs
Changes in bowel/bladder habbits
Any sore that does not heal
Unusual bleeding/dishcarge
Thickening/lump
Indigestion
Obvious change in wart/mole
Nagging cough/hoarseness
Unexplained anemia
Sudden weight loss
diagnostic tests
- biopsy - provides histological proof of malignancy (needle/incision/excisional where lesion removed)
- bone marrow examination
- chest radiograph
- Complete Blood Count
- Computed Tomography
- Positron Emission Tomography
- Cytological studies (papanicolaou test)
- Endoscopic exam (upper GI, sigmoidoscopy, colonoscopy)
- evaluation of serum tumor markers (cacinoembryonic antigen, alphafetoprotein)
- liver function tests
- Magnetic Resonance Imaging
- proctoscopic examination
- radiographic studies (mamography)
- radioisotope scanning (liver, brain, bone, lung)
- stool test for occuly blood
causes of pain
- bone destruction
- pathologic fractures
- lytic lesions (holes where bone tissue is destroyed)
- organ obstruction
- compression of peripheral nerves/spinal cord
- infiltration
- tissue distention
- inflammation
- necrosis
- tumor lysis
- psychological factor (fear/anxiety)
- surgical/neurpathic pain from treatment
pain meds
- mild/moderate: salicylates, acetaminophen/NSAIDS
- severe: opioids
- neuropathic: anticonvulsants, antidepressants
surgery types
- prophylactic: attempt to remove tissue/organ at risk
- curative: all gross + microscopic tissue is removed or destroyed
- control (cytoreductive/debulking): removing large portion of cells
- palliative: reduce pain, relieve airway/GI/urinary obstruction, relieve pressure on the brain/spinal cord, prevent hemorrhage, removed infected/ulcerated tumors, drain abscesses
- reconstructive: restore maximal function + appearance (ex. breast reconstruction)
what it does + common side effects
chemotherapy
kills/inhibits reproduction of neoplastic cells, kills normal cells (mostly skin, hair, GI tract lining, spermatocytes, hematopoietic cells)
side effects: fatigue, alopecia, nausea/vomiting, skin changes, myelospression
what it does
radiation
destroys cancer cells, with minimal exposure of normal cells to the damaging effects (cells die/unable to divide)
- external beam radiation aka teletherapy (radiation source external to client - no radiation emitted + no hazard to anyone else)
- internal radiation aka brachytherapy (source comes in direct + continuous contact with tumor tissues, client emits radiation + is hazardous - capsules, seeds, microspheres)
- permanent brachytherapy = radioactive elements inserted + remain in patient
- temporary = radioactive material removed after minutes or days
- unsealed radiation source: administration via oral/IV route (source enters body fluids + is eliminated via excreta within 48 hours - radioactive + harmful to others)
side effects: fatigue (most common), skin irritation, alopecia, altered taste
what is it
hematopoietic stem cell transplant
bone marrow transplantation + peripheral blood stem cell transplantation replace stem cells destroyed by chemo/radiation (needed to prevent infection + hemorrhage)
donor stem cell types
allogeneic: stem cell donor is usually sibiling/parent/someone with similar tissue type
synegeneic: cells from identical twin
autologous: person’s own stem cells are harvested during disease remission, stored + frozen
what it is + classifications
leukemia
group of hematological malignancies involving abnormal overproduction of leukocytes in bone marrow
classifiaction:
- acute lymphocytic leukemia: mostly lymphoblasts, age of onset younger than 15 years
- acute myelogenous leukemia: mostly myeloblasts, onset 15-39 years
- chronic myelogenous leukemia: mostly granulocytes in bone marrow, onset in 4th decade
- chronic lymphocytic leukemia: mostly lympocytes, onset after 50 years
symptoms
leukemia
- anorexia, fatigue, weakness, weight loss
- anemia (decreased hemoglobin/hematocrit) - palpitactions, tachycardia, orthostatic hypotension, pallor + dyspnea
- decreased platelet count - overt bleeding (nose/gums/rectal/hematuria), eccymoses + petechiae, prolonged bleeding
- elevated temp
- enlarged lymph nodes, spleen, liver
- headache
- bone pain/join swelling
- positive bone marrow biopsy
what is it
hodgkin’s lymphoma
abnormal proliferation of lymphocytes + malignancy of lymph nodes (usually involves lymph nodes, tonsils, spleen, bone marrow)
multile myeloma
malignant proliferation of plasma cells in bone (invade bone marrow + destroy bone)
- decreased production of immiunoglobulin + antibodies, increased uric acid + calcium (can lead to kidneyy failure)
cervical cancer treatments
- laser therapy: vaporizes tissues
- cyrosurgery: freezing tissues
- conization: cone-shaped area of cervix is removed
- hysterectomy
- pelvic exenteration: removal of all pelvic contents (bowel, vagina, bladder) can be anterior/posterior/total, ileal conduit/colostomy may be needed
risk factors
breast cancer
- greater than 65 year
- family history
- early menarche, late menopause
- previous breast/uterus/ovary cancer
- nulliparity (no children)
- late first birth
- oral contraceptie use
- hormone replacement therapy
- obersity
risk factors
endometrial/uterine cancer
- estrogen replacement therapy
- birth control pills
- IUD
- nulliparity
- polycystic ovary disease/endometrial hyperplasia
- increased age
- early menarche/late menopause
- family history
- obestiy
- hypertension
- diabetes mellitus
risk factors
lung cancer
- exposure to cigarette smoke
- exposure to environmental/occupational pollutants
