Osteopathic Considerations in Oncology Flashcards
(30 cards)
What are the adult cancers that cause bone metastases?
- Breast
- Prostate
- Lung
- Kidney
- Thyroid
What are the pathways that cancer can spread?
- Direct extension
- Lymphatic of hematogenous dissemination
- Intraspinal seeding (Batson plexus of veins)
What are the adult cancers that cause spinal cord metastases?
- Lung
- Breast
- Colon
- Sarcoma
Cancers that are of marrow origin
- Multiple myeloma
- Lymphoma
- Leukemia
Matrix and fibrous tumors
- Osteosarcoma: age 20 or younger
- Chondrosarcoma: age 40 or older
- Ewing sarcoma: age 20 or younger
How can tumors effect muscles?
Tumors can metastasize to muscles and cause pain and decreased function due to muscle or nerve compression
Conditions that have proximal muscular weakness and are associated with lung and gastric cancer
Dermatomyositis
Polymyositis
What is acanthrosis nigricans associated with?
Gastric or abdominal malignancies
What is acanthrosis nigricans?
Hyperpigmented, hyperkeratotic skin lesion in the flexor areas of axillary, neck, or anogenital areas.
Associated with gastric and abdominal malignancies
Most common pediatric cancer
- Osteosarcoma- during puberty around the knee
- Ewing’s sarcoma
- Rhabdomyosarcoma
Clinical presentation of leukemia
- Bone pain secondary to marrow hyperplasia
- Fatigue
- Pallor
- Ecchymoses
- Infection
- Fever
- Anorexia
- Weight loss
CNS tumor presentation and what should you look for?
Presents with headache, ataxia, and gait abnormalities
- Seizures or cranial nerve palsies
Look for hx of a headache while sleeping and absence of a family hx of migraines
What is the most common extracranial solid tumor of childhood?
Neuroblastomas
Pediatric cancers with bone metastases (5)
- Neuroblastoma
- Wilms tumor
- Osteosarcoma
- Ewing sarcoma
- Rhabdomyosarcoma
What is a main chief complaint of people with bone metastases have?
back pain
1/3 of pts with cancer develop metastases to the spine
How does pain present in bone metastases?
Often begins as dull and intermittent but worsens steadily over several days or weeks
- Pain at night and at rest is common
- Passive motion of the adjacent joint is not painful
Common sites of bone metastases
- Vertebral column
- Skull
- Humerus
- Ribs
- Pelvis
- Femur
Red flags to look for in a patient with bone or joint pain
- Unexplained MSK pain
- Pain in spine or proximal extremities that doesn’t correlate with a known injury
- Night or rest pain
Posterior headache correlates to?
High cervical spine metastasis
Interscapular pain correlates with?
C7-T1
Flank, iliac crest, or sacroiliac joint pain correlates with?
T12-L1
Sacral destruction correlates with?
Saddle distribution
What is the most specific imaging study for metastatic disease?
Plain film radiography- not sensitive, 50% of bone needs to be eroded
- Obtain radiograph of the entire long bone for all painful sites
Labs for multiple myeloma
Immunoelectrophoresis
