Week 1: Oncology Flashcards
(87 cards)
1
Q
What are the 3 most commonly diagnosed cancer in men/women?
A
Breast
Lung
Colorectal
2
Q
What are the 3 most common cancers to result in death?
A
Lung
Prostate
Colorectal
3
Q
How does the rate of cancer among Indigenous peoples compare to the general population? Why do you think this might be?
A
Tobacco use rates 3x higher in Indigenous populations, and cancer rates are disproportionate to the rest of the population, as well as worst outcomes due to the generational trauma and impact colonization has had
4
Q
Encapsulated tumour?
A
usually benign and rarely malignant
5
Q
Differentiated tumour?
A
normally benign and undifferentiated if malignant
6
Q
Tumour metastasizes?
A
Absent if benign and frequently present for malignant
7
Q
Tumour reoccurs?
A
rare if benign and possible for malignant
8
Q
How a tumour grows for benign/malignant?
A
Expansive if benign and infiltrative and expansive if malignant
9
Q
Characteristics of benign tumour cell?
A
fairly normal similar to parent cells
10
Q
Characteristics of malignant tumour cells?
A
little resemblance to parent cells
11
Q
4 carcinogenic factors that can initiate cancer
A
Chemical carcinogens
radiation
viral/bacterial carcinogens
genetic susceptibility
12
Q
4 promoting factors that can cause the proliferation of cellular mutation?
A
dietary fat
obesity
cigar smoke
alcohol consumption
13
Q
What makes tobacco a complete carcinogen?
A
It is capable of both initiating and promoting the development of cancer
14
Q
What is grading?
A
Grading is the appearance of the cells and comparing the difference
15
Q
What is staging?
A
Staging is classifying the extent and spread of the disease
16
Q
What does stage 0 mean
A
cancer in situ
17
Q
What does stage 1 mean
A
Tumor limited to tissue of origin, localized
18
Q
What does stage 2 mean
A
limited local spread
19
Q
What does stage 3 mean
A
extensive local and regional spread
20
Q
What does stage 4 mean
A
metastasis
21
Q
what are the 8 recommendations to prevent cancer?
A
- reduce or eliminate exposure to carcinogens anf cancer promoters
- eat a balanced diet
- participate regularly
- maintain healthy weight
- limit alcohol use to 1-2/day
- get to know your body
- follow cancer screening guidelines
- know the seven warning signs of cancer
22
Q
What are the warning signs of cancer?
A
CAUTION
1. Change in bowel of bladder habits
2. A sore that does not heal
3. Unusual bleeding or discharge from any body site
4. Thickening or a lump in the breast or elsewhere
5. Indigestion or difficulty in swallowing
6. Obvious change in a wart or mole
7. Nagging cough or hoarseness
23
Q
What is a needle biopsy?
A
Cells and tissue fragments are obtained through a large bore needle and guided into the tissue of investigation
24
Q
What is an incisional biopsy?
A
performed with a scalpel or dermal punch and obtains a tissue sample
25
What is an excisional biopsy?
Involves the removal of the entire tumour
26
What are the goals of cure, control, and palliation
Cure: to eradicate the disease
Control: To have it respond to therapies but not cure
Palliation: to provide relief for long term care, no goal of curing or controlling
27
6 principles when surgery is used to cure or control cancer
1. Cancer that arises from a tissue with a slow rate of cellular proliferation or replication is the most amenable to surgical treatment
2. A margin of normal tissue surrounding the tumour should be resected along with the tumour
3. Only as much tissue as needed removed
4. adjunctive therapy is used when appropriate to eliminate residual micrometatasis
5. Preventative measures are used to reduce the surgical seeding of cancer cells
6. The usual sites of regional spread may be surgically removed for diagnostic or therapeutic purposes
28
6 ways surgery may be used to cure or control cancer?
Diagnosis, palliation of symptoms, rehabilitation, supportive care,cure or control of cancer, determine diagnostic and treatment plan
29
What is a debulking procedure?
removing as much of the tumour as possible and then the patient is given chemotherapy or radiation therapy
30
23. Why might surgery be used for cancer patients receiving palliative care?
to help with the body changes that occur - for example a breast reconstruction
31
What is the goal of chemotherapy?
now used in the treatment of many solid tumours and is the primary therapy for hematological malignancies
32
25. What 5 factors determine the response of cancer cells to chemotherapy?
mitotic rate of the tissue from which the tumour arises, size of the tumour, age of the tumour, location of the tumour, presence of resistant tumour cells
33
What routes/methods can be used to administer chemotherapeutic agents?
biopsy
therapeutic device insertion
reconstructive surgery
obstruction removal
hemorrhage cessation
34
Intra arterial administration
medication is delivered into the tumour via the arterial vessel supplying the tumour
35
Intraperitoneal chemotherapy
involves the delivery of chemotherapeutic agents to the peritoneal cavity for treatment of peritoneal messes from primary colorectal and ovarian cancers and malignant ascites
36
Intrathecal or intraventricular chemotherapy
involves a lumbar puncture and injection of chemo meds into the subarachnoid space
37
intravesicle bladder chemotherapy
instillation of chemotherapeutic agents into the bladder promotes destruction of cancer cells and reduces the incidence of recurrent disease
38
What are the effects of chemotherapy agents on normal tissues?
these agents cannot selectively tell the difference between normal cells and cancer cells therefore affects the bodies systems and can produce things such as anorexia, deficiencies etc
39
What is “simulation”?
is a part of radiation treatment planning used to determine the optimal treatment method
40
What is external beam radiation
the most common form and emits ray
41
What is brachytherapy
when radioactive materials are inserted directly into the tumour or close
42
What care and patient teaching is required for a person who has a permanent radioactive implant?
radioactive after insertion, nurses must be organized to maintain minimal contact
43
Is radiation therapy used to cure, control, or palliate cancer
the goals are to cure control and palliation
44
What factors may increase a cancer patient’s sense of fatigue
accumulation of metabolites could be one potential cause, cachexia, anorexia, fever, and infection
45
How should the nurse advise a patient to manage fatigue?
maintaining good nutrition and hydration, alternating periods of rest and activity, relying on family support, managing pain and anxiety
46
How should a nurse advise a patient to deal with loss of appetite?
small frequent meals of high protein, high calorie foods, and measure weight at least twice weekly
47
How does bone marrow suppression lead to anemia, leukopenia/neutropenia, and thrombocytopenia?
bone marrow suppression causes blood cell production to decrease, leading to these conditions
48
Why might people with bone marrow suppression may be susceptible to a brain tumour
bone marrow suppression causes blood cell production to decrease, leading to these conditions - the severity of myelosuppression is determined by the extent of bone marrow reserves, the pelvis has 40% active bone marrow while 25% is in thoracic and lumbar vertebrae
49
What potentially life-threatening complications are patient with
neutropenia at risk for
serious sepsis and infections
50
What interventions should a nurse implement for a patient who has developed dry desquamation?
lather with lotion that contains no metal, alcohol, perfumes or additives
51
What interventions should a nurse implement for a patient who has developed wet desquamation?
keep clean and prevent further damage (no tight clothes, dressings, irritants)
52
What part(s) of the body are subject to alopecia (hair loss) caused by chemotherapy?
all body hair including eyelashes and eyebrows
53
What should a nurse tell a patient who asks if hair loss is temporary or permanent?
may be permanent or temporary depending on the dose administered
54
What is xerostomia, and what causes it?
dry mouth caused by radiotherapy GI related changes
55
How should nurses teach patients to deal with xerostomia?
constantly check gums and mouth, how to perform oral care
56
Why is tooth brushing and flossing so important in cancer patients? What should patients be taught about brushing and flossing?
this reduces the radiation that carries and causes dry mouth. use a saline solution of 1 teaspoon of salt in 1L of water
57
What additional nursing interventions should be implemented to help maintain good nutrition for a cancer patient?
antifungal agents, feedings soft high protein/calorie foods, avoid alcohol/tobacco, rely on family for support
58
What type of pulmonary complications can result from chemotherapy and radiation therapy?
pulmonary edema, interstitial fibrosis, pneumonitis,
59
Why are the cells of the GI tract particularly susceptible to damage from chemotherapy and radiation therapy?
it is highly proliferative, surface cells are replaced every 2-6 days making them highly vulnerable to cancer therapies
60
How does chemotherapy and radiation therapy lead to nausea/vomiting and diarrhea?
radiation alters the gastric secretion by direct injury to the cells, which causes N/V/D
61
What interventions might decrease a client’s nausea and vomiting due to cancer therapy? -
antiemetic medications or a light meal before treatment
62
What interventions should the nurse implement for a patient with diarrhea due to cancer therapy?
nonirritating foods/meals and spasmodic medications, adequate food/hydration
63
How can radiation therapy affect reproductive capability in men and women?
sperm is terminated with certain dosages, the ovaries have no chance of being repaired therefore are protected
64
What patient teaching should a nurse provide for a man or woman who will be receiving radiation therapy of a reproductive organ?
information to the partner and patient, caring for psychological changes, counselling services, pretreatment harvesting services, sexual information/tools
65
What are some of the late effects of radiation and chemotherapy that may occur months or years after cancer treatment?
leukemias, other secondary malignancies, myelomas
66
What are biological therapies?
treatment involving the use of biological agents such as interferons, interleukins, monoclonal antibodies, and growth factors to modify the relationship between the host and the tumour
67
What is the purpose of a bone marrow transplant? why is it done?
allows for the safe use of very high dose's of chemotherapeutic agent or radiation in patients whose tumours are resistant or unresponsive
68
What are some of the complications of a bone marrow transplant?
some people die, other relapse from the original disease
69
What sorts of foods should be recommended for a patient with cancer?
high calorie, high protein foods
70
How should the nurse advise a patient to cope with changes in taste sensation due to cancer?
help them to understand the changes and to find foods that taste appealing to them, as well as try different spices that are appealing to them
71
Why are cancer patients at increased risk for infection?
from the suppressed immune system cancer patients have
72
Do cancer patients display the typical signs and symptoms of an infection (e.g. fever?)
fever (over 38 go to hospital), necrosis or tumour, neutropenia
73
What is superior vena cava syndrome?
results from obstruction of the superior vena cava by a tumour
74
S&S of superior vena cava syndrome
facial edema, periorbital edema, distention of the veins of the neck and chest, headaches, and seizures
75
What is spinal cord compression?
a neurological emergency caused by the presence of malignant tumour in the epidural space of the spinal cord
76
S&S of spinal cord compression?
intense back pain (localized and persistent), vertebral weakness/dysfunction, sensory paresthesia, autonomic dysfunction
77
What is third space syndrome
involves a shifting of fluid from the vascular space to the interstitial space that results primarily from extensive surgical procedures, biological therapy, or septic shock
78
S&S of third space syndrome
hypovolemia signs, hypotension, tachycardia, low central venous pressure, decreased urine output
79
What is an intestinal obstruction?
occurs when partial or complete obstruction of the intestine prevents the passage of intestinal contents through the GI tract
80
What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
results from abnormal or sustained production of antidiuretic hormone
81
What can cancer cause hypercalcemia?
when the parathyroid hormone like substance is secreted by cancer cells in the absence of bone metastasis
82
What is tumour lysis syndrome (TLS)?
from the rapid destruction of a large number of tumour cells, which can cause fatal biochemical changes
83
S&S of TLS
hyperuricemia, hyperphostphatemia, hyperkalemia, hypocalcemia
84
Infiltrative Emergencies
occur when malignant tumours infiltrate major organs secondary to cancer therapy
85
How can cancer cause cardiac tamponade?
results from fluid build up in the pericardial sac, constriction of the pericardium by tumour, or pericarditis secondary to radiation therapy for the chest
86
How can cancer lead to a carotid artery rupture?
a result of invasion of the arterial wall by tumour or erosion after surgery or radiation therapy
87
What strategies should be used to manage cancer pain?
anti-inflammatorys, a strong pain assessment, analgesics, relaxation therapy, imaging
