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NURS363 - Practice of Nursing IV > Week 5: Oncology - FOR 362 NOT 363 > Flashcards

Week 5: Oncology - FOR 362 NOT 363 Flashcards

1
Q

Cancer Epidemiology

A

study of distributions and determinants of cancer in population groups

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2
Q

What 3 things does cancer epidemiology include

A

incidence

mortality

disparity

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3
Q

Cancer Mortality

A

defined as death rates pertaining to cancer within a specific time frame

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4
Q

What is the overall trend of cancer mortality

A

overall trend downward

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5
Q

Cancer is #__ on the U.S. mortality annually

A

2

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6
Q

What is the most common cancer type of cancer mortality

A

lung

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7
Q

What are the top 4 types of cancer that cause death

A
  1. Lung
  2. Prostate and Breast
  3. Colon (Colorectal)
  4. Pancreatic
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8
Q

What are the 1st and 2nd biggest cause of US mortality

A
  1. Heart Disease

2. CANCER

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9
Q

Which gender is more likely to die from cancer

A

Males

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10
Q

What race/ethnicity is most likely to die from cancer

A

African Americans` (especially males)

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11
Q

Cancer Incidence

A

defined as: # of NEW cancer cases in a specific time frame

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12
Q

The highest cancer type for males in incidence is ___; for females it is ___

A

prostate; breast

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13
Q

The highest cancer type incidence between both sexes is what

A

lung and bronchus cancer

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14
Q

Cancer Incidence has done what over the years

A

slightly decreased but generally plateaud

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15
Q

Cancer Disparity

A

Defined as : Differences in cancer measures such as incidence, mortality, screenings, survivorship between population groups

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16
Q

How does cancer dispairty change with the following: Age, Gender, Geograhy, Low SES, High SES

A

Age - risk increases with age

Gender - males > females

Geography: Cancer is clustered in certain areas

Low SES - increased risk of lung, cervical, stomach, head/neck - increased smoking

High SES - increased breast, prostate, colon cancer

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17
Q

Cancer Mortality differs by ___

A

race

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18
Q

What groups have higher rates of cervical cancer in females than other groups and which one of them has the highest mortality rate from the disease

A

hispanic/latino and black/AA women

AA/Black women have the highest rates

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19
Q

____ have higher death rates than all other racial/ethnic groups for many, although not all, cancer types

A

Black/African Americans

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20
Q

Despite having similar rates of rbeast cancer who is more likely to die from it than white women

A

African american women

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21
Q

The incidence of what cancer is higher in rural appalachia than in urban areas?

A

colorectal, lung, and cervical cancers

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22
Q

People with more education are less likely to do what regarding colorectal cancer

A

less likely to die prematurely (before 65) from colorectal cancer than those with less education REGARDLESS of race or ethnicity

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23
Q

Primary Prevention

A

measures to make sure cancer does not develop

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24
Q

Factors we can control regarding cancer

A

tobacco use

diet

lifestyle choices

occupational exposures

environmental exposures

vaccines and medications

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25
Secondary Prevention
screening guidelines for certain kinds of cancer
26
What is the pattern of breast cancer screening like in those 55+
mammograms every 2 years or continue annual screening
27
Screening for breast cancer should continue as long as what
the woman is in good health and expected to live 10 years or longer
28
The American Cancer Society recommends yearly lung cancer screenings with what if you are at higher risk for lung cancer
low dose CT Scan (LDCT)
29
What are some factors of higher lung cancer risk that indicate need for lung cancer screening
55-74 and in fairly good health AND currently smoke or have quit smoking in the last 15 years AND have at least a 30 pack year smoking hx (a pack year is 1 pack of cigs per day per year. one pack per day for 30 years or 2 packs per day for 15 years would both be 30 pack years)
30
When should those over 65 not be tested for cervical cancer
those who had regular cervical testing in the past 10 years with normal results
31
Who else should not be tested for cervical cancer
people whose cervix has been removed by surgery for reasons not related to cervical cancer or serious pre cancer
32
Should those vaccinated against HPV still follow cervical cancer screening recommendations?
Yes
33
If you choose to be screened by something other than colonoscopy...
any abnormal test results need to be followed up with a colonoscopy
34
What tests are done for prostate cancer
PSA blood test with or without a rectal exam
35
Tertiary Prevention
reduction of disease and symptoms in cancer survivors efforts focus on monitoring for and preventing recurrence of primary cancer as well as screening for development of second malignancies in cancer survivors)
36
Ways Cancer Diagnoses are Made
1. Hx and Physical Exam 2. Diagnostic Work Up - Radiology study, MRI, Ultrasound, nuclear med scan, endoscopy, lab study, tumor markers 3. Pathology testing - surgical biopsy
37
Carcinogenesis
Cause of Cancer 1. Initiation (Initiated cells) 2. Promotion (preneoplastic) 3. Progression (neoplastic) 4. Metastasis (malignant)
38
Causes of Carcinogenesis
Environmental hormonal chemical viral radiation immunosuppression hereditary
39
Important Aspects of Benign Tumors
usually encapsulated partially differentiated absent metastasis rare recurrence slight vascularity expansive mode of growth fairly normal cells SIMILAR to parent cell
40
Important aspects of malignant tumors
rarely encapsulated poorly differentiated metastasis usually present frequent recurrence moderate to marked vascularity infiltrative and expansive cells abnormal and unlike parent cells
41
Benign (not cancer) tumor cells grow how compared to malignant (cancer) tumor cells?
benigng - grow only locally and cannot spread by invasion or metastasis malignant - invade neighboring tissues, enter blood vessels, and metastasize to different sites
42
Malignant tumors are: A usually encapsulated B have marked vascularity C often migrate via lymph nodes D - are similar to parent cells E - remain in one area
B and C
43
What types of cancer often metastasize to the brain
skin melanoma lung cancer breast cancer
44
Where does lung cancer often metastasize to
bone brain adrenal gland
45
Where does breast cancer often metastasize
brain bone lung liver
46
Where does pancreatic cancer often metastasize
lung liver
47
Where does colorectal cancer often metastasize
liver
48
where does ovarian cancer often metastasize
pleura liver
49
6 Major Categories of Cancer Nomenclature
Carcinoma Sarcoma Myeloma Leukemia Lymphoma Mixed Types
50
Histologically, how many different cancers are there
hundreds (but they are grouped into 6 major types with primary and location standpoints)
51
what are the main primary/location standpoints of cancer types
skin lungs female breasts prostates colon rectum cervix and uterus
52
Carcinoma
epithelial tissue cancer
53
Sarcoma
supportive connective tissue cancer
54
Myeloma
plasma cells of bone marrow cancer
55
Leukemia
blood cancer
56
Lymphoma
lymphatic tissue cancer
57
Cancer Grade
the degree of abnormality of cancer cells compared to normal cells under a microscope
58
Cancer grade is an indicator of what
how quickly the tumor will grow or spread
59
How does cancer grading work
increasing abnormality increases the grade from 1-4 (the higher the grade, the more aggressive the tumor)
60
Cancer Differentiation
based on HOW CLOSELY TUMOR CELLS RESEMBLE NORMAL CELLS in their structure and maturity is the process of becoming mature and functional
61
There can be what in a single tumor
different stages of differentiation (1-4)
62
What does G X mean
cancer grading that cannot be determined
63
What does G I mean
Well differentiated, low grade of malignant change, slow growing, look like normal (parent) cells
64
What does G II mean
moderately differentiated, more malignant characteristics, slightly more abnormal
65
What does G III mean
poorly differentiated and very abnormal
66
What does G IV mean
poorly differentiated, immature, cant determine tissue of origin METASTATIC DISEASE
67
____ decreases as grade increases
prognosis
68
What is Cancer Staging
different from grade/differentiation determines the sizeof the tumor, the existence of local invasion, lymph node involvement, and distant metastases
69
What does T mean in cancer staging
extent of the primary TUMOR the size - small or large
70
What does N mean in cancer staging
the absence or presence and extent of regional lymph node involvement the higher the n level the more migration
71
What does M mean in cancer staging
absence or presence of distant metastasis the higher the level of metastasis, the more metastasis sites seen
72
What does Tx mean
primary tumor cannot be measured
73
What does T0 mean
no evidence of primary tumor
74
What does Tis mean
carcinoma in situ
75
What occurs as you move up from T 1 to T 4
increasing size or local extent of the tumor
76
What does Nx mean
regional lymph nodes cannot be measured
77
What does N0 mean
no regional lymph node metastasis
78
What does N1, 2, and 3 mean
Increasing involvement of lymph nodes N1 - to same side, still movable N2 - to same size, fixed to one another or structure N3 - to more distant nodes
79
What does Mx mean
cannot be measured
80
What does M0 mean
no evidence of distant metastasis
81
What does M1 to M4 mean
M1 to M4 is increasing evidence of distant # metastasis
82
GI, T1, N0, M0 stage malignancy means the patient: A - has a small tumor with neg lymph nodes and no mets B- has a large tumor and status of lymph nodes and mets is unknown C- has a small tumor with multiple lymph nodes involved and widespread mets. D- has a large tumor with fixed nodes and mets.
A
83
The patient’s tumor has been staged as G4, T2, N1, M1. Select the correct description. Large tumor, not invasive, positive nodes, some mets Small tumor, very invasive, negative nodes, some mets Large tumor, very invasive, one lymph node, one area of mets Small tumor, very invasive, positive nodes, mets
C
84
SEER
Surveillance, Epidemiology and End Results (Another staging method) Used by NCI for all types of cancer
85
SEER groups cancer into what 5 main categories
in situ localized regional distant unknown
86
Cell Cycle
interval between each cell division
87
4 Phases of the Cell Cycle
G1 - Gap 1 Phase S Phase G2 Phase M Phase G0 Phase
88
G1 Phase
Variable gap 1 postmitotic phase - DNA synthesis ceases; RNA and protein synthesis and cell growth takes place
89
S Phase
10-20 hours DNA synthesis occurs; gives rise to 2 separate sets of chromosomes (one for each daughter cell)
90
G2 Phase
gap 2 2-10 hours Premitotic phase - DNA synthesis ceases; RNA and protein synthesis continues
91
M Phase
0.5-1 hour phase of cellular division or mitosis
92
G0 Phase
variable resting phase - phase in which cells are not actively dividing and are quiescent
93
Length of cell cycle can range from < ___ hours to ...
<8 hours to > 1 year
94
Why is the cell cycle important to cancer treatment
plan chemo cycles, radiation therapy treatments to interrupt "bad" cells before they continue to replicate
95
The goal of cancer treatment is
interrupt cellular growth
96
Each time a tumor is exposed to chemotherapy
a % of tumor cells (20-99% depending on dosage and agent). Repeated doses of chemo are eneded over a prolonged period of time to achieve regression of the tumor
97
3 Major types of cancer treatment
Surgery Radiation Chemo/Immunotherapy
98
Goals of Cancer Treament - 3 Main Types of Goals
1. Cure 2. Control 3. Palliative * think how surgery, chemo, radiation fit into these treatment goals*
99
___ is the ideal cancer treatment
Surgery
100
Surgery can be used to...
diagnose - biopsy OR as a primary treatment
101
Surgeyr can be what types for cancer
Prophylactic Palliative (promote comfort) Reconstructive (improve function or cosmetic results)
102
Debulking
surgical removal of as much tumor as possible
103
Important Areas of Nursing Management for a Cancer Surgery Patient
Physiological Self concept and body image issues education and emotional support referral to support services
104
If having undergone recent chemotherapy or radiation therapy what should you watch for
increased risk for infection increased risk for bleeding poor wound healing anemia increased s=risk of DVT poor nutritional status

NURS363 - Practice of Nursing IV (17 decks)

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