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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
Q

Secondary Prevention

A

screening guidelines for certain kinds of cancer

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26
Q

What is the pattern of breast cancer screening like in those 55+

A

mammograms every 2 years or continue annual screening

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27
Q

Screening for breast cancer should continue as long as what

A

the woman is in good health and expected to live 10 years or longer

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28
Q

The American Cancer Society recommends yearly lung cancer screenings with what if you are at higher risk for lung cancer

A

low dose CT Scan (LDCT)

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29
Q

What are some factors of higher lung cancer risk that indicate need for lung cancer screening

A

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)

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30
Q

When should those over 65 not be tested for cervical cancer

A

those who had regular cervical testing in the past 10 years with normal results

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31
Q

Who else should not be tested for cervical cancer

A

people whose cervix has been removed by surgery for reasons not related to cervical cancer or serious pre cancer

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32
Q

Should those vaccinated against HPV still follow cervical cancer screening recommendations?

A

Yes

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33
Q

If you choose to be screened by something other than colonoscopy…

A

any abnormal test results need to be followed up with a colonoscopy

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34
Q

What tests are done for prostate cancer

A

PSA blood test with or without a rectal exam

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35
Q

Tertiary Prevention

A

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)

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36
Q

Ways Cancer Diagnoses are Made

A
  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
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37
Q

Carcinogenesis

A

Cause of Cancer

  1. Initiation (Initiated cells)
  2. Promotion (preneoplastic)
  3. Progression (neoplastic)
  4. Metastasis (malignant)
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38
Q

Causes of Carcinogenesis

A

Environmental

hormonal

chemical

viral

radiation

immunosuppression

hereditary

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39
Q

Important Aspects of Benign Tumors

A

usually encapsulated

partially differentiated

absent metastasis

rare recurrence

slight vascularity

expansive mode of growth

fairly normal cells SIMILAR to parent cell

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40
Q

Important aspects of malignant tumors

A

rarely encapsulated

poorly differentiated

metastasis usually present

frequent recurrence

moderate to marked vascularity

infiltrative and expansive

cells abnormal and unlike parent cells

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41
Q

Benign (not cancer) tumor cells grow how compared to malignant (cancer) tumor cells?

A

benigng - grow only locally and cannot spread by invasion or metastasis

malignant - invade neighboring tissues, enter blood vessels, and metastasize to different sites

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42
Q

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

A

B and C

43
Q

What types of cancer often metastasize to the brain

A

skin melanoma

lung cancer

breast cancer

44
Q

Where does lung cancer often metastasize to

A

bone

brain

adrenal gland

45
Q

Where does breast cancer often metastasize

A

brain

bone

lung

liver

46
Q

Where does pancreatic cancer often metastasize

A

lung

liver

47
Q

Where does colorectal cancer often metastasize

A

liver

48
Q

where does ovarian cancer often metastasize

A

pleura

liver

49
Q

6 Major Categories of Cancer Nomenclature

A

Carcinoma

Sarcoma

Myeloma

Leukemia

Lymphoma

Mixed Types

50
Q

Histologically, how many different cancers are there

A

hundreds (but they are grouped into 6 major types with primary and location standpoints)

51
Q

what are the main primary/location standpoints of cancer types

A

skin

lungs

female breasts

prostates

colon rectum

cervix and uterus

52
Q

Carcinoma

A

epithelial tissue cancer

53
Q

Sarcoma

A

supportive connective tissue cancer

54
Q

Myeloma

A

plasma cells of bone marrow cancer

55
Q

Leukemia

A

blood cancer

56
Q

Lymphoma

A

lymphatic tissue cancer

57
Q

Cancer Grade

A

the degree of abnormality of cancer cells compared to normal cells under a microscope

58
Q

Cancer grade is an indicator of what

A

how quickly the tumor will grow or spread

59
Q

How does cancer grading work

A

increasing abnormality increases the grade from 1-4 (the higher the grade, the more aggressive the tumor)

60
Q

Cancer Differentiation

A

based on HOW CLOSELY TUMOR CELLS RESEMBLE NORMAL CELLS in their structure and maturity

is the process of becoming mature and functional

61
Q

There can be what in a single tumor

A

different stages of differentiation (1-4)

62
Q

What does G X mean

A

cancer grading that cannot be determined

63
Q

What does G I mean

A

Well differentiated, low grade of malignant change, slow growing, look like normal (parent) cells

64
Q

What does G II mean

A

moderately differentiated, more malignant characteristics, slightly more abnormal

65
Q

What does G III mean

A

poorly differentiated and very abnormal

66
Q

What does G IV mean

A

poorly differentiated, immature, cant determine tissue of origin

METASTATIC DISEASE

67
Q

____ decreases as grade increases

A

prognosis

68
Q

What is Cancer Staging

A

different from grade/differentiation

determines the sizeof the tumor, the existence of local invasion, lymph node involvement, and distant metastases

69
Q

What does T mean in cancer staging

A

extent of the primary TUMOR

the size - small or large

70
Q

What does N mean in cancer staging

A

the absence or presence and extent of regional lymph node involvement

the higher the n level the more migration

71
Q

What does M mean in cancer staging

A

absence or presence of distant metastasis

the higher the level of metastasis, the more metastasis sites seen

72
Q

What does Tx mean

A

primary tumor cannot be measured

73
Q

What does T0 mean

A

no evidence of primary tumor

74
Q

What does Tis mean

A

carcinoma in situ

75
Q

What occurs as you move up from T 1 to T 4

A

increasing size or local extent of the tumor

76
Q

What does Nx mean

A

regional lymph nodes cannot be measured

77
Q

What does N0 mean

A

no regional lymph node metastasis

78
Q

What does N1, 2, and 3 mean

A

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
Q

What does Mx mean

A

cannot be measured

80
Q

What does M0 mean

A

no evidence of distant metastasis

81
Q

What does M1 to M4 mean

A

M1 to M4 is increasing evidence of distant # metastasis

82
Q

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

A

83
Q

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

A

C

84
Q

SEER

A

Surveillance, Epidemiology and End Results (Another staging method)

Used by NCI for all types of cancer

85
Q

SEER groups cancer into what 5 main categories

A

in situ

localized

regional

distant

unknown

86
Q

Cell Cycle

A

interval between each cell division

87
Q

4 Phases of the Cell Cycle

A

G1 - Gap 1 Phase

S Phase

G2 Phase

M Phase

G0 Phase

88
Q

G1 Phase

A

Variable

gap 1

postmitotic phase - DNA synthesis ceases; RNA and protein synthesis and cell growth takes place

89
Q

S Phase

A

10-20 hours

DNA synthesis occurs; gives rise to 2 separate sets of chromosomes (one for each daughter cell)

90
Q

G2 Phase

A

gap 2

2-10 hours

Premitotic phase - DNA synthesis ceases; RNA and protein synthesis continues

91
Q

M Phase

A

0.5-1 hour

phase of cellular division or mitosis

92
Q

G0 Phase

A

variable

resting phase - phase in which cells are not actively dividing and are quiescent

93
Q

Length of cell cycle can range from < ___ hours to …

A

<8 hours to > 1 year

94
Q

Why is the cell cycle important to cancer treatment

A

plan chemo cycles, radiation therapy treatments to interrupt “bad” cells before they continue to replicate

95
Q

The goal of cancer treatment is

A

interrupt cellular growth

96
Q

Each time a tumor is exposed to chemotherapy

A

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
Q

3 Major types of cancer treatment

A

Surgery

Radiation

Chemo/Immunotherapy

98
Q

Goals of Cancer Treament - 3 Main Types of Goals

A
  1. Cure
  2. Control
  3. Palliative
    * think how surgery, chemo, radiation fit into these treatment goals*
99
Q

___ is the ideal cancer treatment

A

Surgery

100
Q

Surgery can be used to…

A

diagnose - biopsy OR as a primary treatment

101
Q

Surgeyr can be what types for cancer

A

Prophylactic

Palliative (promote comfort)

Reconstructive (improve function or cosmetic results)

102
Q

Debulking

A

surgical removal of as much tumor as possible

103
Q

Important Areas of Nursing Management for a Cancer Surgery Patient

A

Physiological

Self concept and body image issues

education and emotional support

referral to support services

104
Q

If having undergone recent chemotherapy or radiation therapy what should you watch for

A

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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