3/10-Cancer Flashcards

1
Q

Quiz question:

One way a family might deal with news of a child’s cleft is?

A

Mourning

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2
Q

Quiz question:

Factors that ease depression in mothers with a neonate cleft child are?

A
  • Family support
  • Education
  • Fewer children

(all of the above)

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3
Q

Quiz question:

In education, teachers may react to children with cleft by having?

A

Lower expectations of the child

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4
Q

Quiz question:

One of the issues with cleft is that attractiveness is correlated with?

A

Social desirability

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5
Q

Quiz question:

child can improve peer relationships by?

A

Presenting info about the cleft

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6
Q

Quiz question:

Children with cleft consistently have more…?

A

Negative self concepts

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7
Q

Quiz question:

Discrediting and objectifying individuals is called?

A

Stigma

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8
Q

Quiz question:

Within a culture, there is considerable consensus about…?

A

Attractiveness

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9
Q

Quiz question:

One of the issues with speech problems is that people assume impaired speech is equal to?

A

Stupidity

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10
Q

Quiz question:

One of the most important traits of families and children dealing with cleft is…?

A

Resiliency

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11
Q

What is the normal cycle that a cell undergoes?

A
  1. Division gap 1
  2. Synthesis period where the DNA duplicates
  3. Gap 2
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12
Q

If you were going to interfere with a cell. what section of its lifecycle would be most effective for interference?

A

Gap 1

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13
Q

What is the problem with gap periods?

A

We don’t know what happens during gap periods, that is why it’s called a gap.

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14
Q

What are the symptoms of laryngeal cancer?

A
  • Cough
  • Dysphagia
  • Dyspnea/Strider
  • Ear pain
  • Hoarseness (shouldn’t be hoarse for more than a couple of weeks
  • Persistent throat pain
  • Sore lump in the throat
  • Unexplained weight loss
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15
Q

What are the different stages of cancer?

A

T
N
M

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16
Q

What does T stand for when staging cancer?

A

Tumor

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17
Q

What does N stand for when staging cancer?

A

Nodes (or neck for pharyngeal and laryngeal cancer). It is metastasis, localized to the neck.

Nodes are local metastasis. Laryngeal cancer is the nodes in the neck.

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18
Q

What does M stand for when staging cancer?

A

Metastasis

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19
Q

When talking about T (tumor) what specifically are we talking about?

A

The size of the tumor and the tissue the tumor encompasses.

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20
Q

What is the problem with tumors?

A
  • Large size tumors crowd out the cells that should be in that spot
  • Tumors also surround other cells (i.e., liver cancer we might start with a small ball of cancer cell but as it reduplicates it starts surrounding healthy cells)

Healthy cells that are cut off from communication from other healthy cells they die. The tumor is growing bigger and crowding out function.

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21
Q

t/f

Cancer is abnormal cell life?

A

true

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22
Q

When talking about N (nodes or neck) what specifically are we talking about?

A

The cancer has traveled to the nodes

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23
Q

What is the problem with nodes?

A

The issue is once cancer goes into your lymph nodes it moves everywhere. The cancer has now metastasized.

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24
Q

When talking about M (metastasis) what specifically are we talking about?

A

The cancer has spread to distant sites. Nodes are still local, but metastasis means it has traveled to different sites.

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25
Q

Where does laryngeal cancer travel to?

A

Up to the brain and down to the lungs.

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26
Q

How can T (tumor) be assessed?

A
Tx
T1
T2
T3
T4
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27
Q

What does Tx mean?

A

A tumor has been identified but it can’t be assessed. It might have been palpated on a physical exam. Without a CAT-scan or other visual aid you can’t see what the tumor is like.

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28
Q

What does T1 mean?

A

Generally the tumor is “in situ” (in place, on site). It is confined. The tumor is small. It appears sitting on the structure surface.

**Vocal folds would still vibrate normally. They still look compliant.

T1 on vocal folds would sit like a lump on the vocal folds (i.e., mole or wart)

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29
Q

What does T2 mean?

A

Less Compliant. Arytenoids are still going to work. The vocal folds might still be vibrating and appear to be compliant.

The tumor is larger but it is still confide.

If we are talking about vocal folds, now the bump is a littler larger than T1 and maybe it is affecting vocal fold movement but maybe not.

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30
Q

What does T3 mean?

A

Arytenoids stop working.

More tissue is involved. One vocal fold might not be straight. Movement is impaired at this point. The structure might appear to be fixed. At this point, the tumor has invaded more than vocal fold tissue (muscle tissue or cartilage). Potentially this tumor could be in the arytenoid cartilage or vocal fold.

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31
Q

What does T4 mean?

A

Tumor is sizable. It has gone through multiple tissues. The larynx is probably immobile. This person is having dysphagia, or breathing problems. The tumor is extensive. The structures are immobile.

32
Q

What are the different types of cancer?

A

Carcinoma
Sarcoma
Lymphoma
Leukemia

33
Q

Why are there different types of cancer?

A

Because there are different types of cells in our bodies

34
Q

All cells originate from the embryological disk (3 layers), what are these 3 layers?

A

Ectoderm (outside layer)
Mesoderm (middle layer)
Endoderm (inside layer)

Types of cancer follow those original cell differentiations.

35
Q

What is Carcinoma cancer?

A

A type of cancer that occurs in the cells that line the surfaces of the body. Respiratory tract, digestive tract.

This is laryngeal cancer. Laryngeal cancer typically begins squamous cell carcinoma. It is the squamous cells that makes up the epithelium of the vocal folds

36
Q

What is Sarcoma cancer?

A

Type of cancer in connective tissues (i.e., tendons, muscles, and bones).

37
Q

What was the most common cancer of AIDS patients?

A

Kaposi sarcoma

38
Q

What is Lymphoma cancer?

A

Lymph system

39
Q

What is Leukemia cancer?

A

Blood and blood forming systems- bone marrow. Bone marrow is not bone, it is marrow

40
Q

How can N (nodes or neck) be assessed?

A
N0
Nx
N1
N2
N3
41
Q

What does N0 mean?

A

No lymph node involvement

42
Q

What does Nx mean?

A

Just like Tx, it spread but you can’t assess how many nodes are involved

43
Q

What does N1 mean?

A

The cancer has spread to the ipsilateral (same side) node involvement. Maybe one or two nodes, not a bunch of nodes, just one or two

44
Q

What does N2 mean?

A

Still ipsilateral but there is larger number and larger tumors in the lymph nodes.

** Don’t forget if you are talking about lymph node involvement it doesn’t mean there are 3-4 cancer cells waiting to o someplace else. It means there are tumors in the lymph nodes.

45
Q

What does N3 mean?

A

Bilateral spread to the nodes on both sides of the neck. Bilateral lymph node involvement. Cancerous tumors in the lymph noes on both sides of the neck.

46
Q

How large does the tumor have to be before it can be detected?

A

1 gram

47
Q

How long may it take a tumor to get big enough to detect (1 gram)?

A

4-5 years

48
Q

What types of tests can detect tumors earlier/before they are 1 gram?

A

screening tests (mammogram, PSA (prostate))

49
Q

cellular changes that might be seen on certain types of evals usually involve what type disorder?

A

Leukoplakia

a mucous membrane disorder characterized by white patches, esp. on the cheek, tongue, or vulva.

50
Q

Besides size, what are other signs of cancer detection?

A
  • leukoplakia

- Stiffness, no vibration, no mobility in the vocal folds

51
Q

What is Leukoplakia?

A

The cellular change on the surface of the vocal folds. These appear as EXTRA white patches on the vocal folds.

It is not cancerous tissue but it is considered to be pre cancerous.

52
Q

t/f

cancers in the larynx tend to start superficially?

A

True

53
Q

t/f

If the vocal folds are still vibrating, then the cancer has not remained superficial?

A

False…if vocal folds are still vibrating then the cancer has remained superficial. Once the vf begin to stiffen then the cancer is traveling through.

During an exam you are looking for compliance of the vf, you are looking at arytenoid movement to be symmetrical, and vocal fold stretch and compression to be symmetrical.

54
Q

How can M (metastasis) be assessed?

A

M0
Mx
M1

55
Q

What does M0 mean?

A

No metastasis. No evidence that the cancer has spread. Looking at the brain and lungs. First look at the lungs.

56
Q

What does Mx mean?

A

Pretty sure there is metastasis but can’t assess it

57
Q

What does M1 mean?

A

There is metastasis. Laryngeal cancer will most commonly travel to the lungs (or the brain)

58
Q

What are the different types of treatments for laryngeal cancer?

A
  1. Radiation
  2. Surgery
  3. Chemo (last resort, on death bed)
59
Q

What is radiation therapy?

A

Saturation of a tumor with high radiation.

It works on quickly dividing cells

It catches cells that are dividing rapidly in very delicate phases.

There is a high probability the radiation will kill the rapid dividing cells before killing normal cells.

60
Q

What are the reactions to the radiation?

A
  1. Hair loss (because hair cells are rapid cells…just like cancer)
  2. Immune cell is compromised because T cells are rapid cells (just like cancer)
  3. Sick to their stomachs, they don’t eat much, they throw up. Digestive system lining is rapid developing cells (just like cancer)
  4. Blood is rapidly reproducing (anemic).
61
Q

What is the issue with radiation?

A

Tissue where the radiation was directed, (i.e. thyroid) doesn’t recover very well and irradiated tissue becomes very stiff. Eating becomes a problem, talking, swallowing, & spit.

62
Q

What is the first type of treatment that most likely will be tried?

A

Radiation

63
Q

How long does radiation treatment last?

A

5-8 weeks

64
Q

How is radiation measured?

A

Gys

65
Q

What is a Gray?

A

Radiation dose. Iodizing radiation/ Atomic level. 1 gy is a specific dose of ionizing radiation

66
Q

Besides a Gray, what is another way of measuring radiation doses?

A

Rad

67
Q

How many Rads equal 1 Gray?

A

100

68
Q

How many Gys will a patient receive during radiation therapy for laryngeal cancer?

A

50-80 Gys total

69
Q

What is the max number of gys any tissue can receive in a lifetime?

A

80 gys

70
Q

t/f

larges doses of radiation will cause more cancer rather than cure it.

A

true

71
Q

At what dosage of gys will tissue start breaking down and become permanently damaged?

A

70 gys

72
Q

What is the largest carcinogen?

A

Radiation

73
Q

What does radiation affect the ability to produce?

A

Laryngeal voice. It will have a real affect on the tissues.

NOTE- If someone is getting radiation on a breast if that tissue is damaged by the radiation, the breast isn’t doing much it is just laying there. But if the laryngeal tissue is damaged then it will have a larger affect in terms of producing a laryngeal voice, healing post surgery, swallowing and producing spit.

74
Q

What are some other considerations with radiation?

A
  • Type of tissue and its response to radiation
  • Maximum dosage before tissue breaks down
  • With enough radiation it can cause cancer rather than cure it.
  • Things not noted in the book or mentioned by medical professionals:
    The spine is irradiated (it can affect lower motor neurons- ipsilateral paresis). It can cause some paresis (muscular weakness cause by nerve damage or disease; partial paralysis)
    Cataracts
    Blood pressure- blood vessels. Most important the carotid artery. Radiation also affects the tissue of the blood vessels. Blood vessels should be just as compliant as vocal folds.
75
Q

What are some general effects of radiation?

A
  • Xerostomia (drymouth- no spit). This affects the mucous glands, without spit you get dysphagia, decreased tissue compliance (stiffness)
  • Speech/esophageal affects- esophagus is irradiated (impacting esophageal speech). It might be stiffer. Your voice could be quieter, slower, not enough tissue movement or volume. Sounds quality might be affected.
76
Q

t/f

Chemotherapy is NOT the first choice for laryngeal cancer?

A

true

This might be a last, desperate hope of controlling or stopping the cancer. They will use chemo on ones that probably aren’t going to survive anyway.

77
Q

What is Angiogenesis?

A

Chemo therapy drug.

Aims at stopping the formation of new blood vessels. A tumor needs new blood vessels, it produces its own hormones and increased blood vessel production. These drugs are point towards VEGF (vascular endothelial growth factor).