Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medically Complex Tx Planning > 6. Cancer Therapy > Flashcards

6. Cancer Therapy Flashcards

1
Q

What are the risk factors for squamous cell carcinoma?

A
  • Age
  • Race
  • Tobacco/alcohol
  • Immune suppression
  • Viral (HPV 16/18)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the clinical descriptors of cancerous lesions in the mouth?

A
  • Anatomical site
  • Size
  • Multiple lesions? Proliferative verrucous leukoplakia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the staging steps for epithelial dysplasia to malignant transformation?

A
  • Mild
  • Moderate
  • Severe
  • Carcinoma In-situ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the role of oral health care providers in cancer in patients?

A
  • Prevention!
  • Risk for infection
    • Dental Caries
    • Periodontal disease
  • Risk for osteonecrosis of the jaw
  • Screenings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the purpose of a pre-radiation dental screening?

A

To locate and eliminate oral foci of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristics of the per-cancer treatment health exam?

A
  • Ideally 1 month prior cancer Tx
  • Establish a schedule for dental Tx
  • Identify and treat sites of low-grade and acute oral infections:
    • Caries, perio & endo disease, mucosal lesions
  • Identify and eliminate areas of trauma/problems
  • Instruct patients about oral hygiene
  • Educate patients on preventing demineralization and dental caries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What would you want to know on a med consult for a patient about to recieve cancer treatment?

A
  • Diagnosis with TNM staging
  • Timing of treatment
  • Field of radiation
  • Dosage of radiation, specific to the areas you will be working in
  • Prior history of surgery to area
  • Chemotherapy?
  • Type of radiation treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What’s the dental treatment for head and neck radiation patients?

A
  1. Pre-treatment comp maxillofacial exam and prophy
  2. Treat all sources of infection
  3. Focus on prevention
    1. Prophy, fluoride treatment, trismus (remove orthobands)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What’s considered oral foci of infection and should be eliminated prior to radiation?

A
  • Deep caries that could lead to pulp exposure
  • Active perio disease
    • >6mm pockets
    • Furcation grade I
    • Recession >6mm
  • Non-restorable teeth
    • Large restorations, root caries
    • Periapical abnormalities or necrotic pulp
    • Partially impacted or erupted teeth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What’s the dental treatment DURING radiation therapy?

A
  • Monitor patient’s oral hygiene
  • Watch for mucositis and infection
  • Advise against wearing removable devices during treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’s the dental treatment after radiation therapy?

A
  • Establish appropriate recall interval
  • Reinforce good oral hygiene
  • Monitor patient for trismus
  • Consult with oncology team regarding use of appliances after healing of oral mucositis
  • Monitor for demineralization and caries
  • Avoid elective surgical procedures
  • Dentures: do not begin fabrication until 3-4 months after therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does chemotherapy target?

A
  • The vasculature and affects the healing response of the oral cavity
  • Targets hematopoietic cells of the bone marrow
    • Leads to anemia, thrombocytopenia and leukoplakia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What complications can arise with chemotherapy?

A
  • Mucositis, oral ulceration
  • Anemia, thrombocytopenia, leukoplakia
  • Infection: viral, bacterial, fungal
  • Neurotoxicity, secondary to medication
  • Osteonecrosis of the jaw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When do you want to perform pre-chemotherapy treatment?

A

At least 1 week before it starts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Should patients wear removable appliances during chemotherapy?

A

No - should advise them not to

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long before chemo should you perform extractions, gingivoplasties or any flap surgery?

A

3 weeks or a minimum of 10-14 days prior

17
Q

Is a medical consult needed for treating patients while they’re going through chemotherapy?

A

Yes - even for prophy’s

Get blood work

18
Q

When do you post-pone treatment during chemo?

A
  • Platelet count is less than 50,000 or abnormal clotting factors are present
  • Absolute neutrophil count is less than 1,000/mm3
19
Q

Before perfoming dental treatment after chemotherapy what do you want to make sure of with the patient?

A
  • Granulocyte count >2000 cells/mm3
  • Platelet count >50,000 cells/mm3
  • Ask about IV bisphosphonate therapy or been treated with a RANKL inhibitor
20
Q

When do patients feel best after chemotherapy?

A

Around 17-20 days after, good time for elective dental care.

21
Q

What is Hematopoietic Stem Cell Transplanation?

A
  • Intentional destruction of the bone marrow
    • Leaves patient with no functioning immune system.
  • Diseases include:
    • Leukemias, aplastic anemia, myelodysplasia, myeloma, lymphoma
  • Types:
    • Autologous
    • Allogeneic
    • Syngeneis
22
Q

What is important in regarding pre-HSCT dental treatment?

A
  • Risk for infection is paramount
  • Risk for bleeding is paramount
    • Confirm platelet count, neutrophil count
  • Follow similar principles for pts going through chemo
23
Q

What do you watch for in treating patient after their HSCT ?

A
  • Watch for infections - herpes simplex & candida albicans
  • Graft-vs-host disease
  • Secondar malignancies in oral area
24
Q

How long do you delay dental treatment after HSCT?

A

Delay elective Tx for 1 year.

  • First 100 (and up to 365 days)days after is crucial to maintain oral health - provide only routine oral hygiene, emergency care
  • >180 days (autologous) or >365 (allogeneic) routine oral hygiene and standard care
  • Chronic GVHD - emergency care only
25
Q

What are the common oral complications of radiation therapy?

A
  • Oral mucocitis
  • Xerostomia
  • Candidiasis
  • Osteoradionecrosis
  • Trismus
  • Caries
26
Q

What are the common complications of chemotherapy?

A
  • Mucositis, oral ulceration
  • Anemia
  • Infection
  • Neurotoxicity
  • Osteonecrosis of the jaw
  • Xerostomia
27
Q

What are some of the oral complications for patients recieving HSCT?

A
  • Viral, Fungal infections
  • Graft-vs-Host disease (allogenic transplants)
    • Donor cells against host cells
  • Taste changes
  • Mucoceles & mucosal sclerosis

Medically Complex Tx Planning (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions