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Med Conditions II > Breast and Prostate Cancer > Flashcards

Breast and Prostate Cancer Flashcards

1
Q

biopsy

A

removal of cells or tissue for examination by a pathologist

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2
Q

incisional biopsy

A

only a sample of the tissue is removed

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3
Q

excisional biopsy

A

the entire lump/suspicious region is removed

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4
Q

needle biopsy

A

sample of tissue or fluid is removed with a needle

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5
Q

fine-needle aspiration biopsy

A

when a thin needle is used

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6
Q

tumor markers

A

Produced by cancer cells and/or other cells of the body in response to cancer cells
Substances found in the blood, urine, stool, or other bodily fluids and/or tissues of some patients with cancer
Used to help diagnose cancer, predict the response to certain cancer therapies, and check a response to treatment
Used to determine whether the cancer has returned

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7
Q

CT Scan uses

A 
Detect abnormal growth
Diagnose presence of tumor
Provide staging information
To determine where to perform a biopsy
To guide local treatments
To help plan external-beam radiation therapy or surgery
Diagnose recurrence of cancer
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8
Q

mammogram

A

X-ray picture of the breast
Used to check for breast cancer in women, ages 40 to 70, who have no signs and symptoms of the disease
Potential harms: false-negative results, false-positive results, over diagnosis, overtreatment, and radiation exposure.

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9
Q

PET scan

A

Procedure in which a small amount of radioactive glucose (sugar) is injected into a brain
Cancer cells take up more glucose, and PET scan will “light up” areas where glucose is taken
Patient cannot eat before this test or will get false positives

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10
Q

xray

A

Chest Xray will be used if suspicious of metastasis to the lungs or suspicious of lung cancer

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11
Q

Tumor grades

A 
GX:  Grade undetermined
Grade 1
Well differentiated (low grade)
Grade 2
Moderately differentiated (intermediate grade)
Grade 3
Poorly differentiated (high grade)
Grade 4 
Undifferentiated (high grade)
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12
Q

Tumor grading

A

Description of a tumor based on how abnormal the tumor cells and tumor tissue look under a microscope
Intended to be an indication of how likely a tumor is to grow and spread
Well-differentiated: organization of the tissue is close to normal cells and tissue, grows at a slower rate
Un-differentiated: tumors tend to grow and spread at a slower rate (aka “poorly differentiated”)

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13
Q

tumor staging

A

Describes the severity of a person’s cancer based on the size and/or extent of the original tumor and whether or not cancer has spread in the body
Clinical need for staging
Helps the doctor plan treatment
Estimates prognosis
Helps the PT understand nature of treatment

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14
Q

TNM system - letters

A

Primary tumor: T
Regional Lymph Nodes: N
Metastasis: M

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15
Q

primary tumor staging

A

TX: Primary tumor cannot be evaluated
T0: No evidence of primary tumor
Tis: Carcinoma in situ
Abnormal cells are present but have not spread to neighboring tissue
Sometimes referred to as “pre-invasive”
T1, T2, T3, T4: size and/or extent of primary tumor

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16
Q

regional lymph nodes

A

NX: Regional lymph nodes cannot be evaluated
N0: No regional lymph node involvement
N1, N2, N3: Degree of regional lymph node involvement (number and location of lymph nodes)

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17
Q

distant metastasis

A

MX: Distant metastasis cannot be evaluated
M0: No distant metastasis
M1: Distant metastasis is present

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18
Q

lymph

A

thin, watery, protein rich fluid originating in organs and tissues of the body, containing chyle, erythrocytes, and leukocytes

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19
Q

lymph node

A

filter harmful materials (protection), produces lymphocytes (immune), and thicken lymph fluid via absorption of water

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20
Q

lymphatic trunks

A

large lymphatic vessels that drain into venous circulation (example: thoracic duct)

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21
Q

lymphatic territories

A

skin areas connected by a common lymph collector

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22
Q

right lymph duct

A

empties at junction of right internal jugular and right subclavian veins

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23
Q

thoracic duct

A

empties into junction of left internal jugular and left subclavian veins

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24
Q

cisterna chyli

A

most inferior part of thoracic duct

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25
lymphatic watersheds
drainage systems,” separate lymphatic territories
26
saggital watersheds
divides the head, neck, trunk and external genitalia
27
upper horizontal watershed
separates neck and shoulder from arm and thorax
28
lower horizontal watershed
starts at umbilicus and separates the upper from the lower territories on the trunk
29
lymphatic vessels
Superficial: millimeters into the epidermis Deep: sub fascial layer of our skin, running through the muscles beneath the fascia (Quirion 2010) Note: the hand does not have deep lymphatics (Foldi and Foldi 2006)
30
highways of lymphatic drainage
activated when normal lymph flow within a territory is interrupted, possibly preventing onset of swelling
31
anterior axillo-axillary
Right and left upper quadrants on anterior surface
32
posterior axillo-axillary
Right and left upper quadrants, posterior surface
33
axillo-inguinal
Ipsilateral upper and lower quadrants (bilaterally)
34
anterior inter-inguinal
Runs over mons pubis, right and left inguinal lymph nodes connecting right and left lower quadrants anteriorly
35
posterior inter-inguinal
Runs over sacrum, connecting right and left lower quadrants posteriorly
36
pattern of lymph return
lymph -> capillaries -> precollectors -> collectors -> lymph nodes -> trunks -> venous angles
37
total transport capacity
amount of lymph fluid transported by the lymphatic system utilizing its maximum amplitude and frequency
38
lymphatic load
the amount of lymph that our body needs to transport
39
lymphedema staging
0: latency stage 1: lymphedema reversible stage 2: spontaneously irreversible stage 3: lymphostatic elephantiasis
40
lymphedema risk factors
NLN Modified Risk Factor List Obesity is consistently cited as one of the biggest predictors of lymphedema Lack of movement should be considered a risk factor Extent of radiation and numbers of lymph nodes removed increase risk factor for lymphedema Infection can cause or exacerbate lymphedema
41
breast cancer types
Ductal Carcinoma Most common type, begins in cells that line a breast duct, 7 out of every 10 woman have this type of cancer Lobular Carcinoma 2nd most common, begins in a lobule of the breast, 1 of every 10 women with breast cancer has lobular carcinoma Mixture of ductal and lobular Less common type
42
types of cancer
Inflammatory Breast Cancer Very aggressive cancer, needs detection to happen immediately for positive results Symptoms include redness, swelling, tenderness and warmth in the breast Metastatic Cancer Cancer that has metastasized Example: Breast Cancer in the bone is still breast cancer, it’s just considered “metastatic breast cancer” Most common types of metastases: Bone Brain Liver Lungs
43
types of breast cancer ("positives")
HER-2 Positive BRCA 1 and BRCA 2 positive Estrogen Positive/Progesterone positive
44
HER-2 positive
Cancer cells make too much of the protein HER2/neu, they tend to be much more aggressive and grow fast. Occurs in 20-25% of breast cancers Herceptin is used to reduce the risk of recurrence, and is given with chemo for those with metastatic cancer
45
BRCA1 and BRCA2 positive
BRCA1 and BRCA2 are genes that produce tumor suppressor proteins. Tumor suppressor proteins help repair damaged DNA and ensure stability of a cell’s genetic material If mutations occur, DNA damage may not be repaired properly Inherited mutations in BRCA1 and BRCA2 increase the risk for breast and ovarian cancers BRCA mutations can be inherited from a person’s mother or father, and each child has a 50% chance of inheriting this gene. Accounts for 20-25% of hereditary breast cancers and 5-10% of all cancers.
46
hormone receptor positive cancers (ER/PR)
Roughly 75% of all breast cancers are ‘ER Positive,’ they grow in response to estrogen. 65% of those are ‘PR Positive,’ they grow in response to progesterone. These tumors are 60% likely to respond to endocrine therapy (i.e. tamoxifen, aromatase inhibitors) typically given after chemo/radiation.
47
triple negative cancer
breast cancer cells that do not have (not positive for) estrogen or progesterone receptors, or large amounts of HER2/neu protein (also referred to as ER-negative, PR-negative, HER2/neu-negative). Majority are associated with BRCA1 gene
48
triple positive cancer
breast cancer cells that are positive for estrogen receptors, progesterone receptors and HER2
49
surgery side effects
decreased strength, changes in lymphatic system, changes in body image, pain, changes in psychological factors, Axillary Cording Scar tissue development, adhesions, muscle injury Muscle atrophy (dependent on approach) Pain Postural Changes Lymphedema or lymphatic system compromise
50
breast reconstruction risks
complications include rupture, capsular contracture, development of scar tissue, failure of reconstruction
51
radiation risks
acute and late effects, acute involving skin erythema, desquamation, aplastic anemia, fatigue and long term including loss of mobility, pain, adhesions, and lung and heart issues, lymphedema, brachial plexopathy, and new malignancy
52
chemo common side effects
Bone Marrow/Blood Cells – Myelosuppression Cells of Hair Follicles Cells in the Reproductive and Digestive Tracts Implications in bowel functioning Implications in abdominal distention/pain secondary to changes in bowel functioning Increased demands on your pelvic floor
53
radiation side effects
Radiation fibrosis: hardening of soft tissues restricting movement, blood flow, posture, pelvic floor function, and ability to participate in daily activities Decreases strength of skeletal system (pelvic girdle) In pelvic region can cause increased frequency of bowel/urine and lack of control
54
side effects of tamoxifen and aromatase inhibitors
“Starves” “estrogen needing” tissues of estrogen Pain in all vulnerable joints (Tamoxifen) Effects/changes due to decreased estrogen Aromatase and Tamoxifen both lead to decreased neck, shoulder girdle, pelvic girdle stabilization, increased risk of plantar fascia, and increased incidence of trigger finger and carpal tunnel syndrome
55
types of mastectomy
``` Unilateral Bilateral Prophylactic Skin-Sparing Mastectomy Areolar Sparing Mastectomy Nipple Sparing Mastectomy Skin Reducing Mastectomy ```
56
types of breast reconstructive surgeries
``` iGap sGap Diep Implants LAT Flap TRAM Flap TUG Flap ```
57
prostate cancer definition
Cancer that forms in the tissue of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum)
58
new cases of prostate cancer annually
238590
59
deaths secondary to prostate cancer annually
29720
60
prostate cancer treatment options
``` Open prostatectomy (original) Laparoscopic and Robotic Assisted Prostatectomy (nerve sparing) Brachytherapy Implantation of small sources of radioactivity into the prostate Radiation therapy Chemotherapy Sipuleucel T Hormonal Therapy GnRH agonists ```
61
aging and the prostate
``` Prostate grows larger with aging Squeezes the urethra and cause difficulty with urine Incomplete bladder emptying Frequency/urgency Hesitancy of urine Pain May start as early as the 30s and 40s ```
62
gleason score
Tumor scoring based on architectural pattern of gland Lowest possible is score of 2 Highest possible is score of 10 Labels severity of cancer
63
prostate specific antiget test
Blood Test for Protein Normal is 4.0 ng/ml or less Looking for a change in blood values
64
functional changes possible following various treatments
``` Urinary Changes Bowel Changes Radiation Damage Sexual Function Back Pain Perineal/Pelvic Pain (depending on approach) ```
65
post prostatectomy incontinence
Immediately after catheter removal an incidence of 91% has been described. Reports following up with patients after one year vary widely, with some reporting continence in 95% of patients (0-1 pads daily) and others reporting a 30-40% incidence of incontinence and need for a pad for 1 or more years following surgery
66
evidence for pelvic floor muscle training
When pelvic floor exercises are started immediately after catheter withdrawal, there is a significant difference between control and experimental groups following radical prostatectomy
67
pelvic exercises
Target the endurance function of the pelvic floor muscle with long hold contractions. Target the quick contraction, power function of the pelvic floor muscle short hold contractions. Try to walk for 30 minutes, up to 5 times weekly. Postural Incontinence is often the most frustrating for patients
68
research study BFB vs education
BFB versus Education Education includes internal examination Research HEP: 80-100 exercises daily, divided into 4 sets of 20-25 Holding parameter: 3-5seconds Resting parameter: 6-10 seconds Start supine, progress sitting, then standing
69
research study BFB vs education - Results
No significant difference in outcome between groups at 6 months 91% continence per objective testing (urine loss greater than 1g) 95% continence per subjective tetsing (0-1 pad/day)

Med Conditions II (8 decks)

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