Cancer Flashcards
Rx for malignant ascites in palliative care
Furosemide
Spironolactone
Dexamethasone
Most common type and place of pancreatic cancer
Adenocarcinoma, Head of the Pancreas (approx. 60-70%)
RF for pancreatic cancer
Smoking
Alcohol Overuse
Diabetes
Obesity
Prior Gastrectomy/Cholecystectomy
Family History
BRCA1 Gene
Chronic Pancreatitis
Cystic Fibrosis
Peutz-Jeghers Syndrome
Atypical Multiple Moles or Melanoma Syndrome
Hereditary Nonpolyposis Colon Cancer (Lynch Syndrome)
Cancer associated W/ celiac
Lymphoma of small bowel
When to do next pap for pt with ASCUS
Repeat in 6mo
Lab work up for malignancy
CBC, Cr, lytes, calcium, magnesium, phosphate, LFTs w/ albumin, INR, LDH, SPEP, tumor markers
Tumor markers for
1) colon, hepatocellular
2) pancreatic
3) breast
4) ovarian
5) prostate
6) hepatocellular
7) germ cell
CEA = colon, hepatocellular
CA 19.9 = pancreatic
CA 15.3 = breast
CA 125 = ovarian
PSA = prostate
aFP = hepatocellular
beta-HCG = germ cell
Ix for breast staging
not needed if asymptomatic, tumor <5cm + <3 nodes. Otherwise, CT chest/ abdo/ pelvis + bone scan
Lung staging
CT chest/ abdo/ pelvis, bone scan, MRI brain
Colon staging
CT chest/ abdo/ pelvis
Prostate staging
not needed if asymptomatic, PSA <10 + Gleason <5. Otherwise, bone scan, CT abdo/ pelvis
Lung cancer screening
low dose CT q1yr x 3, pts 55-74 y/o w/ >30 pack yr smoking hx who currently smoke or quit within last 15yrs
Colorectal cancer screening, inc high risk, IBD, FAP and HNPCC
avg risk 50-74 FIT q2yr or sigmoid q10yr
High risk (FDR w/ colon Ca) = colonoscopy 40-50 y/o q5 yrs
IBD = q1-2 yrs colonoscopy 10 yrs after pancolitis or 15 yrs after left sided colitis
FAP = genetic counselling, flex sigmoidoscopy annually starting age 10
HNPCC = genetic counselling, colonoscopy q1-2yrs at age 20
Most Common bladder cancer
Transitional (Urothelial) Cell Carcinoma
Cancer associated with flushing, diarrhoea and bronchospasm
Neuroendocrine Tumor (carcinoid tumors)
Types of thyroid cancer
Papillary
Follicular
Medullary
Anaplastic
* from most common to least common
* from least aggressive to most aggressive
Ix for bony mets
calcium, alkaline phosphatase, LDH
Multiple myeloma features
CRAB
high calcium
renal failure
anemia
bony lesions
RF for cervical cancer
Sexual activity <20 y/o
Multiple partners
Smoking
Immunocompromised
Long term OCP
Protective factors for cervical cancer
Routine pap
HPV immunizations
Screening for cervical cancer
Q3 yrs 25-69 if ever sexually active
>70 y/o = DC if 3 consecutive negative results in 10 years
Annual screening for immunocompromised, SLE
TAHBSO = no screening
Pregnancy = same screening
RF for colorectal cancer
Age >50 y/o
Family history
IBD
High fat diet
Obesity
Smoking
Excessive alcohol intake
Sedentary life
Sx for colorectal cancer
Blood in stool
Change in BMs
Persistent bloating
Weakness, fatigue, wt loss
Rectal mass on DRE
Anemia
Rx + associated complications for colorectal cancer
Surgery (infection, anastomosis breakdown, bleeding, adhesions)
Chemo (premature ovarian failure, dilated cardiomyopathy, secondary cancers, cognitive decline)
Radiation (weakness, paresthesia, CAD, valvular disease)
Immunotherapy (bone pain, fatigue, fever, rash, bleeding)
Mets of colorectal cancer
Liver > lung > peritoneum
RF for leukemia
Down syndrome
Neurofibromatosis
Ionizing radiation
Exposure to benzene
Household pesticides
Obesity
Sx of leukemia
Acute: fever, fatigue, wt loss, anemia, bleeding, hepatosplenomegaly, MSK sx in kids
Chronic: usually asymptomatic, hepatosplenomegaly
Ix + results for leukemia
Anemia
Thrombocytopenia
Peripheral smear = increased hematopoietic precursor cells or increased lymphocytes
LFTs, Cr, lytes, coag
Bone marrow aspirate + biopsy
Flow cytometry
Rx for leukemia
Chemo
RT
Monoclonal antibodies
Stem cell transplant
RF for lung cancer
Smoking
Asbestos
Occupational exposure to dust
Occupations (miners, painters)
Personal or family hx of cancer
Hx of COPD
TB
HIV
Sx of lung cancer
Clubbing
Hemoptysis
Wt loss
Anorexia
Dyspnea
Chest pain
Fatigue
Ix for lung cancer
CBC, ALP, AST, ALT, Calcium, albumin, lytes, urea, Cr
Staging = CT chest abdo pelvis, bone scan, CT/ MRI brain
Mets of lung cancer
Liver
Bone
Lymph
Brain
Rx of lung cancer
NSCLC: stage 1 + 2 = surgery, 3 = chemo + RT, 4 = palliative
SCLC: chemo + RT
Prevention of upper GI cancer
Stop smoking
Reduce alcohol
Maintain healthy weight
Increase fruit and veg consumption
When to screen for pancreatic cancer
screen if high risk:
family history, high risk syndromes like Peutz-Jeghers or BRCA1 w/ affected relative
Breast cancer treatment SE
cardiomyopathy, valvular dz, ovarian failure, lymphadenopathy, fatigue, secondary malignancy
Management of radiation dermatitis
loose fitting clothing, avoidance of fragrances, weak topical steroids, emollients
