Cancer Flashcards
What is cancer?
- LEADING cause of death WORLDWIDE!
- Second most common cause of death in the U.S.
- A malignant (unregulated) transformation of cell within a specific body system LEADING to uncontrolled cell growth (proliferation/autonomy) and differentiation (Anaplasia)
- Genetic & Immune factors
- GENETIC alterations: - Direct mutation to DNA –> carcinogen can damage the DNA and cells
- Gene varients
- Epidemic things like environment
- Modifiable & non-modifiable risk factors
What is the MOST significant adverse effect of CHEMOTHERAPY????
NEUTROPENIA (low WBC) = Infection!!!!!
What are the 4 causes of Cancer??
- Gene mutation
- Factors that cause DNA alterations
- Overwhelming immune surveillance
- Modifiable and non-modifiable risk
- Modifiable: lifestyle and environment exposure to carcinogen
- Non-modifiable: age & genetic predisposition
What are the 6 Common Risk Factors of Cancer???
- Advancing Age**
- Cigarette Smoking**
- Obesity
- Pathogens
- Lack of exercise
- Dietary factors:
- Lack of fruits and veggies
- ALCOHOL
- Meat concerns
- High fat
- Sugar
- Artificial sweeteners
- Salt & salt preserved foods
What are the 8 Characteristics of Cancer cells?
- Altered proliferation (autonomy)
- Lack of contact inhibition
- Lack of apoptosis
- Lack of “anchorage dependance”
- Possible rapid proliferation
- Migratory potential (Metastasis):
- Blood
- Lymph node
- Direct invasion
- Seeding: small cancer cells break off the primary tumor & go into the cavities (pleural & abdomen) - Poor differentiation (Anaplasia)*
- Angiogenesis
What’s cellular dysplasia?
Cellular change in size, shape, & organization!
What’s neoplasia??
Uncontrolled proliferation
Can a benign neoplasia be problematic? Why?
YES! Even though benign neoplasm doesn’t have those cancer cell characteristics, they uncontrollably grow/proliferate and can cause, for ex in the brain, pressure and lead to headache and N/V
What are the 2 types of cancer???
- Solid Tumor Malignancies: from organs and grow into assess that invade normal tissue as they expand in size
- Hematological Malignancies: from cells of the hematopoietic cell line OR from secondary immune organs such as lymph nodes or spleen
What are the clinical manifestations of cancer?????**
- CAUTION symptoms
- Constitutional signs/general signs:
- FATIGUE
- UNEXPLAINED WEIGHT LOSS
- Fever
- Night Sweats
What are the TWO MOST general manifestations of Cancer???????***
- FATIGUE
- UNEXPLAINED WEIGHT LOSS!!
What are the Tumor specific symptoms????
- Primary tumors: tumor tht came first
- Secondary tumor: the one tht METASTATIS from the primary
- METABOLIC CHANGES (Paraneoplastic syndrome)** - where the tumor is producing weird substances
What are the 6 Common Complications of MALIGNANCY????***
- Anorexia/Cachexia Syndrome:
- Treatment related
- Psychological factors
- Alterations in CNS role in appetite & satiety
- Local effects of cancer - HYPER-COAGULATION**
- Thrombogenic tumor cells
- Inflammatory influence - EFFUSIONS*
- Pleural space or pericardial sac
- Manifestation of fluid in the pleural space: Dyspneic, increased RR with accessory muscle, unequal chest excursions, diminished breath sounds!!!!!!!!!!!!
- Manifestation of fluid in the pericardial space: Heart can’t contract well & signs of low perfusion
- Cancer in the blood, lymph, breast, lungs, prostate, & ovaries - Fluid & Electrolye imbalance
- GLUCOSE metabolism abnormalities
- DEPRESSION!!!!!!!!****
What are the oncologic emergencies???
Acute clinical complications that occur in the presence of malignancy!!!
1. The process of tumor growth and invasion of body organs
2. *Metabolic changes cells (Paraneoplastic syndrome)
3. *TREATMENT MODALITIES (like radiation and chemo) = TUMOR LYSIS SYNDROME!!!!!
What is tumor lysis syndrome and how can it be an oncologic emergencies????
- Occurs when cancer cells are killed and burst open stuff
1. Burst out lots of potassium (Hyperkalemia) and can cause Cardiovascular issues AND GI Hypermotility!!!!!
2. Purines are released and will be converted to URIC ACID and can cause HYPERURECIMIA!! This can be damaging to the kidneys can cause KIDNEY FAILURE = elevated BUN and creatinine and decreased urine output
3. Elevated phosphorus causing HYPOCALCEMIA!!! Can lead to Damage nerve (Numbness& Tingling/parathesia, Neuromuscular irritability, LARYNGEAL CONSTRICTION) AND DECREASED CONTRACTION OF THE HEART!!!!!!!!!!!
What are the MANAGEMENT interventions for TUMOR LYSIS SYNDROME????!!!!!!*****
- Prevention : ***HYDRATE & meds
- DIALYSIS*****
- Drug therapy:
- Diuretics**
- ALLOPURINAL (LEADING CAUSE OF STEVEN JOHNSON syndrome)***
- Insulin/Dextrose - Monitor EKG
- Monitor Electrolytes
- Monitor Renal function!!!!
What are the 3 DRUGS FOR TUMOR LYSIS SYNDROME????
- Diuretics**
- ALLOPURINAL (LEADING CAUSE OF STEVEN JOHNSON syndrome)***
- Insulin/Dextrose!!!
What is one of the drug of tumor lysis syndrome that causes a specific syndrome???
Allopurinal!!!!!!! Causes Steven Johnson Syndrome!!
What are the 3 cancer prevention methods???***
1) PRIMARY prevention:
1. Risk modification
- AVOID CARCINOGEN
- Active & maintain proper weight.
- Avoid too much sun exposure and Use SUNSCREEN
- AVOID ALCOHOL; women no more than 1 drink per day, men no more than 2 drinks
- RECOGNIZE family risk and CONSIDER prophylactic interventions for genetic mutation
2. Chemoprevention
3. Vaccination
2) SECONDARY prevention:
1. Screenings
2. Better Clinical outcomes and reduces number of cancer deaths
3) TERTIARY prevention:
1. Reduce morbidity and mortality once a disease has been diagnosed
Cancer increases risk of what???
Inflmattion = (&) clotting!!!!!!!!
What are the classification of Cancer?? THEN, What 2 goals are set????
- Helps to standardize diagnosis, prognosis, and treatment!!
- Based on: Grading and Staging (TNM system)
- Grading (Grade1-4, degree of differentiation)
- Staging (TNM system: T- tumor size and spread, N- node involvement, M- metastatic state)
THEN, GOALS ARE SET:
- therapies is determined by the HCP in order to PROLONG SURVIVAL and IMPROVE QUALITY OF LIFE
What’s the difference between Cure, Remission, Control, and Palliation??
- Cure- Free of Disease
- Remission- Disease free states, unclear if eradicated or controlled
- Control- not cured, just controllable
- Palliation- Relief of symptom
What are the treatment modalities of cancer??
- Surgical procedures, from prophylaxis to reconstruction
- Radiation
- Chemo
- NEOADJUVANT and ADJUVANT
- NEOadjuvant: BEFORE primary treatment!!! (Ex: chemo or radiation BEFORE getting surgery to shrink the tumor down is that surgeon will have easier time to get it out)
- Adjuvant: AFTER primary treatment!! (Ex: having surgery for ur cancer and then going into Chemo or Radiation)
What are the 3 types of Radiation??
- External Beam Radiation (Teletherapy)
- Internal Radiation Therapy (Brachytherapy)
- Radiopharmaceutical Therapy (Systematic therapy)
Which one of the 3 types of radiation therapy does NOT make the patient radioactive?????
EXTERNAL BEAM RADIATION (TELETHERAPY)!!!!!
What’s the MAIN common difference between Internal Radiation Therapy (Brachytherapy) and Radiopharmaceutical Therapy (Systematic Therapy)???????
Internal Radiation Therapy (Brachytherapy) emits radiation BUT waste products are NOT radioactive!!
While, Radiopharmaceutical Therapy causes waste products that are RADIOACTIVE!!!!
What is the External Beam Radiation (Teletherapy)?????
1) Distance therapy in divided doses
1. Shield vulnerable tissues if possible
2. Potential for damage of healthy tissues
2) AREA MARKED (Teach patient not to remove markings!!!)
3) The patient is NOT “Radioactive”!
Which radiation therapy need the area of the cancer to be “tattooed”??
External Beam Radiation (Teletherapy)
What is the patient care for External Beam Radiation (Teletherapy)?????***
- Provide a well-balanced diet that DOESN’T contain RED MEAT!!
- Manage fatigue by scheduling activities w/ rest periods in between AND using Energy-saving measurements!
- Wear SOFT CLOTHING and avoid TIGHT/constricting clothes
- DON’T expose the irradiated skin to the sun or heat!!!
What are the side effects of radiation therapy??????
- ** FATIGUE
- ** CHANGE IN TASTE SENSATION – METALLIC TASTE (or unpalatable taste)
- Hair loss (that’s permanent)
- SKIN inflammation
- GI tract Inflammation!
What are the assessments of anemia?
Signs of POOR PERFUSION!!!!!!!!
Pallor, sluggish, lightheadedness, fatigue, SOB with short exertion.
What are the CAUTION symptoms???
Changes in the bowel or Bladder Habits
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in the breast or anywhere in the body
Indigestion (difficulty swallowing)
Obvious change in wart or mole
Nagging cough or hoarseness!!!
oh What is Paraneoplastic syndrome?
substances/weird stuff that a tumor is producing instead of the cancer itself, that causes metabolic changes. This is under Tumor Specific Symptoms of the Clinical Manifestations of Cancer!!!
What are the causes of Anorexia/Cachexia syndrome, a common complication of malignancy?????
- Treatment related
- Psychological factors
- Alterations in CNS role in appetite & satiety
- Local effects of cancer
What are the TWO MOST COMMON risk factors* of cancer????
Advancing age and Smoking!!!!
What are the common COMPLICATIONS of Malignancy????
- Anorexia/Cachexia syndrome
- Hyper-coagulation
- Effusions
—- - Fluid and electrolyte imbalances
- Glucose metabolism abnormalities
- DEPRESSION**