Cancer Flashcards
What is the generic definition of cancer?
Abnormal new tissue growth characterized by progressive uncontrolled multiplication of cells
What is the abnormal growth of cells called?
Neoplasm
Tumor
What are the traits of a benign tumor?
Tumor is encapsulated in connective tissue
Contains fairly well differentiated cells
Cells retain recognizable tissue structure
Do not travel through blood vessels or lymphatics or form secondary tumors in other organs
What is a tumor designated if it is encapsulated in connective tissue/
Benign
T/F: benign tumors are harmless
False. While they do not spread to other parts of the body, their growth can put pressure on surrounding organs and structures like the brain
Most people dont use theirs anyway so its up for debate
Describe the growth of cells in malignant tumors
Unorganized
What does a malignant tumor do that a benign tumor does not?
Invade surrounding structures, tissues, blood vessels and lymphatics
Cancers that arise from the epithelial tissues are called what?
Carcinomas
What can happen as a side effect of rapid tumor growth?
The tumors can grow so rapidly that the new cells deprive the older cells of nutrition resulting in necrosis or cavity formation within the tumor
What are carcinomas?
Cancers that arise from epithelial tissue
What are adenocarcinomas?
Cancers arising out of glandular tissues
Cancers arising out of glandular tissues are what?
Adenocarcinomas
Cancers arising from connective tissue are called what?
Sarcomas
What are sarcomas?
Cancers arising from connective tissues
A tumor that arises from bronchial mucosa is called what?
Bronchogenic carcinoma
What is the fancy term for lung cancer?
Bronchogenic carcinoma
Which type of lung cancer has the strongest correlation with smoking?
Small cell lung carcinoma
What are the 4 major types of lung cancer?
Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Small cell (oat cell) carcinoma
Describe the growth rate and size of small cell carcinomas
Grow rapidly
Grow large
When does a small cell carcinoma tend to metastasize?
Early
What percent of patients with small cell carcinoma respond to treatment?
90%
If left untreated, how long do individuals with small cell carcinoma tend to live?
1-3 months
T/F: nearly all patients who have had small cell carcinoma relapse within 36 months
False. Nearly all patients who have had small cell carcinoma relapse within 24 months
Squamous cell carcinomas make up what percent of all bronchogenic carcinomas?
25-30%
What tissue do squamous cell carcinomas arise from?
Bronchial epithelium
Small cell lung carcinomas make up what percent of all bronchogenic carcinomas?
10-15%
Describe the general location squamous cell carcinomas
Central bronchus or hilum
Describe the growth rate of a squamous cell carcinoma
Slow
Squamous is flat, turtles are flattish
A bronchogenic carcinoma found in the central bronchus or hilum is most likely…
A squamous cell carcinoma
At what point do squamous cell carcinomas tend to metastasize?
Late
Adenocarcinomas make up what percentage of bronchogenic carcinomas?
40%
Where do adenocarcinomas tend to arise?
From a gland
Describe the growth rate of adenocarcinomas
Moderate growth rate
At what point do adenocarcinomas metastasize?
Early
Where do adenocarcinomas tend to be located in the lung?
Generally situated in the periphery of the lung
A cancer that is located in the periphery of the lung could be an
Adenocarcinoma
What percentage of bronchogenic carcinomas are large cell carcinomas
10-15%
Describe the growth rate of large cell carcinomas
Rapid growth
At what point do large cell carcinomas metastasize?
They metastasize early to distant locations
Where do large cell carcinomas tend to be located in the lungs?
Peripherally or centrally
What are some pulmonary complications associated with large cell carcinomas?
Chest wall pain
Pleural effusion
PNA
Hemoptysis
Pulmonary cavities
T/F: Lung cancer is the leading cause of cancer related deaths in the US
True
What is the 5 year survival rate from lung cancer
Approximately 15%
How many people die from lung cancer annually?
> 154k
How many new cases of lung cancer are diagnosed in the US annually?
234k
What is the average age at the time of diagnosis with lung cancer?
70
T/F: White men are about 25% more like to develop lung cancer than black men
False. Black men are about 20% more likely to develop lung cancer than white men
What are the first and second most common causes of lung cancer?
Smoking
Radon
T/F: Black women are less likely to develop lung cancer than white women
True. Black women are 10% less likely to develop lung cancer than white women
T/F: Different cigarettes have different risks associated with them
False. All cigarettes generally pose the same amount of risk with menthol being considered to be higher risk as it encourages deeper inhalation
What symptoms are associated with lung cancer?
Progressively worsening cough
Chest pain
Hoarse voice
Poor appetite and weight loss
Dyspnea
Fatigue
Frequent respiratory infections
Sudden onset of wheezing
What are some symptoms that could mean that the cancer has spread to other parts of the body?
Bone pain
Neurologic problems
arm/leg weakness/numbness
Dizziness
Seizures
Jaundice
Enlarged lymph nodes
Pancoast syndrome, superior vena cava syndrome, and paraneoplastic syndrome are suggestive of what?
Lung cancer
What is pancoast syndrome?
Unilateral effects of a nerve being compressed by a tumor in the upper portion of the lung
Drooping or weakness in one eyelid (ptosis), small pupil in same eye, reduced or absent perspiration on same side of face
What is superior vena cava syndrome?
Swelling of the vessels of the face, neck, arms, and upper chest due to a tumor in the right upper lung obstructing venous blood flow at the superior vena cava
What are paraneoplastic syndromes?
Remote effects of a tumor that are not directly related to its growth or metastasis
Hypercalcemia, excessive bone growth, blood clots
What is the second diagnostic question you should ask when considering lung cancer?
Is the tumor benign or malignant?
What is the first diagnostic question you should ask when considering lung cancer?
Is the cancer primary or secondary?
Did the cancer start in the lungs or did cancer somewhere else spread to the lungs
What is the 3rd diagnostic question that you should ask when considering lung cancer?
What type of cells make up the tumor
What are the diagnostic procedures when dealing with lung cancer?
Confirm the presence of lung carcinoma
Establish the cancer cell type
Confirm the stage of cancer
When looking for cancer, what could a CXR tell you?
Whether or not there are any masses or nodules
When looking for cancer, what could a CT scan tell you?
Clear image of tumor, its location, size, and whether or not there is anything in the lymph nodes
When looking for cancer, what could a PET scan tell you?
Whether or not the mass is metabolically active
When looking for cancer, what can an MRI tell you?
Whether or not its spread to the brain or spinal cord
What would a sputum cytology tell you when looking for cancer?
Information on cell forms
What does an EBUS do when looking for cancer?
Endobronchial ultrasound
Allows for lymph node biopsy
What purpose would a thoracentesis serve when looking for cancer?
Sample fluid from pleural space, look for cancer cells
Describe the TMN staging of lung cancer
Tumor = how big, is it spreading
Lymph nodes = metastasis there yet? How far from the source?
Metastases = how far? How many? How much?
0-4 represents level of severity, 0=meh, 4=PANIC
T/F: A new onset cough is not a concerning symptom in regards to cancer in patients who are current or former smokers
False. A new onset cough in a smoker or former smoker should ring raise suspicion for cancer with a cough presenting in 50-75% of patients upon presentation
Patients who have cancer present with a cough ______ of the time
50-75%
What symptom frequently is a tipping point for patients to seek help for their respiratory symptoms?
Hemoptysis
Coughing up blood is generally alarming
Patient with cancer present with dyspnea how often?
Occurs in 25-40% of the time
How can cancer affect the results of PFT?
Cancer can present as obstructive or restrictive or both depending on where the mass is located
When might cancer present as an obstructive issue on a PFT?
Cancer may present as obstructive when the malignancy obstructs a major airway
When might cancer present as a restrictive disease on a PFT?
When large amount of pulmonary tissue, chess wall or diaphragm are involved in the disease process such as with extensive bronchioalveolar carcinoma
Describe the effects a localized lung cancer may have on an ABG
Increases pH
Decreased PaCO2
Decreased but Normal HCO3
Decreased PaO2
Decreased Sat
Describe the effects an extensive or widespread cancer could have on an ABG?
Decreased pH
Increased PaCO2
Increased but Normal HCO3
Decreased PaO2
Decreased Sat
What signs on a CXR might be indicative of cancer?
Small oval or coin lesion
Large irregular mass
Alveolar consolidation
Atelectasis
Pleural effusion
What are supportive care options RTs have for working with cancer patients
Oxygen therapy
Airway clearance therapy
Lung expansion therapy
Inhaled medications
How can heliox help patients with cancer?
If there is an airway restriction from the tumor growth, heliox can pass by it easier that normal oxygen therapy due to decreased turbulence
What are the three main ways cancer patients treatment is managed?
Supportive care
Curative or palliative treatment
Specialized treatments
What practices qualify as curative or palliative treatment?
Chemotherapy
Radiotherapy
Surgery
What practices qualify as supportive care?
Oxygen therapy
Airway clearance therapy
Lung expansion
Inhaled medications
What is the goal of immunotherapy?
Trigger the bodys immune system to fight the cancer
Describe therapies that can “starve” the tumor
Angiogenesis inhibitors
Target the blood supply to the tumor
What does epidermal growth factor receptor inhibitor therapy do/
Turns off the biological signal to grow
What is radiofrequency ablation?
“Cooking” a tumor
What are different surgical options that cancer patients might have?
Pneumonectomy
Lobectomy
Segmentectomy or wedge resection
Sleeve resection
Video assisted thoracic surgery
Describe a sleeve resection
Remove cancerous portion of the lung along with portion of the bronchus that attaches to it then reconnect the remain segments to the remaining portion of the bronchus
If a tumor is creating an airway obstruction, what are surgical options to treat it?
Debulking the tumor
Stent placement
Tumors can lead to uncontrolled bleeding, how can this be treated?
Argon plasma coagulation
T/F: Routine CXRs are recommended for screening for lung cancer
False, it is not recommended for most patients.
