Cancer Flashcards
Exam 1
the genetic and physiologic processes that control cellular growth, replication, differentiation, and function maintain homeostasis
Cellular regulation
nuclear-to-cytoplasmic ratio
the nucleus is small compared to the rest of the cell
Euploidy
23 pairs of chromosomes
Ratio of cells undergoing mitosis to the total number of cells
Mitotic index
benign tumor cells
normal cells growing in the wrong place or at the wrong time as a result of a problem with cellular regulation
cancer / malignant cells
abnormal cells that serve no function and are harmful to normal body tissues
carcinogenesis
process of changing a normal cell into a cancer cell
What are the 4 stages of carcinogenesis?
Initiation
Promotion
Progression
Metastasis
Irreversible event that can lead to cancer development
initiation
substances that change the activity of a cell’s genes so that the cell becomes cancerous
carcinogens
enhanced growth of an initiated cell by substances known as promoters
promotion
the time between cell initiation and the development of an overt tumor
latency period
continued change of a cancer cell to more malignant over time
progression
the original group of cancer cells
primary tumor
when cancer cells move from the primary location by breaking off from the original tumor
metastasis
metastatic tumors
additional tumors
What is the purpose of grading and staging?
To help standardize cancer diagnosis, prognosis, and treatment
Grading
how similar the cancer cells look to the parent cell
What is the purpose of grading cancer?
Prognosis and therapy
the description of cancer cells by chromosome number and appearance
Ploidy
gain or loss of chromosomes and/or structural abnormalities
Aneuploidy
What is the purpose of assessing ploidy?
Determine diagnosis and prognosis
Staging
Determines the exact location of the cancer and whether metastasis has occurred
What does cancer staging influence?
selection of therapy / treatment
Name the three types of staging
Clinical, surgical, pathologic
Which type of staging is the most definitive?
Pathologic
Tumor, Node, Metastasis (TNM) staging system
describes the anatomic extent of cancers
What are 3 factors that account for variation in cancer development?
Carcinogen exposure
Genetic predisposition
Immunity
Name the 3 main external factors that cause cancer
Chemical
Physical
Viral
What is the single most preventable source of carcinogenesis?
Tobacco use
Which tissues are at greatest risk for tobacco-induced cancer?
Tissues that have direct contact with tobacco (i.e., lungs and airways)
Ionizing and UV radiation are examples of ____ factors
physical
What is the single most important risk factor for cancer?
Advancing age
What does CAUTION stand for?
C = changes in bowel or bladder habits
A = A sore throat that does not heal
U = Unusual bleeding or discharge
T = Thickening or lump in breast or elsewhere
I = Indigestion or difficulty swallowing
O = Obvious change in a wart or mole
N = Nagging cough or hoarseness
Name the 6 most common cancers
Colorectal
Lung
Prostate
Skin
Leukemia
Bladder
Name at least 3 family history “red flags”
(1) Cancer in multiple members of every generation
(2) Similar cancers in multiple first-degree relatives
(3) Multiple instances of rare cancer within a family
(4) Cancer at a young age
(5) Cancer in both of paired organs
(6) Breast cancer is present in genetic male adult
use of strategies to prevent the actual occurrence of cancer
primary cancer prevention
using drugs, chemicals, or natural nutrients to disrupt cancer development
Chemoprevention
What is the only known vaccine approved for cancer prevention?
HPV
the use of screening strategies to detect cancer early, at a time when cure or control is more likely
Secondary cancer prevention
Thrombocytopenia
Decreased platelet count
Cachexia
Extreme body wasting and malnutrition
Changes in peripheral nerve function are more commonly caused by ____, rather than cancer.
Neurotoxic chemotherapy
Why is bone metastasis significant?
Pain, fractures, and hypercalcemia can occur, which all lead to reduced mobility
Which effects of bone metastasis are oncologic emergencies?
spinal cord compression (SCC) and hypercalcemia
Hypoxia
inadequate supply of O2 to the body’s tissue
Hypoxemia
low level of O2 in the blood
Radiation can cause which 4 cardiac problems?
(1) Pericarditis
(2) coronary artery disease
(3) Myocardial dysfunction
(4) valvular heart disease
Name the 6 functions of surgery
(1) prophylaxis
(2) diagnosis
(3) cure
(4) control
(5) palliation
(6) tissue reconstruction
removes potentially cancerous tissue as a means of preventing cancer development
prophylactic
removal of all or part of a suspected lesion for examination and testing to confirm or rule out a cancer diagnosis
diagnostic
removes all cancer tissue
curative
removes part of the tumor if removal of the entire mass is not possible
debulking
providing symptom relief and improving quality of life
palliative
increases function, enhances appearance, or both
reconstructive / restorative
How does debulking surgery help the pt?
Alleviate symptoms, enhance success of other tx, increase survival time
What are two priority care needs for patients after surgery?
(1) psychosocial support
(2) maximum functioning after surgery
After surgery, the nurse’s role includes teaching patients the importance of what?
Performing exercises;
Regaining function
Nurses should reinforce what 3 things following cancer surgery?
(1) early mobilization
(2) pain management
(3) prevention of infection
the amount of radiation delivered to a tissue
Radiation exposure
the amount of radiation absorbed by the tissue
Radiation dose
Fractionation
series of divided doses (related to radiation)
In external beam radiation, is the patient radioactive?
No
In internal radiation therapy / brachytherapy, is the patient radioactive?
Yes
What is the most common side effect of radiotherapy?
radiation dermititis
What is the priority intervention for someone receiving radiation therapy?
Teach patients about skin care needs
activates immune system to attack cancer cells
Immunotherapy
chemo agents used to shrink a tumor before surgery or radiation
neoadjuvant chemotherapy
chemo agents used to kill remaining cancer cells follow surgery or radiation
adjuvant chemotherapy
How do you choose which chemotherapy agent?
tumor type
tumor markers
growth rate
pt’s performance status
giving chemotherapy rounds closer together with bone marrow growth factors to prevent neutropenia
Dose-dense chemotherapy
How can you prevent extravasation during chemo treatment?
Monitor for blood return at the access site at regular intervals
T/F: Oral drugs are just as toxic as IV chemotherapy
True
For missed doses of oral chemotherapy, do you always take the drug when remembered?
No, usually not
Neutropenia
Decreased number of neutrophil WBC
time when bone marrow activity and WBC counts are at their lowest after chemo
Nadir
Name the 2 priority care issues during chemotherapy
(1) Protect pt from life-threatening side effects
(2) Manage distressing symptoms
What is one treatment to reduce the risk for infection during chemotherapy?
Use of growth factors to stimulate bone marrow production of granulocytes
What are the priority interventions for patients with neutropenia?
(1) protect from infection
(2) teach patients and family how to reduce infection risk at home
Name the priority nursing intervention for thrombocytopenia.
Provide a safe environment to reduce risk of falls or injury
Name the 4 types of chemotherapy-induced nausea & vomiting (CINV)
(1) anticipatory
(2) acute
(3) delayed
(4) breakthrough
What does CINV put patients at risk for, especially older adults?
Risk for dehydration and fluid imbalance
Inflammatory process that affects the mucous membranes of the oral mucosa and GI tract
Mucositis
Reduced ability to concentrate, memory loss, or difficulty in learning new info
Chemo brain
Name 3 nursing priorities for a patient experiencing chemo brain.
(1) support the patient
(2) provide resources for cognitive training
(3) ensure that other patients have experienced this
What is the nursing priority for chemotherapy-induced peripheral neuropathy (CIPN)?
Prevent injury
3 side effects of immunotherapy are…
(1) Fatigue
(2) Rash
(3) Risk of infection
Immune-related adverse events (irAEs)
when the stimulation of the immune system affects healthy cells
What is the typical treatment for irAEs?
immunosuppression via corticosteroids
Combination actions from immunotherapy and targeted therapy to help treat specific cancers
Monoclonal antibodies
Rituximab is what type of treatment?
Monoclonal antibody
When infusion-related reactions occur w/ monoclonal antibodies, what is the nursing priority?
Pt assessment to recognize potentially life-threatening reactions
drugs designed to block the growth and spread of cancer by interfering with the specific cellular growth pathways or molecules involved
Targeted therapy
What is the nursing priority for targeted therapy?
Careful assessment for adverse reactions to treatment
Decreasing the amount of hormones reaching hormone-sensitive tumors to slow cancer growth
Endocrine therapy
What is the nurse’s role in endocrine therapy?
(1) teach pt and family about side effects
(2) encourage exercise
(3) avoid hormonal replacement
Support chemo by enhancing recovery of bone marrow function after tx-induced myelosuppression
Colony-stimulating factors
Filgrastim and pegfilgrastim are examples of what treatment?
Colony-stimulating factors as supportive therapy
occurs if body has a physiological need for more cells (e.g., increases in WBC during an infection) or presence of apoptosis (cell death)
Proliferation
an orderly process where cells progress from immaturity to maturity leading to a specific cell function
Differentiation
______ regulate and promote cell growth
proto-oncogenes
regulate and suppress cell growth
Tumor suppressor genes
BRCA1, BRCA2 are examples of what?
Tumor suppressor genes
Treatment given after the primary treatment (e.g., surgery) to eliminate remaining cancer cells.
Adjuvant therapy
Treatment given before the primary treatment to shrink the tumor and improve outcomes.
Neoadjuvant therapy
Treatments that work throughout the body, such as chemotherapy, hormonal therapy, or targeted therapy
Systemic therapy
Treatments focused on a specific area, such as surgery or radiation therapy
Localized therapy
Blocking hormones that fuel certain cancers
Hormonal therapy
Why is IV chemo often given via central line?
To avoid extravasation
steroids are given to treat what side effect of chemotherapy?
Nausea and vomiting
Time and energy a person spends dealing with cancer treatments
Time toxicity
osteoporosis and cardiovascular risk are two long-term effects of what?
Hormonal / endocrine therapy
Continued treatment to prevent cancer recurrence or progression
Maintenance therapy
Participation in clinical trials for new treatments
Experimental therapy
Radiation sources comes into direct, continuous contact with tumor for a specific amount of time
Brachytherapy
