Cancer

Question 1

Acute Lymphoblastic Leukemia (ALL)

Answer 1

• develops from lymphocytes
• 30% childhood cancer, 75% leukemia
• 65-75% cured with chemo

Question 2

Acute Myeloid Leukemia (AML)

Answer 2

• develops from granulocytes or monocytes
• 25% leukemia
• 50-60% long term survival

Question 3

general symptoms

Answer 3

-weight loss, fever, malaise, loss of appetite, bruising, pain

Question 4

ALL Chemo 1 - induction

Answer 4

-first 28-35 days of therapy, child in remission

Question 5

ALL Chemo 2 - consolidation

Answer 5

-further chemo given, including CNS prophylaxis, lasts 4-6 weeks

Question 6

CNS Prophylaxis

Answer 6

occurs during consolidation

-chemo given directly into CSF (intrathecal)

Question 7

ALL Chemo 3 - Delayed Intensification

Answer 7

• 3-6 months

- intensive chemotherapy

Question 8

ALL Chemo 4 - Maintenance Therapy

Answer 8

less intensive, often lasts 2-3 years

Question 9

Chemo Side Effects

Answer 9

neutropenia, thrombocytopenia, nausea/vomiting, mouth/throat sores, loss of appetite, alopecia

Question 10

Chemo-induced Peripheral Neuropathy

Answer 10

• vincristine

- objective measures - Total Neuropathy Score and Modified Total Neuropathy Score

Question 11

Graft v. Host Disease

Answer 11

• acute or chronic

- skin rash, GI sx, liver, dermititis, hair loss, infection risk, contracture

Question 12

Osteosarcoma

Answer 12

• cells act like osteoblasts, produce a matrix of malignant bone tissue (weaker)
• usu. at ends of long bones (80% knee, 10 humerus)

Question 13

Osteosarcoma sx

Answer 13

• pain (inconsistent, worse at night, increases with activity)
• gait changes/limp
• swelling
• palpable lump/mass
• pathologic fx

Question 14

Osteosarcoma - chemo meds

Answer 14

• methotextrate (CNS toxicity)
• Cisplatin (peripheral neuropathy)
• Doxorubin (cardiac dsfunction)
• Ifosfamide (fatigue)

Question 15

Brain Tumor

Answer 15

• 2nd most common malignant tumor
• 20% childhood cancer
• most common location = infratentorial (brain stem, cerebellum)
• 2nd most common location = cerebral hemispheres

Question 16

Most common brain tumor in children

Answer 16

-astrocytoma (JPA)

Question 17

Brain Tumor - sx

Answer 17

loss of appetite, decline in intellectual skills, decline in motor abilities, FTT, gait changes

Question 18

Neuroblastoma

Answer 18

• affects SNS
• most often in infants/young children
• avg age 1-2 years
• 2/3 cases have metastasized at time of dx

Question 19

Wilms Tumor (nephroblastoma)

Answer 19

• kidney tumor
• can be anaplastic or not
• avg age 3, very rare over 6

Question 20

Wilms Tumor - sx

Answer 20

-swelling/abdominal mass, fever, nausea, loss of appetite, hematourea, constipation

Question 21

cancer long term side effects

Answer 21

pain, neuropathy, fine motor skills, ADLs, balance, QOL, endurance