Cancer Flashcards by Alex Stein

Cancer is characterized by what

rapidly proliferating anaplastic cells

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CA - early warning signs

Unusual bleeding or discharge
A lump or thickening of any area
A sore that does not heal
Change in b/b 
Hoarseness or persistent cough
Indigestion or difficulty swallowing
Change in size or appearance of wart or mole
Unexplained weight loss

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Pathophys - Tumor or neoplasm

An abnormal growth of new tissue that is nonfunctional and competes for vital blood supply an nutrients

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Pathophys - Benign tumor (neoplasm)

localized, slow growing, usually encapsulated, non invasive

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Pathophys - Malignant tumor (neoplasm)

Invasive, rapid growth giving rise to metastasis, can be life threatening
Carcinoma, Sarcoma, Lymphoma, Leukemias, and Myelomas

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Pathophys - Malignant tumor (neoplasm) - Carcinoma

A malignant tumor originating in epithelial tissues (skin, stomach, colon, breast, rectum)
Carcinoma in situ is premalignant that has not invaded the basement membrane

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Pathophys - Malignant tumor (neoplasm) - Sarcoma

A malignant tumor originating in the connective and mesodermal tissues (muscle, bone, fat)

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Pathophys - Malignant tumor (neoplasm) - Lymphoma

affecting lymphatic system (hodgkins, lymphatic leukemia)

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Pathophys - Malignant tumor (neoplasm) - Leukemias and Myelomas

affecting blood and blood forming organs

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Pathophys - Metastasis

Movement of cancer cells from one body part to another

Spread is via lymphatic system or bloodstream

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Cancer staging describes what

Describes the extent or severity of a person’s cancer

Based on primary tumor (T), Regional lymph node involvement (N), and Metastasis (M)

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Cancer staging - Stage 0

Carcinoma in situ

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Cancer staging - Stage 1

Tumor is localized, equal to or less than 2 cm

Has not spread to lymph nodes

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Cancer staging - Stage 2

Tumor is locally more advanced

2cm to 5cm with or without lymph node involvement

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Cancer staging - Stage 3

Tumor is locally more advanced
Spread to lymph nodes
Designated type 2 vs. 3 depending on cancer type

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Cancer staging - Stage 4

tumor has metastasized

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Cancer grades - Grade 1

Low grade

CA cells resemble normal cells (well differentiated) and are slow growing

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Cancer grades - Grade 2

Intermediate grade

CA cells look more abnormal (moderately differentiated) and are slightly faster growing

Cancer grades - Grade 3

High grade
CA cells are abnormal (poorly differentiated)
Grow or spread more aggressively

Cancer grades - Grade 4

High grade

CA cells are abnormal (undifferentiated)

RED FLAGS - with radiation therapy can see

pain, fatigue, radiation sickness, immunosuppression, fibrosis, burns, delayed wound healing, edema, hair loss, CNS effects

RED FLAGS - with chemotherapy can see

Fatigue, GI symptoms, bone marrow suppression, fatigue, skin rashes, neuropathies, phlebitis, hair loss

RED FLAGS - with immunotherapy can see

fatigue, weight loss, flu symptoms, n/v, anorexia, fluid retention

RED FLAGS - with hormonal therapy can see

GI symptoms, hypertension, steroid induced diabetes and myopathy, weight gain, hot flashes, sweating, altered mental status, impotence

Pain - CA pain syndrome

CA related pain is a common experience Sympathetic signs might accompany Pain at site distal to initial tumor site might be sign of metastasis Iatrogenic pain can occur from surgery, radiation or chemo

CA related fatigue (CRF)

Most common symptom reported by pt with CA | Need to assess QOL!

RED FLAGS - lung, breast, prostate, thyroid and lymphatic commonly metastasize where

to bone | Pathological fractures, pain, mm spasms may result

RED FLAGS - paraneoplastic syndrome

s/s produced at site distal to initial tumor site or metastasized tumor sites, from ectopic hormone production by tumor cells or metabolic abnormalities from secretion of tumor vasoactive products

RED FLAGS - adverse effects of CA tx

Need to monitor vitals cont. Mm atrophy and weakness ROM deficits Hematological disruption - dec WBC, platelet suppression, RBC suppression

RED FLAGS - PT for those with significant bony metastases, OP, or low platelet counts (below 20,000)

AROM and ADL exercise ONLY! WB may be restricted High risk vertebral compression and other fractures

Contraindications to exercise

Day of IV chemotherapy or within 24 hrs of tx Severe reaction to radiation therapy Acute infection or fever Sever n/v or diarrhea within 24-36 hrs Unusual or extreme fatigue, recent bone pain Chest pain, vitals

Postmasectomy focus is on

restoration of pain free full ROM of shoulder, prevention/reduction of edema, restoration of function Early postoperative exercise is stressed

Post bone marrow transplant focus is on

restoration of function, overcoming effects of deconditioning Experience prolonged hspitalization and inactivity - avg is 30 days

RED FLAGS - exercise is contraindicated for patients with what platelet count

20,000 or less! | Use caution when 20,000 - 50,000

RED FLAGS - physical agents - Thermal agents

Do not use directly over tumor Do not use over dyvascular tissue (tissue exposed to radiation) Do not use with those with dec sensitivity to temp or pain Do not use in areas of inc bleeding Do not use with acute injury, inflammation, open wounds

Normal platelet count

150,000 - 450,000

WBC norm

4,800 - 10,800

WBC - when no exercise

less than 1,000

Hemoglobin norm (F and M)

F - 12-16 | M - 13-18

Hemoglobin - when no exercise

less than 8

Hematocrit norm - F and M

F - 37-48% | M - 45-52%

Hematocrit - when no exercise

less than 25%

RED FLAGS - thermal agents - Cryotherapy

Do not use with pt wth insensitivity to cold or delayed wound healing Do not use over dysvascular tissue

RED FLAGS - thermal agents - Hydrotherapy with agitation

Do not use of dyvascular tissue Do not use with those that have dec sensitivity Do not use with those at inc bleeding risk Risk of cross infection is high with immunosuppressed individuals