Cancer Assessment and Targeted Therapy Flashcards
Mutated cells become tumors only when they establish the ability to
• self-replicate and grow.
The amount of damage in the cell is related to
• the dose of radiation it receives.
Some of the other cancers most strongly linked to radiation exposure in studies include:
- Lung cancer
- Skin cancer
- Thyroid cancer
- Multiple myeloma
- Breast cancer
- Stomach cancer
Ultraviolet radiation is associated with _____ and _____ and _____ cell carcinoma.
• melanoma and squamous and basal cell carcinoma
Progression of cancer is characterized by
- Increased growth rate of tumor
- Invasiveness
- Metastasis
What is Tumor angiogenesis?
• Formation of blood vessels w/in the tumor
Tumor cells must create an environment conducive to
• growth and development.
Endoderm cells differentiate into
- Trachea
- Lungs
- Epithelium
Mesoderm cells differentiate into
- Muscles
- Bones
- Connective tissue
Ectoderm cells differentiate into
- Brain
- Skin
- Glands
Carcinomas originate from
- Embryonal ectoderm (skin, glands)
- Endoderm (mucous membrane of respiratory tract, GI and GU tracts)
Sarcomas originate from
• Embryonal mesoderm (connective tissue, muscle, bone, and fat)
Lymphomas and leukemias originate from
• Hematopoietic system
What is an indicator that a cancer has a poor prognosis and is harder to treat?
- If the cancer cells are very abnormal and poorly differentiated or
- If the cancer cells are immature and primitive and undifferentiated
Extent of cancer is based on what 3 parameters?
- Tumor size and invasiveness (T)
- Spread to lymph nodes (N)
- Metastasis (M)
Explain the 5 grades of the TNM staging system
- 0 = Cancer in situ
- 1 = Tumor limited to tissue of origin; localized tumor growth
- 2 = Limited local spread
- 3 = Extensive local and regional spread
- 4 = Metastasis
What are the seven warning signs of cancer?
- C.A.U.T.I.O.N.
- C hange in bowel or bladder habits
- A sore throat that does not heal
- U nusual bleeding or discharge from any part of the body
- T hickening or a lump in the breast or elsewhere
- I ndigestion or difficulty in swallowing
- O bvious change in a wart or mole
- N agging cough or hoarseness
What are the two critical assessments while taking an H&H that help in the dx of cancer?
- Identification of risk factors
- Physical examination
Specific diagnostic studies depend on…
• The site of cancer
Biopsy tissue may be obtained by
- Needle or aspiration
- Incisional procedure
- Excisional procedure
An “ABCDE” method is used to help identify moles or skin growths as potential Melanoma. Explain each.
- A is for asymmetrical shape.
- Look for moles with irregular shapes, such as two very different-looking halves.
- B is for irregular border.
- Look for moles with irregular, notched or scalloped borders
- C is for changes in color.
- Look for growths that have many colors or an uneven distribution of color.
- D is for diameter.
- Look for new growth in a mole larger than 1/4 inch (about 6 millimeters).
- E is for evolving.
- Look for changes over time, such as a mole that grows in size or that changes color or shape.
True or False
Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding
• True
What are some commonly used diagnostic studies used to help dx cancer?
- Tissue biopsy (most common and definitive)
- Cytology studies
- CBC, chemistry profile, LFTs
- Endoscopic examination
- Radiographic studies (X-Ray, CT, MRI)
- PET Scan (w/ tracer)
- Tumor markers
- Genetic marker
True or False
CTs require the use of contrast dye.
• False, some do, some don’t
Cancer treatment is aimed at…
- Cure
- Control
- Palliation (when there is no response to treatment)
What are the main factors that determine treatment for cancer?
- Cell type
- Location and size
- Extent of disease
- Physiological & Psychological status
- Patient’s desires
What is the goal of palliation therapy when cancer is non-responsive to treatment?
- Relief or control of symptoms
- Maintained quality of life
What are good prognostic indicators regarding tumor removal?
- Good prognostic indicators include
- Small tumor size
- Clean tissue margins
- Absence of lymph node involvement and abnormal tumor marker values
When may “De-bulking” procedures be used?
• If the tumor cannot be completely removed.
Which is more targeted: radiation or chemotherapy?
• Radiation
What is the benefit of stereotactic radiotherapy?
• Highly precise, targeted radiotherapy, accurate to within 1-2mm
When palliative care is necessitated, outside of making the patient comfortable, what supportive care may be required (pending type of cancer)?
- Insertion of gastric feeding tube
- Creation of a colostomy
- Suprapubic cystostomy
- Placement of venous access device
- Removal of metastatic liver lesions
What is the goal of rehabilitative care in cancer treatment?
• Help the patient cope w/ the outcomes of treatment
Why is helping the patient cope with cancer tx necessary?
- Patients are often left with functional deficits, disfiguration of the body with colostomy, ileostomy, mastectomy, scars form surgical procedures, and the nurse will need to help them cope with the loss of self.
- It can lead to breakdown in relationships
- They may end up with neurological dysfunction and weakness of limbs for example which will require months of rehabilitation and physiotherapy
