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Med Conditions II > Cancer Overview > Flashcards

Cancer Overview Flashcards

1
Q

What is cancer?

A
  • Abnormal cell division and growth (neoplasia)

- Malignant as opposed to benign

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2
Q

How is cancer named?

A

Often named for the organ or cell type
E.g.: Organ  colon CA; pancreatic CA; lung CA; breast CA
Cell type  basal cell CA

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3
Q

Define the word “benign”

A

Slow growth, non-invasive, no metastasis

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4
Q

Define the word “malignant”

A

Rapid growth, invasive, potential for metastasis

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5
Q

What is the function of Proto-oncogenes & oncogenes?

A

Inhibit cell death and apoptosis (Not surprisingly, these genes are expressed in high levels in tumor cells)

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6
Q

What is the function of Anti-oncogenes/ tumor suppressors?

A
  • Inhibit cell proliferation & growth
  • Halts cell division if DNA damaged
    • Allows DNA to be repaired if damage or mutation is minor;
    • If damage is significant, triggers apoptosis
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7
Q

What factors influence carcinogenesis?

A

Environmental Factors
Chemicals (e.g.: asbestos) & radiation exposure
Lifestyle and habits (food choices; smoking; alcohol)

Genetics (family history)
Breast, colon, ovarian, prostate

Virus exposure

Most cancers are believed to be due to a combination of these factors.
Virus + genetics + environment

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8
Q

What are the six hallmarks of cancer?

A
  1. Self-sufficient growth signals
  2. Resistance to anti-growth signals
  3. Immortality
  4. Resistance to cell death
  5. Sustained angiogenesis
  6. Invasion and metastasis
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9
Q

Define “primary” cancer

A

Neoplasia of a specific tissue

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10
Q

Define “secondary” cancer

A

Cancer cells from another tissue that have metastasized to a different location

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11
Q

Define “in situ” cancer

A

Glandular or squamous cells

Remain within the basement membrane

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12
Q

What three factors determine the “TNM” stage?

A

T - Tumor size
N - Spread to regional lymph nodes
M - Presence of distant metastasis

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13
Q

Define the different ‘T’ scales of the “TNM” staging system

A

Tx=Tumor cannot be evaluated
T0=No evidence of primary tumor
T1-4=Increasing size of tumor

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14
Q

Define the different ‘N’ scales of the “TNM” staging system

A

Nx=Lymph node cannnot be evaluated
N0=No lymph node involvement
N1-3= Increasing involvement of regional lymph nodes

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15
Q

Define the different ‘M’ scales of the “TNM” staging system

A 
M0 = No distant metastasis
M1 = Distant metastasis
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16
Q

What procedures are used to diagnose cancer?

A

Blood Values (Cancer Markers )
Imaging (Radiographs, CT Scan, MRI, PET Scan)
Biopsy

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17
Q

Name some cancer-specific antigens

A

PSA- prostate specific antigen
CCSA 3 & 4- Colon Cancer Specific Antigen
CEA- Carcinoembryonic Antigen
CA 125

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18
Q

What is a PET scan?

A

Nuclear medicine imaging technology. A radioactive tracer is used to assess metabolic activity. Assesses glucose uptake prior to radioactive decay

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19
Q

What are common medical interventions for cancer?

A 
Removing “precancerous” lesion
Debulking tumor
Correction of life-threatening condition caused by cancer
Fracture prevention
Palliation
Cure
Chemotherapy
Radiation therapy
Surgery
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20
Q

What is the primary effect of chemotherapy?

A

Killing cells that divide rapidly (high growth fractions) including normal cells
Non-selective – doesn’t distinguish b/w healthy (e.g.cells in the bone marrow, digestive tract and hair follicles) and diseased tissue

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21
Q

What are potential goals of chemotherapy and XRT?

A

Cure
Slow CA progression
Shrink tumor for palliation
Shrink tumor for surgical resection

22
Q

What are common side effects of chemotherapy?

A

Immunosuppression (infection risk)
Anemia (reduced O2 carrying capacity)
Thrombocytopenia (bleeding risk)

Organ damage
Nausea and Vomiting 
Alopecia (hair loss)
Diarrhea
Mucositis or mouth sores
Sterility
Neuropathies
23
Q

Name the motor symptoms of peripheral neuropathy

A

Sense of heaviness in legs
Tripping due to motor weakness of anterior tibialis
Difficulty holding or manipulating objects
Shaky handwriting

24
Q

Name the sensory symptoms of peripheral neuropathy

A

Sensation of pins/ needles
Cold extremities
Burning sensation
Sharp “electrical” shooting pain

25
Q

Name the autonomic symptoms of peripheral neuropathy

A

Orthostasis
Feeling flush
Tachycardia

26
Q

How does XRT work?

A

Damaging the DNA of exposed tissue (targeted to tumor, but non-selective in that normal tissue can also be damaged)

27
Q

What is Brachytherapy?

A

Internal radiotherapy (Radiation source w/in body)

Radiation sources (i.e.: radioactive “seeds”) are placed inside or next to area of treatment/ tumor

Localized & precise therapy for multiple cancer types: prostate; cervical; breast; skin; brain…etc

28
Q

What are common side effects of radiation therapy?

A 
Immunosuppression
Skin Changes
Gastrointestinal Changes
Fatigue
Avascular Necrosis (AVN)
Radiation Myelitis
29
Q

What is radiation myelitis?

A

Damage to small blood vessels in the spinal column resulting in loss of blood flow, necrosis and demyelination.
Time of onset is typically 4-12 months after the completion of radiation.
Sx: sensory dysfunction and motor weakness.

30
Q

What is the process for bone marrow transplant?

A

1) Bone marrow removed
2) Stem cells collected
3) Chemo destroys bone marrow
4) Stem cells stored
5) Stem cells returned to bloodstream

31
Q

Characteristics of Small Cell Lung CA

A

Faster growth rate, worse prognosis than non-small cell lung CA

32
Q

Common sx of colorectal CA

A

bleeding; pressure/ pain with defecation

33
Q

Risk factors for colorectal CA

A

Age; Family hx; diet; exercise

Ulcerative colitis/ Crohn’s Disease

34
Q

Describe pulmonary impairment following thoraco-abdominal surgery

A

Day 1
Abdominal surgery - 30% decrease in function
Thoracic surgery - 70% decrease

Gradually restored over ~8 days

35
Q

What is leukemia?

A

Leukemia is a malignant disease characterized by unregulated proliferation of one cell type (leukocyte cell line)

Abnormal growth crowds out normal cell lines in the bone marrow

36
Q

What is chronic leukemia/lymphoma/myeloma?

A

The onset is insidious, the disease is usually less aggressive, and the cells involved are usually more mature cells

37
Q

What is acute leukemia/lymphoma/myeloma?

A

The onset is usually rapid, the disease is very aggressive, and the cells involved are usually poorly differentiated with many blasts.

38
Q

Compare Hodgkin’s Lymphoma with NHL

A

Hodgkin’s Lymphoma:
Reed Sternberg Cell
Better “cure” rate

Both are disease of the lymphoid system

39
Q

What is myeloma?

A

Disease of the plasma cells of the immune system

Sx: pain, bruising, lytic lesions/ fracture

40
Q

What occurs in L/L/M as a result of bone marrow failure?

A

Overcrowding by abnormal cells
Inadequate production of normal bone marrow components
Anemia, thrombocytopenia, ↓ number and function of WBCs
Fatigue/pallor/ weight loss

41
Q

What complications can arise when leukemic cells infiltrate other organs?

A 
Splenomegaly
Hepatomegaly
Lymphadenopathy
Bone pain & pathologic fracture
Meningeal irritation
Oral lesions
42
Q

Exam questions for CV system review for a patient undergoing CA rehab?

A 
Primary disease?
Are there metastasis to these systems?
Effected by anti-neoplastic treatment?
Restricted pulmonary function due to bone lesion (e.g.:  rib fractures and vertebral collapse?)
Lymphedema
43
Q

CV physical exam for CA rehab?

A

Vital signs (resting & activty) - Response of vital signs to exercise; Impact of medications; Exercise stress tests/ submaximal tests/ endurance testing

Cough
Breathing Pattern
Breath Sounds
Performance Scales

44
Q

Exam questions for MSK system review for a patient undergoing CA rehab?

A

Tumor effecting stability of bone?
Weakness?
Steroids?
ROM deficits?

45
Q

Exam questions for NM system review for a patient undergoing CA rehab?

A 
Metastasis to brain? What part of the brain?
What is their comprehension?
Coordination deficits
“Chemo brain”
Metastasis to spinal column?
Motor and/or sensory impairment
46
Q

Exam questions for integumentary system review for a patient undergoing CA rehab?

A

Compromised from radiation or surgery?
Decreased lymphatic flow?
Poor nutrition?

47
Q

Exercise and CA - summary of the literature

A

Most reported significant benefits
No adverse events - safe!
Moderate exercise improves fatigue, anxiety, self-esteem, cardiovascular fitness, muscle strength and body composition

48
Q

Recommendations for aerobic conditioning for a patient undergoing CA rehab

A 
3-5x/wk
Intensity 60-80% HRreserve / RPE 11-14 (3-5)
20-30 minutes
Interval training program
    Lower cardiac stress 
    Lower RPE score
    30s/60s
49
Q

Recommendations for resistance training for a patient undergoing CA rehab

A

Low weight

High repetition

50
Q

Goals of exercise in a CA rehab program

A

improve activity level/ exercise capacity
influence ADL & work performance
Improve quality of life/ mental health

Med Conditions II (8 decks)

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