cancer presentations Flashcards
manifestations skin cancer
A is for asymmetry. One-half of a mole does not have the same shape as the other half.
B is for border. The edge of a mole is uneven (irregular). It can look jagged, notched or blurry. The colour may spread into the area around the mole.
C is for colour. The colour of a mole is not the same throughout. It could have shades of tan, brown and black. Sometimes areas of blue, grey, red, pink or white are also seen.
D is for diameter. The size of a mole is larger than 6mm across, which is about the size of a pencil eraser.
E is for evolving. There is a change in the colour, size, shape or feel of the mole. The mole may become itchy or you may have a burning or tingling feeling.
Risk factors and carcinogens
skin cancer
Non-modifiable:
- Immunocompromised
- Hx: melanomas, fair skin, freckling and light hair, many moles
- Older age, male gender
- Previously had melanoma
- Have squamous cell skin cancers
Modifiable:
- UV (sun, mercury vapor lamps, tanning lamps, black lights)
- Outdoor and indoor tanning
- Not using sunscreen -Occupational/environmental exposure
Recommen-dations for screening skin cancer
Recommended to inspect skin q month - Schedule a yearly verification with Dr for full body examination - Major features (2 points each): - Change in size - Uneven (irregular) colour - Uneven shape - Minor features (1 point each): ●more than 7mm in diameter ●changes in feeling, such as itchiness, tenderness or pain ●oozing or crusting ●inflammation or bleeding
●Sunscreen over entire body
30 min before going outside; Every 2 hours; After swimming/excessive sweating
Avoid overexposure to the sun:
- Wear wide-brimmed hats and long sleeve and pants with proper sunglasses
- Avoid tanning under the direct sun at midday (10-11 am to 4pm) or seek shade
- Avoid tanning parlors or tanning pills
- Inform if pt is taking medications that makes the skin more sensitive (ex. Cordarone, NSAIDS, the tetracycline family)
herbal remedies skin cancer
curcumin; bilberry, ginkgo, milk thistle, ginger, and hawthorn; green teas
EARLY Manifestations - No manifestations - Persistent cough (+/- sputum) - Pneumonitis Fever Chills Cough Dyspnea Wheezing - Chest pain (localized or unilateral, mild or severe)
LATE Manifestations
- Nonspecific: anorexia, fatigue, weight loss, No/Vo
- Metastasis = symptoms
- Blood tinged sputum, hemoptysis = bleeding malignancies
- Hoarseness = recurrent laryngeal nerve
- Palpable lymph nodes at neck and axilla
- Unilateral paralysis of diaphragm, dysphagia, superior vena cava obstruction = intrathoracic region
- Pericardial effusion, cardiac tamponade, dysrhythmias = mediastinal region
lung cancer
MODIFIABLE RISK FACTORS
- Smoking (cigarette, smoking, cigars, pipe)
- Second hand smoke
- Radon
- Workplace chemicals: asbestos, arsenic, diesel exhaust, silica, chromium, nickel, iron, iron oxides, uranium, polycyclic aromatic hydrocarbons, chromates, arsenic, beryllium, cadmium, vinyl chloride, coal products, mustard gas, chloromethyl ethers
- Radiation therapy
- Beta-carotene supplement
NON-MODIFIABLE RISK FACTORS
- Having undergone radiation therapy
- Air pollution (heavy traffic areas)
- Hx lung cancer
- Family Hx lung cancer
- Single nucleotide polymorphisms
PROBABLE RISK FACTORS
- Different genetic carcinogen metabolizing pathways
- Genetics (strong family hx)
- Smoking marujuana
- E-cigarettes
- Talc and talcum powder
- Poor diet, alcohol consumption
- Estrogen
- HPV, HIV, Epstein Barr virus
lung cancer
risk factor colorectal cancer
- Age: >50, the risk increases with age
- Gender: men are more at a risk
- Family cancer history (specifically colon cancer)
- Personal Hx of ovarian, endometrial or breast cancer: genes
- Colorectal polyps
Inflammatory Bowel Disease (IBD): damaged mucosa lining of intestinal tract causing inflammation, can develop dysplasia after many years, which can turn cancerous. - Smoking: tobacco increases the risk
Poor diet: A diet that’s high in red meats (such as beef, pork, lamb, or liver) and processed meats (like hot dogs and some luncheon meats), cooking meats at very high temperatures (frying, broiling, or grilling) creates chemicals that might raise your cancer risk, so does smoking them or BBQ with flames that create smoke - High fat: increases production of acid, irritant and can cause inflammation→ carcinogenic
- Fiber: evidences showed that fiber protects us against colorectal cancer
- Excessive alcohol: the ethanol in alcohol is a carcinogen, no more than 2 drinks a day for men and 1 drink a day for women
- Sedentary lifestyle: exercise can lower the risk
- Obesity or high BMI (overweight)
screening colorectal cancer
- Digital rectal examination is the most important aspect the physical examination
- Guaiac-based fecal occult blood test (gFOBT)→ find traces of blood in the stool.
- Fecal test (FIT) uses antibodies to detect human hemoglobin protein in stool.
Right/Left hemicolectomy
•Abdominal-perineal resection
•Laparoscopic colectomy
Postoperative Care
•Sterile dressing changes; assess drainage for amount, color, and consistency
•Examine wound regularly and record bleeding, excessive drainage and unusual odour
•Patient and caregiver teaching on stoma
•Negative pressure therapy to enhance wound healing
colorectal Sx
Echinacea or coneflower; ginseng; ginkgo; elderberry; st John’s Wort; Turmeric; Ginger; Valerian, Chamomile: In relation to cancer, herbal remedies are often used to manage, reduce, and minimize side effects of chemotherapy and radiation therapy (nausea and pain)
colorectal cancer
female reproductive risk factors
NON-MODIFIABLE RISK FACTOR - Age - Weakened immune system - History of cervical, vulvar, and anal cancer Diethylstilbestrol (DES) - Late menopause/early menarche - Family history of female genital cancer - Increased number of ovulatory cycles - Estrogen
MODIFIABLE RISK FACTOR
- Smoking
- Human Papillomavirus
- Multiple sexual partner/ no use of protection
- Nulliparity
- Obesity
- Oral contraceptive
- Previous Radiation therapy
- Diabetes Mellitus
screening female reproductive
General
- Physical examination
- Past medical history
- Laboratory tests
- Imaging procedures
- Genetic tests
Ovarian Cancer
- Abdominal & Transvaginal Ultrasound (TUV)
- DNA testing
- CA-125 Levels
- Laparotomy (Dx staging)
- Pelvic examination
Uterine Cancer
- Endometrial biopsy
- Transvaginal ultrasound
- CA-125 levels
cannabis and cancer
Cannabis is a plant grow in many parts of the world. It makes a resin than contains compounds called cannabinoids.
THC vs CBD
Cannabis can be taken by mouth (tablets, spray under the tongue), inhaled, topical oils.
Cannabinoids may help treat the side effects of cancer and cancer treatment.
- Nausea and vomiting caused by cancer or cancer treatment
- Increase appetite
- Decrease anxiety
- Relieve pain.
Side effects of cannabis
- Fast heartbeat.
- Low blood pressure.
- Muscle relaxation.
- Bloodshot eyes.
- Slowed digestion.
- Dizziness.
- Drowsiness.
- Depression.
- Hallucinations.
- Paranoia
- Symptoms of withdrawal from cannabinoids
- Lung cancer
clinical manifestations prostate cancer
- Pain in the lumbosacral region that radiates downward
- Dysuria
- Hesitancy
- “Dribbling”
- Increased frequency
- Feelings of urgency
- Hematuria
- Nocturia
- Retention
- Interruption of stream
- ** Similar to BPH
- Primary screening tool is digital rectal examination (DRE); may feel hard, nodular and asymmetrical.
- Biopsy if DRE is abnormal and is done using TRUS (transrectal ultrasonography)
- Elevated levels of prostatic acid phosphatase (PAP)
- Prostate cancer associated 3 gene found in urine.
- CT, MRI, bone scan
Recommendation - Prostate-specific antigen (PSA) blood test is no longer recommended as it may not indicate prostate cancer.
- Men should talk to primary HCP about their potential risk of developing prostate cancer.
prostate cancer screening
