Cancer Screening Flashcards
_______ and ________ are the two biggest red flags for cancer
advancing age and previous history of cancer
inadequate surgical margin, skip metastases, tumor thrombus, and lymph node metastasis all could cause _______
cancer recurrence
survivors of childhood cancers are at higher risks for ________
secondary cancer, organ dysfunction, reduced growth/development, decreased fertility, early death.
________ involves regular screening for early detection of cancer and the prevention of progression of known premalignant lesions
secondary prevention
_______ is a method for detecting disease or body dysfunction before an individual would normally seek medical care
Screening
__% of cancers can be linked to environmental factors
80-90%
include: age over 50, ethnicity, family history (1st gen), environment/lifestyle factors
incidence of cancer _____ after 25 years of age and increases every __ years until mid 80’s
doubles; 5 years
______ ethnicity has a 10% increase rate of cancer
African American
______ is the primary cause of cervical cancer
HPV
reactions from carcinogens from occupations or environment can lay dormant up to __ years
30
Leading cause of skin cancer is _______
UV rays and tanning beds
_______ is the development of molecular signatures for the effects of specific hazardous chemical agents
toxicogenomics - defects may occur in one or more genes
______ is a malignant tumor that comprises epithelial tissue and accounts for 85% of all cancers affecting the skin, large intestine, stomach, breast, lungs.
carcinoma - they spread by invading local tissues and by metastasis
_______ is a fleshy growth and refers to a large variety of tumors arising in the connective tissue
Sarcoma - affects bone, cartilage, muscle, fibrous tissue, fat, and synovium
Neoplasms are divided into 3 categories: ____, _____, ______
benign, invasive, and metastatic
-metastatic can spread as late as 15-20 years after initial diagnosis. Most early metastasis die in transit. patterns of blood flow, regional venous drainage, and lymphatic channels determine the distribution of most metastasis
Besides metastasis, cancer can also be transported through _______
mechanical transport - likely through lymph or circulatory
5 most common sites of cancer metastasis are bone, lymph nodes, lung, liver, brain and affect which systems?
integumentary, pulmonary, neurologic, MS, hepatic
early warning signs of malignancy are ______
rapid unintended weight loss, unusual vitals, bleeding from ulcerations, lumps, lesions, enlarged lymph nodes (T), proximal muscle weakness (may be secondary to hypercalcemia), night pain
What type of reflexes can indicate malignancy?
hyperreflexive or hyporeflexive (if large tumor completely blocks)
metastases to the skin often come directly from ______ or ______
breast cancer or upper respiratory tract cancer
skin cancers are the most common types of cancer and are usually classified as ________
non-melanoma (further classified as basal cell or squamous cell)
- most common cause is UV rays or tanning bed.
- is increased risk after solid organ transplantation and tend to be more aggressive
ABCD
A-asymmetry
B-border irregularity
C-color variegation
D-diameter of 6 mm >
______ involves bottom layer of epidermis and occurs in hair areas with slow growing lesions in sun exposed areas
Basal cell carcinoma
-present pearly papule with small crater, scaly, red, outlined plaque, scar-like tumor, tough
_______ involves the top epidermis on areas exposed to skin appeaing as small, red, hard nodules with smooth or warty surface
Squamous cell carcinoma
-metastasis uncommon
______ is the most serious form of skin cancer and can appear anywhere on body with asymmetric, irregular shape
Malignant Melanoma
-early symptoms are ABCDE
________ are the most common of all metastatic tumors
pulmonary
- because vena cava goes everywhere. pleural pain and dyspnea are two most common symptoms.
- lung cancer is the most common cancer to metastasize to brain causing neuro symptoms
S/S of brain tumor
- can be asymptomatic
- extremity weakness, ataxia, HA, personality change, seizures, papillary edema
- if compressing SC, it will present as SCI
S/S of LBP, sciatica, saddle anesthesia, bowel/bladder changes, LE weakness, sexual dysfunction, decreased rectal tone, decreased perineal reflexes, diminished LE reflexes all suggest ______
Cauda Equina Syndrome
when tumors produce S/S at distance from tumor as remote effects, its called _______ and can be first sign of malignancy
paraneoplastic syndromes
- common ones are to brain, endocrine/fluid/electrolyte abnormalities, CNS
- often is implicated with immune issues such as Rheumatic disorders (common from breast or lung cancers)
Tumor cells commonly metastasize to which parts of bone?
- marrow of axial skeleton, proximal ends of long bones, pelvis, ribs
- bone pain is usually deep, intractable, poorly localized described as burning or aching
- worse at night unrelieved by change in position, reproduced b heel strike
- back pain may be result of vertebral metastasis
______ metastasis are among the most ominous signs of advanced cancer because it filters blood from stomach, colon, pancreas
Liver
- may see bilateral CTS
- may also see asterixis
mild-to-moderate superficial pain is ________ response whereas severe/visceral pain is _________
- sympathetic
- parasympathetic
Why is bone pain so bad with cancer?
-the pain threshold is reduced through sensitization of free nerve endings. there is a more rich supply of nerves and tension or pressure on the sensitive periosteum or endosteum.
5 causes of cancer pain are:
- bone destruction
- visceral obstruction
- nerve compression
- skin/tissue distention
- tissue inflammation/infection/necrosis
What are some common S/E of cancer treatment?
-bone marrow suppression, leukopenia, anemia, fatigue, cardiopulmonary dysfunction, radiation recall, bone demineralization
_______ is often used to describe mental fogginess experience by some people during the course of chemotherapy
chemobrain
Persistent swelling or lump in muscle, pain, pathologic fracture, local swelling, and warmth overlying skin suggests _________
soft tissue sarcoma
-relatively rare. in kids. often goes unnoticed until some other injury
Pain/swelling in body part, loss of motion, tender lump, pathologic fracture, occasional weight loss, malaise, fatigue suggest ______
osteosarcoma
- ages 10-25
- 80-90% in long bones
Increasing pain/swelling decreasing in movement, fever, fatigue, weight loss, bowel/bladder disturbance suggest _________
Ewing Sarcoma
-ages 5-16
Palpable mass, back/pelvis/thigh pain, sciatica, bladder symptoms, unilateral edema suggest _______
chondrosarcoma
- most common malignant cartilage tumor, older 40
- usually slow-growing
bone pain worse at night, pain relieved by aspirin, warmth and tenderness over involved site suggest _______
Osteoid Osteoma
-50% in femur
increased intracranial pressure, HA, vomiting, visual changes, mentation, personality change, drowsy, weakness, bladder dysfunction, hyperreflexia, ataxia, positive Babinski, clonus, vertigo all suggest ______
brain tumor
- more likely over 40
- 80% intracranially
Infection, fever, abnormal bleeding, easy bruising or petechie, epistaxis, hematuria, rectal bledding, weakness, fatigue, enlarged lymph nodes, bone/joint pain, weight loss, loss of appetite, splenomegaly all suggest ________
Leukemia
-develops in bone marrow with abnormal multiplication of WBCs
recurrent bacterial infections, anemia with weakness/fatigue, bleeding tendencies, bone paion, spontaneous fracture, osteoporosis, hypercalcemia, kidney stones, renal insufficiency, CTS, back pain with radicular symptoms, SC compression suggest _________
multiple myeloma
- 50-70 years
- bone disease is the most common complication; drainage of Calcium and Phosphorus from damaged bones eventually lead to renal stones
Painless enlarged lymph nodes, pruritus, fever, night sweats, anorexia, weight loss, anemia, fatigue, malaise, jaundice, edema, nonproductive ough, dyspnea, chest pain, nerve root pain, paraplegia, cyanosis suggest ________
Hodgkin’s Disease
- is a chronic, progressive, neoplastic disorder of lymphatic tissue with unknown mechanism
- any change in size, shape, tenderness, consistency is a red flag
- obstruction of bile ducts as result of liver damage causes bilirubin to accumulate
Enlarged lymph nodes, fever, night sweats, weight loss, bleeding, infection, red skin suggest __________
Non-Hodgkin’s Lymphoma
- 40-60 years
- HIV increases risk
Painless enlarged mass, subcutaneous nodules, constitutional symptoms (fever, night sweats, weight loss), MS lesions (lytic bone, pain, swelling) suggest ________
AIDS-NHL
-95% of all HIV-associated malignancy are NHL or Kaposi’s sarcoma
Immediate Referral if…
- recent lumps/nodules found
- palpable mass in breast
- recurrent cancer
- suspicious node changes
- idiopathic weakness w/ DTR changes
- unexplained breathing
- sign of metastasis
- man w/ pelvic, groin, SI, LBP w/ sciatic and Hx of prostate cancer
clues to cancer screening
long slide
- older than 50, Hx of cancer
- woman w/ chest, breast, axillary, shoulder pain of unknown origin
- back, pelvic, groin, hip pain w/ mass
- prolonged or excessive menstrual bleeding
- recent weight loss, MS symptoms better by eating/drinking, reproducible by heel strike, constant pain, intense pain at night
- disproportionate relief from aspirin, growing mass, changes in node variation.
Cancer Red Flags
- pain on WB unrelieved by rest of position, no response to treatment, unremitting night pain, history of cancer
- also skin changes, any masses, node changes.
