Cellular Regulation: Cancer

Question 1

Stage 0

Answer 1

• Carcinoma in situ

Question 2

Stage 1

Answer 2

Early stage
- Tumor is 2 cm or less; no cancer cells outside of the breast

Question 3

Stage IIA

Answer 3

• 2 cm or less and spread to underarm lymph nodes or tumor size is between 2-5 cm

Question 4

Stage IIB

Answer 4

• 2 to 5cm and cancer has spread to underarm lymph and is 5cm

Question 5

Stage III

Answer 5

• Locally advanced cancer ( 5cm, 3 lymph nodes )

Question 6

Stage IV

Answer 6

• Distant metastatic cancer
• Bone, liver

Question 7

Leukemias and Lymphomas

Answer 7

• Within bone marrow that causes an increase production of immature WBC’s
• Goal: Eliminate all leukemic cells
• Occurs most in children

Question 8

AML

Answer 8

• Most common leukemia in adults; prognosis is poor

Question 9

CLL

Answer 9

• Most cases involve people older than 50
• Most common adult leukemia

Question 10

CML

Answer 10

• Most prevelent after age 50

Question 11

Hodgkins Disease

Answer 11

• Peaks in two age groups; teens and young adults in 50’s
• Viral infection cause and exposure to chemical agents

Question 12

Non-Hodgkins

Answer 12

• More common in males

Question 13

Risk Factors for CRC

Answer 13

• African
• IBC
• Excess body weight
• Smoking
• Diet
• Alchohol
• Meds

Question 14

CRC Presentation

Answer 14

• Changes in bowels
• Blood in stool
• Bleeding
• Anemia

Question 15

CRC Diagnostic tools

Answer 15

• Fecal occult testing
• Stool dna
• CEA levels
• Colonoscopy

Question 16

CRC Treatment

Answer 16

• Colectomy
• Abdominal perineal resection

Question 17

Education for CRC

Answer 17

• Preoperative Diet : Clear liquids
• Complete bowel prep
• Post : Assess stoma should be reddish pink, moist, small amount of blood, report ischemia, necrosis, frank bleeding

Question 18

Pancreatic Cancer

Answer 18

• Vague manifestations
• Diagnosed in late stages
• Adencarcinoma

Question 19

Pancreatic Cancer Risks

Answer 19

• Smoking
• African
• DM, Cirrhosis
• Family history
• Increased body weight
• Alchohol

Question 20

Pancreatic Cancer Presentation

Answer 20

• Jaundice
• Skin itching
• Dark urine
• Anorexia
• N/V

Question 21

Pancreatic Cancer Treatment

Answer 21

• Partial or full pancreartecromy
  -Whipple: Removal of head of pancreas, duodenum, parts of jejunum, and stomach, gallbladder and spleen
• Last resort

Question 22

Cytotoxic Systemic Therapy

Answer 22

• Can be used alone, before or after treatment or in combination
• Kills cancer cells and normal cells
• Places pt at high risk for infection, immunosuppression

Question 23

Neoadjuvant Therapy

Answer 23

• Used to shrink tumor before surgery and radiation

Question 24

Anticancer Drugs

Answer 24

Antimetabolites: Interfere with the biosynthesis of metabolites or NA necessary for RNA and DNA synthesis
Treats bone marrow and GI Cancers
Risk for neutropenia

Antitumor or antibiotics: Damage cell DNA and interrupt DNA and prevent RNA synthesis
Lifetime max for these meds
Cardiac and pulmonary toxicity

Antimitotics: Arrest metaphase by inhibiting mitotic tubular formation and inhibiting DNA and protein synthesis
May cause peripheral neuropathy
Severe constipation

Alkylating Agents: Cross link DNA, making DNA strands bind closely together, prevents proper dna and rna synthesis
May cause peripheral neuropathy
Renal failure
Severe N/V

Topoisomerase I Inhibitors: Induce breaks in DNA strand by binding to enzyme Topoisomerase, preventing cells from dividing.
Significant diarrhea

Question 25

Gonadotropin Releasing Hormone ( Leuprolide, Triptorelin, Goserelin )

Answer 25

- Suppress production of androgens by testes by acting on the pit gland to cause release of LH over time this results in decreased testosterone - Cotreatment with an androgen receptor blocker for prostate cancer - Hot flahses, ED, loss of libido, gynecomastia, reduced muscle mass, MI, stroke

Question 26

Androgen Receptor Blockers ( Flutamide )

Answer 26

- Works with GNRH to suppress the production of testes altogether. Prevent binding of testosterone to prostate cancer cells. - For prostate cancer - Liver toxic, gynecomastia, decreased libido, impotence - Interacts with warfarin = increased risk of bleeding

Question 27

Monoclonal Antibodies ( Trastuzamab )

Answer 27

- MOABS to destroy the cancer cells and spare normal cells - HER2-positive breast cancer and gastric - Binds with epidermal growth factor HER2 to reduce the growth of cancer cells - Bronchospasm, hypotension, uriticaria, chills, fever, flu, heart failure

Question 28

Aromatase Inhibitors ( Anastrozole = Arimidex, Letrozole = Femara, Exemestane = Aromasin )

Answer 28

- ER- positive breast cancer in postmenopausal women - Deprive breast cancer cells of estrogen they need to grow - *MSK pain, asthenia, HA, osteoporosis

Question 29

Targeted Antineoplastic Drugs ( Imantinib = Gleevac )

Answer 29

- Intracellulary block tyrosine kinase for cell growth. - For CML, ALL, Rare metastic GI tumors - Adverse: Rash, diarrhea, N/V, MSK pain, cramping, pulm edema - No grapefruit juice

Question 30

Bevacizumab

Answer 30

- For metastatic colorectal cancer - Nose bleeds `

Question 31

Neoplasia

Answer 31

Any new or continued cell growth not needed for normal development or replacement

Question 32

Benign

Answer 32

-Normal cells growing in the wrong place or at the wrong time -Moles, uterine fibroid tumors, skin tags, endomrtriosis, nasal polyps

Question 33

Common cancer in Females

Answer 33

- Breast , Lung, colorectal, uterine , melanoma

Question 34

Common cancer in Males

Answer 34

- Prostate, lung, colorectal, bladder, melanoma

Question 35

Risks for Cancer

Answer 35

- Smoking - Alchohol - Excessive body weight - Sedentary lifestyle - Dietary habits - Viruses