cellular regulation/cancer (final) Flashcards by presley vlazny

carcinogenesis

normal cells become mutated and continue to split into more cancerous cells

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benign

non cancerous, well differentiated, non invasive
doesnt spread

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malignant

cancerous, poorly differentiated, moveable, grow rapidly

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stages of cancer

initiation - mutation of cells
promotion - acceleration of growth
progression - metastasize occurs

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factors increasing cancer survival

early detection and treatment
stage/type/grade @ detection
pts overall health response

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most common cancers

breast
lung
prostate
colorectal

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most deadly cancer

lung cancer in both men and women

23% of cancer deaths

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cancer risk factors

exposure to carcinogens (chemicals, radiation, smoking, virus’)
behavior (lifestyle, diet, smoking, drugs)
genetics
age, sex, race
radiation

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breast cancer s/s

nipple discharge
breast dimpling
peau’d orange (orange peel texture of skin)
swelling
hard, nonmobile, nontender, irregularly shaped lumps in outer breast

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breast cancer risk factors

female over 50
family history
late menopause
hormone use
obesity
90Z% is non genetic
most lumps are benign

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breast cancer screening

mammogram @45-54)
MRI/ultrasound for high risk pt
monthly self exam @20
biopsy is diagnostic
ovary removal decreases risk

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breast cancer treatment

surgery is primary TX
radiation, drugs, hormones
tamofixen- report vision changes pt at risk for DVT , PE, CVA - no smoking

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breast cancer pts are at risk for

lymphedema

fluid build up - numbess, tingling, edema
can lead to cellulitis/fibrosis
LIMB ALERT - no BP/ injections, avoid compromised circulation

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lung cancer s/s

chronic cough
dyspnea
wheezing
bloody sputum
clinically silent (late s/s)

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lung cancer risk factors

smoking
exposure to radon/espestis/ 2nd hand smoke
family history
COPD- men at greater risk

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lung cancer screenings

biopsy to diagnose
CT
MRI
PET
thoracentisis
screen high risk pts with low dose CT scan (heavy smokers, current smokers, 30 packs/yr history)

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small cell carcinoma

20% of all cancers
very aggressive
most malignant
responds better to chemo

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non- small cell lung cancer

squamous cell carcinoma
adenocarcinoma - most common- can try surgery removal - does not respond well to chemo
large cell carcinoma

treatment of lung cancer

surgical resection
radiation
chemo
targeted/immunotherapy
teach about chronic/constant pain

prevention of lung cancer

focus on prevention of TEEN SMOKING
quitting smoking
limiting environmental exposure

colorectal cancer s/s

iron deficiency anemia
rectal bleeding
abd. pain
change in bowels
palpable mass
ascites
hepatomegaly
tenderness

complications of colorectal cancer

bleeding
perforation
fistula
peritonitis

RIGHT SIDE: IDA, diarrhea
LEFT SIDE: bowel obstruction

colorectal cancer risk factors

family history
men
high mortality in blacks
diet (low fiber, high red/processed)
smoking
IBD

colorectal cancer screenings

@45-75 yrs old
colonoscopy q10 yrs for high risk
biopsy w/ colonoscopy
abd CT/ MRI
occult blood
CEA for reoccurence

only cure for colorectal cancer

surgery is the only cure pt may need colostomy, NSAIDS may decrease incidence

skin cancer

non- melanoma (keratosis, basal, squamous) melanoma (aggressive) - lower legs of women, trunk/head of men

precancerous skin

actinic keratosis (may resolve if sunlight exposure decreased)

ABCDEs of melanoma

asymmetry border irregularity color/pigment diameter (greater than 6mm) eveolving

skin cancer risk factors

smoking sun exposure immunsuppression UV rays fair skin outdoor sunbathing outdoor frequently indoor tanning

skin cancer treatment

melanoma that has spread requires combo therapy wide surgical incision targeted/immunotherapy radiation (treat lymph nodes) report any lesions with ABCDEs

cancer surgery

prevention/prophylaxis (moving non vital organs) cure/control (mastectomy, hysterectomy) palliative care (feeding tube, central line) implication (remove cancer & surrounding tissue)

chemotheraphy

reduce number of cancer cells can be a cure, control or palliative admin. by specialized RN IV chemo is irritant and can cause infiltration

chemotherapy side effects

n/v dysrhythmias organ damange alopecia skin rash bone marrow suppression neurotoxicity anemia anorexia

radiation

only affects tissues in targeted area TWO TYPES teletherapy - external machine brachytherapy - implanted/inserted

brachytherapy uses principles of

ALARA (as low as reasonably acheiveable) no more than 30 mins, 6ft of space, wear lead apron and dosimeters must be isolated, stay away from pregnant women and kids 16 or younger

immunotherapy

cytokines vaccines monoclonal antibodies AKA targeted therapy- most successful, usually have flu like symptoms premedicate with tylenol side effects: flu like symptoms, tachycardia, confusion, memory loss, insomnia

primary prevention of cancer

limit drug/smoking use maintain good health and sleep diet regular screenings use sunscreen

seven warning signs of cancer

C hange in bowel/bladder A sore that doesnt heal U nusual bleeding/discharge T hickening/lump development I ndigestion/difficulty swallowing O bvious changes in wart/mole N agging cough/ hoarseness

secondary screening for cancer

ct, mri, pet, xray cbc, tumor markers, ast, alt, albumin direct visualization

tertiary treatment of cancer

cure, control, or palliative coping education reconstructive surgery

cancer side effect management

antiemetic small frequent meals increase fluids cut hair prior to loss pace activities daily planner, no multitasking, mind stimulation no sun exposure non scented lotions soft bristle toothbrush

cancer pain

moderate to severe is common undertreatment is a big issue pain is subjective gabapentin used for neuro pain PQRST COLDERRA - characteristics, onset, location, duration, exacerbation, relief, radiation, associated symptoms)

TNM classification system of cancer

T umar N odes M etastasizes