ch 29 oncology Flashcards
types of cancer that have genetic basis (can be inherited -3)
wilms tumor
retinoblastoma
neuroblastoma
type of cancer associated with down syndrome (chromosome abnormality)
leukemia
Dx of cancers
labs
biopsy
lumbar puncture
imaging studies
review of symptoms and physical exam
modes of therapy for cancers
-surgery
-chemo
-radiation
-biologic response modifiers (BRMs)
-bone marrow transplant
2 categories bone marrow transplant
allogenic (not from pt)
-matched related donor
-matched unrelated donor
-umbilical cord blood
autologous (from pt)
-peripheral stem cells
what is made in bone marrow
white
blood
platelets
what type of bone marrow would someone get if they have blood cancer (leukemia)
allogenic
what type of bone marrow would someone get if they don’t have blood cancer but need bone marrow saved for post-chemo “rescue”
autologous
S+S ped cancer
pain
fever
skin changes
anemia
abdominal mass
swollen lymph nodes
risk factors acute tumor lysis syndrome
large tumor burden
sensitive to chemo
high proliferative rate
high WBC at Dx
S+S acute tumor lysis syndrome
-flank pain
-lethargy
-N/V
-oliguria
-pruritis
-tetany
-altered LOC
consequences acute tumor lysis syndrome
-hypocalcemia
-hyperphosphatemia
-hyperkalemia
-uremia
-hyperuricemia
-acute renal failure
-death
Tx acute tumor lysis syndrome
-aggressive fluids
-frequent labs
-monitor I&O, urine output
nursing consideration for vaccines with chemo
they have to get them all again
unrestricted proliferation of immature WBCs in bone marrow and lymphatic system
*most severely affects liver and spleen
leukemia
S+S leukemia
-infection
-anemia (cold, fatigued)
-low platelets (bruising, bleeding)
-pain
-weight loss
-spleen and liver enlarged
-easy to break bones
-leukemic meningitis
two types leukemia
ALL: acute lymphocytic leukemia (higher survivability)
AML: acute myeloid leukemia
most common site for relapse in cancer pts
CNS (brain and spinal cord)
what do pts get with every chemo Tx to prevent CNS involvement
lumbar puncture with chemo
side effects of Tx
infection
hemorrhage
anemia
N/V
alopecia
altered nutrition (weight loss)
mouth sores (all throughout GI system)
side effects of high doses steroids
mood changes
swollen face
who is hodgkin lymphoma more common in
older kids (15-19 yo)
who is non-hodgkin lymphoma more common in
younger kids (<14 yo)
S+S hodgkin lymphoma
*REED STERNBERG cells under microscope
-painless enlargement lymph nodes
S+S non-hodgkin lymphoma
-spreads really fast
-pain and swelling lymph nodes
infratentorial brain tumor
in posterior 1/3 of brain (brain stem and cerebellum)
supratentorial brain tumor
in anterior 1/3 of brain (cerebrum)
malignant extracranial solid tumor
-most common diagnosed in infancy
-majority develop in adrenal gland (on top of kidneys)
-primary site: mass in abdomen
neuroblastoma
-can metastasize
wilms tumor location
kidney
-doesn’t cross midline
what age is more survivable with neuroblastoma
1 yo or younger (spontaneous regression with maturation of adrenal gland cells)
Dx neuroblastoma
radioactive iodine xray (MIBG)
who is bone tumors more common in
more common in males and adolescents
Dx bone tumors
-rule out trauma/infection
-CT scans/bone scans/bone biopsy
-MRI
-labs: elevated alkaline phosphate
most primary bone tumor sites
femur right above knee
Tx osteosarcoma
rotationplasty
2 types bone tumor
osteosarcoma: in bone
ewing sarcoma:in soft tissue
trademark of ewing sarcoma under microscope
small blue cells
Tx ewing sarcoma
radiation
chemo
(not usually surgery and rotationplasty)
malignant renal and intraabdominal tumor of childhood
-genetic component
-doesn’t cross midline
wilms tumor
who is wilms more frequent in
males
2-3 yo
african americans
where is rhabdomyosarcoma
striated muscle
is retinoblastoma genetic
yes
common sign retinoblastoma
“cats eye reflex”
white in pupil of eye
straying of eye to side
strabismus
long term effects cancer Tx for the survivor
-hormonal imbalances
-sterilization
-overproduction iron (impacts heart and liver)
-learning disabilities
-delayed growth and development
-T2 diabetes
