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ALU 301 > Chapter 8- Childhood Cancers > Flashcards

Chapter 8- Childhood Cancers Flashcards

1
Q

What are the most frequent childhood malignancy cancers?

A
  1. acute leukaemia
  2. brain tumours
  3. lymphoma
  4. neuroblastoma
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2
Q

When are neuroblastoma, nephroblastoma, retinoblastoma and medilloblastoma more common ? (age of incidence)

A
  • First years of life

- they are congenital

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3
Q

Which cancer are more common in the teenage years?

A

bone malignancy,
hodgkins disease
testicular and ovarian

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4
Q

why is mortality and morbidity rates higher in children who recieved radiation and chemo?

A
  • secondary malignancies
  • developmental abnormalities related to administration
    future complications
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5
Q

Most primary conditions associated with juvenile cancer have significant mortality in and of themselves. Such as?

A 
neurofibromatosis, 
tuberous sclerosis
von hippel-Lindau disease
ataxia telangiectasia 
Down syndrome
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6
Q

Which children are at the highest risk of serious late effects from their cancer treatment, including second cancers, congestive heart failure, and eventual joint replacements?

A

Those treated for:
Brain tumours
hodgkinds lymphoma,
or any use of radiation to the abdomen, pelvis or chest.

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7
Q

what tumors is the most common childhood solid tumor, and also the second most frequent malignancy in children and adolescents?

A

brain tumours

  • 45% mortality rate from the disease and highest morbidity
  • sxs: headaches, vomiting, papilledema, seizures, personality changes, balance and weakness.
  • usually diagnosed late
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8
Q

What is the most common juvenile brain lesion?

A

Astrocytoma

  • low-grade malignancies more favourable.
  • tx is radiation, chemo and surgery.
  • 90% survival
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9
Q

which astrocytomas have a more favourable prognosis

A

Low-grade (grade 1 and 2) with complete excision.

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10
Q

What is the most lethal type of astrocytomas?

A

Glioblastoma (multiform)

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11
Q

What is a Medulloblastoma?

A

occurs exclusively in children

  • in posterior fossa of the brain
  • complete remove is difficult and usually requires re-excision
  • 5 year survival rate of 70%
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12
Q

What is the Ependymoma

A

posterior fossa tumor

  • poor prognosis
  • tx’ed with radiation,
  • 40% 5 year survival rate
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13
Q

What is a neuroblastoma?

A

most common solid extra-cranial tumour in children.

  • arise in abdomen (adrenal gland or sympathetic ganglia)
  • sxs: bone pain, loss of appetite, weight loss, fatigue≥ Anemia, high platelet and iron counts
  • CXR diagnosis, f/u MRI or CT.
  • tx: chemo and bone marrow transplant, and radiation. Surgery is not always effective.
  • stage 3 and 4 have poor prognosis
  • mortality can be sig for 10 years
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14
Q

What is Nephroblastioma ( Wilms’ tumour)

A
  • second most common abdo tumour in children
  • starts in kidney and is composed of blastema, epithelia and stroma
  • 7% Bilateral.
  • sporadic + genetic cases
  • sxs: asymptomatic mass or swelling, sometime fever or hematuria, HTN
  • U/s or CT diagnosis.
  • metastasis is common.
  • tx: surgery and chemo. post-op radiation if needed
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15
Q

What is the survival rate for Wilms’ tumour?

A

better for stage 1 and 2
5 year survival 90%, unless cells show aggressive behaviour.
- 150% mortality 5-10 years. Better prognosis as kids get older.
- morbidity ^^ d/t radiation = muscle atrophy, bone grow issues, spinal shortening.

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16
Q

What are retinoblastomas?

A

higher rates of cure 90%
cancer is bilateral
dx before 5 yo.
usually familial, 25-30% of dx are d/t mutation in gene RNA
-older age is worst prognosis d/t advancement of disease
- sxs: leukocoria, white papillary reflex of light during
- dx: opthomology exam, ultrasound and bone scans

17
Q

How are retinoblastoma’s treated?

A
  • used to remove whole eye. only now used when 50% of retina is involved with tumour.
  • Main tx is radiation, and chemo if child is at risk of metastasis.
18
Q

True or False

those who has the familial type have a significant risk of developing a second cancer?

A

yes,
develop in and outside of radiation field.
most common second cancer are soft tissue sarcomas, and ostosarcoma.

19
Q

What are the two most common types of malignant bone tumors in children?

A

osteosarcoma (60) and Ewing sarcoma.

- later occurring cancer (10’s/20’s)

20
Q

what are some growth changes that occur with osteosarcoma?

A
  • usually correlate with growth spurts
  • children with dx are taller than peers
  • appears in bones with greater increase in size/length ie: distal femur
21
Q

What are the symptoms, and treatments for osteosarcoma?

A

sxs: pain and swelling,
dx: Xray, and bone marrow/CBC tests. MRI assess the severity.
complication: pulmonary metastases,
tx: chemo, amputation.

22
Q

What is Ewing Sarcoma?

A

less common, Males > females

  • dx made on biopsy,
  • sxs: pain swelling and bone mass on Xray signs and diagnostic
  • better prognosis, unless metastatic
23
Q

What are Rhadomyosarcoma?

A

most common pediatric sarcoma,

  • occur everywhere in the body
  • prognosis is related to age of the child, site or origine, metastasis and lymph node involement.
24
Q

what are the symptoms of rhabdomyosarcomas?

A

palpable mass,
organ displament d/t tumour
- sxs relate to location of tumour
- hard to diagnose, biopsy and histrochemical staining is most effective diagnostic test.

25
Q

What is the primary treatment for Rhabdomyosarcoma

A

excision of the lesion,
chemo- preoperatively to shrink growth. Radiation is effective means to control local spread
- location of disease = better prognosis
- second malignancies are most common,

26
Q

When are Germ cell cancers of reproductive organs most likely to occur in the paediatric life?

A

later ages once organs have begun sexual function

  • radiotherapy and surgical tx.
  • favourable long-term outlooks
27
Q

How are Hepatic Tumors treated?

A

cure rate is only about 50%

chemo and resection of the tumor mass, liver transplant in children

28
Q

What are the two most common problems for juvenile cancer survivors?

A

psychological and psychosocial complications

  • they miss school, ongoing academic support requires and psychiatric counselling well into adulthood.
  • radiation therapy have higher risk of neuropsychological problems (lack of visual motor integration, short-term memory deflicts, and sequencing ability problems).
29
Q

What endocrine problems can occur in children who received extensive chemo and radiation therapy?

A

hypothalmic-pituitrary-end organ axis is activated prematurely, epiphyseal closure can be premature, and height and growth can be delayed.
- hypothyroidism and thyroid cancer ^
reproductive function can be affected when germ cell cancers are treated.

30
Q

Why are cardiopulmonary and renal complications that occur d/t the treatment rather than the disease in children?

A

bleomycin in a recognized cause of pulmonary fibrosis.
Doxorubicin and Adrimycin are known for cardiac toxicity and eventually cardiomyopathy
radiation can induce pericarditis and lower EJ
Cisplatin causes renal tubular necrosis and renal toxicity

31
Q

What cancers are at higher risk for secondary cancers?

A
  1. Genetic and familial conditions: retinoblastoma

2. Leukaemia (acute lymphatic leukaemia) and Hodgkin’s

ALU 301 (14 decks)

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