CHEMO Flashcards
General risk factors for CA: (12)
Lifestyle
´ Age
´ Genetics
´Immunosuppression
´ Alcohol
´ Cancer causing substances
´ Diet
´ Hormones
´ Obesity
´ Tobacco
´ Radiation
´ Sunlight
Types of CA:
Where do all of these originate from?
Basal cell:
Squamous cell:
Adenocarcinoma: cells
Sarcoma
Leukemia
Lymphoma
Basal cell:
basal (base) layer of epidermis
Squamous cell:(epithelial cells) that lie just beneath skin
´ Also line stomach, intestines, lung, bladder
Adenocarcinoma: cells
that produce mucous
´ Glandular tissue: breast, prostate
Sarcoma: bone and soft tissue; Such as osteosarcoma
Leukemia:
begins in blood-forming tissue of the bone marrow
Lymphoma:
begins in lymphocytes (T or B cells)
´ Build up in lymph nodes and lymph vessles
Cancer cell differences: How do cancer use these ways to grow?
1.) Less specialized
2.) Abnormally influence normal cells
3.) Can evade immunesystem
Less specialized
´easier to divide longer than needed
–>Can ignore pre-programmed apoptosis signals
Abnormally influence normal cells
–>Can make normal cells form blood vessels which feed a tumor
Can evade the immune system
–>Can actually use the immune system to prevent cancer cell damage
Drivers of Cancer:
How do these cause cancer?
1.) Proto-oncogenes
2.) Tumor suppressor genes
3.) DNA repair genes
*These contribute to CA
Proto-oncogenes
´ Involved in normal cell growth and division
´ Become cancer-causing…allow cells to grow and survive
Tumor suppressor genes
´Alterations allow genes to divide uncontrollably
DNA repair genes
-Incorrect damage repair; cause other mutations
Standard screenings:
1.)
2.)
3.)
1.) Colonoscopy
2.) Mammograms
3.) Pap tests
Cancer metastasis
´Breast, lung, kidney, and prostate
´Frequently radiate to ____.
Tx: (5)
´Breast, lung, kidney, and prostate
–> Frequently radiate to bone
´ Osteolytic, osteoblastic or both lesions
Tx:
-Hormonal therapy
-Radiotherapy
-Chemotherapy
-NSAID +/- opioids
-Vertebroplasty?
Cause for tumor recurrence??
1.)
2.)
Surgery impact on inflammation and stress:
_____ signals: fight or flight. Lasts for WEEKS!
1.) Ressection
2.) Immunosuppression
-Inflammation
-Surgery stress
-Anesthesia
-Opioids
SURGERY IMPACT
-Activate COX2
-Catalyze Prostagladins
-Catalyze TXA
-^ Cell survival/growth CA
-Suppress NK cells
**Fight or flight –> signaled by Beta-adrenergic –> upregulate biological activity
Tumor Staging: TNM
T= T1/T2/T3/T4
N= N1/N2/N3
M= M0/M1
In situ: _____
Localized: _____
Regional: ______
Distant: ______
T: size/extent of primary tumor
N: # of nearby lymph nodes which are +
M: is there metastasis?
In situ:
abnormal cells are present but have not spread to nearby tissue
Localized: limited to place where it started; no sign of spread
Regional: has spread to nearby lymph nodes, tissues, or organs
Distant: spread to distant parts of body
Cancer prognosis of 6 months or LESS:
ADL:
Weight?
Labs:
-Calcium=
-Albumin=
Mestastases
3 types:
<3
-Spend 1/2+ in bed
-Weight loss >10% in 6 months
-Spinal cord compression with limited mobility
-Calcium >11.2mg/dL
-Albumin <3.5 mg/dL
-DVT/PE
-2+ brain metastases
-Hepatic, bone, adrenal mestastases
-Recurrence disease after chemo
-Malignant peri-cardial effusion
How does cancer cause pain??
Invasion of tumor into tissues innervated by afferent neurons –> Invade NERVE PLEXUS
´ Pleura, peritoneum
´ Most due to cancer itself not treatment
Celiac plexus Nerve Block
Used for what types of cancer? (3)
Neurolysis sympathetic for fibers:
-___ to ____
-_______ plexus fibers
-Unresectable
1.) Pancreatic cancer,
2.) Hepatic
3.) Gastric cancer
Neurolysis sympathetic fibers of T5-T12 and parasympathetic celiac plexus fibers
Alcohol…pain relief 3-6 months
´ Side effects: diarrhea and hypotension
´ Intercostal nerves
´ For rib metastasis
´ Lumbar sympathetic ganglion
´ Pelvic tumors
