Childhood Cancer Flashcards
Childhood Cancer: Cancer Usually Affects:
Tissues
Childhood Cancer: Histologic Type
Embryonal, Leukemia, Lymphoma
Childhood Cancer: Most Common Sites
- Blood
- Lymph
- Brain
- Bone
- Kidney
- Muscle
Childhood Cancer: Environmental and Lifestyle Factors
Only a small amount of environmental influence proven
Childhood Cancer: Cancer Prevention
Little Known
Childhood Cancer: Detection
Usually incidental or accidental
Childhood Cancer: Latent Period
Relatively Short
Childhood Cancer: Extent of Disease
Metastasis often present at diagnosis
Childhood Cancer: Response to Treatment
Very Responsive
Warning Signs of Cancer in Children
- Most often related to changes in blood cell production
- As a result of compression, infiltration, or obstruction caused by the tumor
- Changes in blood cell production may result in FATIGUE, PALLOR, FREQUENT OR SEVERE INFECTION, EASY BRUISING*
- Infiltration, obstruction, or compression by a tumor may result in BONE OR ABDOMINAL PAIN, PAIN IN OTHER PARTS OF THE BODY, SWELLING OR UNUSAL DISCHARGE*
Adult Cancer: Cancer Usually Affects
Organ
Adult Cancer: Histologic Type
Epithelial in Origin
Adult Cancer: Most Common Sites
- Breast
- Lung
- Prostate
- Bowel
- Bladder
Adult Cancer: Environmental and Lifestyle Factors
Strong Influence on Cancer Development
Adult Cancer: Cancer Prevention
80% preventable
Adult Cancer: Detection
Very early detection possible if screening recommendations followed
Adult Cancer: Latent Period
Can be very long (20 years or greater)
Adult Cancer: Extent of Disease
Metastasis less often present at diagnosis
Adult Cancer: Response to Treatment
Less responsive
Common Medical Treatment for Pediatric Cancer Diagnosis
- Chemotherapy
- Radiation
- Hematopoietic Stem Cell Transplantation
Chemotherapy
- Chemotherapy works by cell cycle-specific agents exert their actions during a specific phase of the cell cycle
- Chemotherapy works by cell cycle-nonspecific drug exert their effect on the cells regardless of which phase the cell is in
- Often use a combination of drugs that act on different phases of the cell cycle, maximizing the destruction of cancer cells
- Chemotherapeutic medications disrupt the cell cycle of both the cancer cell and normal cells
- Cells affected by chemotherapy are those in the bone marrow, digestive tract, the reproductive system and hair follicles
Adverse Effects of Chemotherapy
- Immunosuppression
- Infection
- Myelosuppression
- Nausea and Vomiting
- Constipation
- Oral Mucositis
- Alopecia
- Pain
Long-Term Complications of Chemotherapy
- Microdontia and Missing Teeth
- Hearing and Vision Changes
- Hematopoietic
- Immunologic
- Gonadal Dysfunction
- Endocrine Dysfunction
- Alterations in Cardio-Respiratory, GI, Genitourinary Systems
- Development of a second cancer as an adolescent or adult
Radiation Therapy
- Uses high-energy radiation to damage or kill cells
- Affects not only cancer cells but also any rapidly growing cells with which they are in contact
- May be used as a curative, adjuvant, or palliative treatment, either alone or in combination with chemotherapy
- Area that is treated is marked carefully to minimize damage to normal cells
Adverse Effects of Radiation Therapy
- Fatigue
- Nausea and Vomiting
- Oral Mucositis
- Myelosuppression
- Alteration in skin integrity at the site of irradiation
Long-Term Complications of Radiation Therapy
- Related to the area of the body that was irradiated and includes alterations in growth
- Hormone Dysfunction
- Hearing and Vision Alteration
- Learning Problems
- Cardiac Dysfunction
- Pulmonary Fibrosis
- Hepatic, Sexual or Renal Dysfunction
- Osteoporosis
- Development of Secondary Cancer (particularly at the site of irradiation)
Hematopoietic Stem Cell Transplantation
- Also called Bone Marrow Transplantation
- A procedure in which hematopoietic stem cells are infused intravenously into the child followed by purging of abnormal cells in the child that is accomplished through high-dosed chemotherapy or radiation
- The use of high-dose chemotherapy and total body irradiation kills the tumor cells but also destroys the child’s bone marrow
- Used for Leukemia, Lymphoma, Brain Tumors, Neuroblastoma and other solid tumors
- NOT THE FIRST LINE OF TREATMENT
Complications of Hemopoietic Stem Cell Transplantation
- Infection
- Electrolyte Infection
- Bleeding and Organ, Skin, and Mucous membrane toxicities
Long-term Complications of Hemopoietic Stem Cell Transplantation
- Impaired growth and fertility related to endocrine dysfunction
- Developmental Delays
- Cataracts
- Pulmonary and Cardiac Disease
- Avascular Necrosis of the bone
- Development of Secondary Cancer
Nursing Assessment: Signs of Changes in the Hematological System
Skin Changes
1. Pallor
2. Bruising
3. Flushing
- Changes in mental status such as lethargy can indicate a decrease in Hgb and a decreased amount of oxygen being delivered to the brain
Nursing Assessment: Health History
- Birth and Maternal History (note low birth weight and gestational diabetes and vitamin given after birth)
- 7
Oncologic Emergencies: Sepsis
- Associated with neutropenia resulting from bone marrow suppression due to chemotherapy
- Signs and Symptoms:
> Fever or low temperature
> Respiratory Distress
> Poor Perfusion
> Altered LOC - Labs
> ANC <500
> Positive Blood Cultures
> Increased BUN, Creatinine, Potassium, Clotting Times
> Decreased Platelets
> Metabolic Acidosis - Management:
> Airway and Ventilation Maintenance
> Fluid Volume Resuscitation
> Broad-spectrum antibiotics
Oncologic Emergencies: Tumor Lysis Syndrome
- Associated with ALL, Lymphoma and Neuroblastoma
- Signs and Symptoms:
> Nausea, Vomiting and Diarrhea, Anorexia
> Lethargy
> Increased heart rate and blood pressure
> Decreased or absent urine output
> Altered LOC - Management:
> Double IV fluid maintenance
> Sodium Bicarbonate
> Prevent by giving allopurinol for several days prior to chemotherapy
