Childhood cancer Flashcards
1
Q
Cancer in kids
A
- leading COD in kids under 15
- good survival
- not all curable tho
2
Q
Diff in kids and adult cancer
A
- pedatrics often from embyronic tissue (mesodermal and neuro)
- often leukemia, lymphoma, sarcoma, or CNS tumors
- not from lifestyle choices
- respond well to tx
- most arise from epithelial cells
3
Q
Etiologic factors
A
- genetic basis for some
- chromosome abnormalities
- immunodeficient child more likely to dev various cancers
- enviro carcinogens make more sus–Epstein barr
4
Q
Cardinal sx of cancer in kids
A
- unusual mass or swelling
- unexplained pale and energy loss
- sudden tendency to bruise easily
- persistent localized pain or limp
- prolonged unexplained fever or illness
- freq HA, often with vom
- sudden eye or vision chx
- excessive rapid wt loss
5
Q
Childhood cancers diagnostics
A
- labs
- complete hx and assess
- imaging studies
- biopsies
6
Q
Childhood modes of therapy
A
- Surgery (more conservative)
- radiation therapy
- biologic response modifiers (BRMs)
- chemo
- bone marrow transplantation
7
Q
CNS tumors
A
- brain tumors and neuroblastoma derived from neural tissue
- 20% childhood cancer
- hard to treat, poor survival
8
Q
Brain tumor diagnostics
A
- sx depend on location of tumor and size, child’s age
- HA, vom (sign of inc ICP), clumsy, motor prob, weak, behavioral or personality chx, FTT, irritable, VS
- neuro eval
- reflexes, cranial nerves, mobility
- MRI, CT, EEG, LP
- histologic dx via surgery
9
Q
Therapeutics for brain tumor
A
- depends on type
- surg is best (often hard to get out w/o damaging other tissue)
- shrink with chemo and radiotherapy before surg
- radiotherapy is over 2Y
- chemo
- prognosis–varies on type
10
Q
Postop care for tumor
A
- positioning–avoid pressure on the operative side bc things can shift into that empty space; midline is best
- reduce ICP
- neck flexion
- NPO until gag/swallow reflex returns
- comfort measures
- eye care–may need artificial tears if can’t close eyes all the way
- promote return to optimal functioning
- prevent aspiration
- some cerebral edema–ice, sit upright
- may need PT, OT
11
Q
neuroblastoma
A
- most common infancy cancer
- can grow prenatally
- most dev in adrenal gland or retroperitoneal sympathetic chain
- s/s depend on location and stage– may be bulging eyes
- metastasis may have already occurred before dx is made
- dx: radiologic studies, bone marrow eval, renal involvement
12
Q
Management of neuroblastoma
A
- clinical staging to est tx plan
- surg to remove tumor and obtain biopsies
- radiation to shrink tumor
- chemo
- bone marrow transplant or stem cell rescue
- prognosis worse in older
13
Q
Hodgkin lymphoma
A
- presence of Reed-Sternberg cells
- more prevalent 15-19Y
- neoplastic disease originating in lymphoid sys
- often metastasize to spleen, liver, bone marrow, lungs, other tissues
- cancerous B lympocytes, causing lymph nodes to enlarge and compress other structures, destroy normal cells
- linked to Epstein Barr
- staged
- dx with lymp biopsy
14
Q
Non-Hodgkin lymphoma
A
- more prevalent in kids under 14Y
- invaded lymphocytes
- 60% are NHL
- disease more diffuse
- cell type undifferentiated
- dissemination early and rapid
- invasion of meninges
15
Q
Hodgkins sx
A
Painless, enlarged lymph nodes, fever, night sweats
16
Q
Hodgkins tx and NC
A
- radiation, chemo, Hematopoietic stem cell transplant
- prognosis depends on stage, tumor bulk, classification
- complications include liver failure, secondary cancers, del
- NC: support, causes significant pain following alc drinking
17
Q
Non-hodgkin lymphoma management
A
- Dx with biopsy
- good survival
- chemo in 3/4 stages
- remove what they can
18
Q
Non-hodgkin s/s
A
pain, lymph node swelling (abdomen), D/C, cough, dyspnea, orthopnea, facial edema, venous engorgement–EMERGENCY
19
Q
Bone cancer
A
Bone cancers more common in males
- bone pain or limping
- r/o trauma or infection, then used radiologic and bone biopsy to dx
- MRI to eval neurovasc and soft tissue extension
- labs–elevated alkaline phosphatase with some bone tumors
20
Q
Osteogenic sarcoma
A
- most freq bone tumor in kids
- peak around 15Y
- primarily metaphysis of long bones, esp legs
- over 50% in distal femur; humerus, tibia, pelvis, jaw
- s/s: pain (can feel like growing pains), limp, dec ROM
- often diagnosed after fracture of big bones
- complications–lungs or other bones
- recurrence w/i 3Y
21
Q
Osteogenic sarcoma NC
A
- preop care is crucial (talk about phantom pain)
- support during amputation, surgical resection
- body image concerns–issues of adolescents
- phantom limb pain management
22
Q
Ewing sarcoma
A
- second most malignant bone tumor in kids; rare after 30
- arise in marrow, esp femur, tibia, ulna, humerus, vertebrae, pelvis, scapula, ribs, skull
- highly malignant
23
Q
Ewing sarcoma s/s
A
- intermittent pain progressing to constant and severe
- swelling and erythema at site
- systematic sx–fever, spinal cord complications, resp distress
- pain like growing pains
24
Q
Ewing sarcoma tx
A
- radiation and chemo adjunct and first
- myeloablative chemo then stem cell rescue transplant for severe cases
- surgical resection to preserve affected limb
- prognosis best if no metastasis; distal lesions most curable
- avoid active play and wt bearing (pathological fracture)
25
Q
Rhabdomyosarcoma
A
- highly malignant from undiff mesenchymal cells in muscle, tendon, bursa, and fascia or fibrous conn, lymph, or vasc tissue
- hard to dx
- head, neck, genitourinary, extremities
26
Q
Rhabdomyosarcoma s/s
A
- s/s depend on site and tissue compression
- many sx vague and common to childhood maladies
27
Q
Rhabdomyosarcoma tx
A
- highly malignant and freq metastasis
- complete removal if possible
- long-term chemo needed
- excellent prognosis stage 1, poor if metastasis occurs
28
Q
Wilms tumor (nephroblastoma)
A
- malignant neoplasm of kidney
- often affects young kids
- more common in AfrAm
- more freq in males
- staged
