childhood cancer Flashcards
how does the development of cancer typically differ in children than adults?
- cancer arises from abnormal and unregulated cell growth, leading to crowding out of healthy cells
- in children the cell of origin is typically an immature cell (where as in adult it is typically mature cells making replication errors)
what are predisposing factors to childhood cancers?
- down syndrome, Li Fraumeni, Noonan’s Syndrome, NF1, p53 mutation
- with down syndrome AML is more common
- with p53 mutation increased risk of osteoblastoma, retinoblastoma
how prevalent is childhood cancer in Canada?
- there are about 950 cases a year in Canada and about 40 per year in Saskatchewan
- children make up less than 1% of all new cancer diagnosis in Canada
How is cancer in children diagnosed?
- depends on type of cancer
- first investigation is often a CBC (CBC often how leukemia is diagnosed)
- bone marrow aspiration and biopsy
- lumbar puncture
- imaging (x-ray, MRI, CT, ultrasound)
- surgical biopsy
- urine and blood samples for tumor markers
treatment options for cancers
- chemotherapy
- surgery
- radiation
- biotherapy
- allo or auto bone marrow transplant
- some treatments are appropriate for certain types of cancers while others are not*
what is the difference between allo and auto bone marrow transfers?
- both are a hemopoetic stemcell transplant (aka blood transfusion)
- allo is when someone else’s bone marrow is used. this is done when bone marrow is where cancer is
- auto is where bone marrow is taken, treatment done, then it is given back. sometimes called a rescue because bone marrow is rescued from destruction by the treatment
what are some types of biotherapies to treat cancer?
- treatments using substances from living organisms: immunotherapy like vaccines, antibodies, or cytokines, genetherapy, or targeted therapies
Chemotherapy
- a name for a group of medications that work by slowing or stopping growth of cancer cells, which grow and divide rapidly
- often referred to as cytotoxic
- can be used curatively or palliatively
- lots of routes of administration
- most not disease-targeted, meaning they have systemic side effects
- each chemotherapy has a different mechanism of action - some target certain cell stages, why often given in combination and/or at different times
what are side effects of chemotherapy?
- because chemotherapy targets rapidly growing and dividing cells, this often includes normal/healthy cells as well (like GI, hair, skin, etc)
- bone marrow suppression
- mouth sores
- nausea and/or voiting
- anorexia
- hair loss
- pain
- lethargy
- constipation
- diarrhea
when do health care professionals need to take precautions when patients are receiving cytotoxic medications?
- during drug preparation
- during drug administration
- management/contact with body fluids
- spills (5mL is considered a large chemo spill)
what are chemotherapy handling precautions?
- wear double gloves, gown, eye protection, possibly N95 mask
- use special storage and disposal precautions of body fluids for at least 48 hours following last dosage
what is leukemia
a general term that refers to cancer of blood cells, which form and develop in the bone marrow
what is AML?
leukemia that occurs in the myeloid stem cells
what is ALL?
leukemia that occurs in lymphoid stem cells
what type of leukemia is the most common?
b lymphocytic (a form of ALL)
what type of leukemia is less responsive to chemotherapies?
t cell or t lymphocyte leukemia (a form of ALL)
what are signs and symptoms of leukemia?
- mostly directly correlate to effects of leukemic cells crowding out healthy blood cells in bone marrow
- recurrent or prolonged fever
- lethargy/general malaise
- anemia, pallor
- therombocytopenia, ecchymosis and petechiae
- hepatosplenomegaly
- enlarged lymph nodes
- recurrent infections
- bone and joint pain
what age group has the highest incidence of leukemia?
-1-4 year olds
what type of leukemia is more common in older children and teenagers?
-AML
what type of therapy is standard, up-front therapy for all types of leukemia?
- chemo
- for ALL usually 4-5 cycles, followed by 2-2.5 years of maintenance therapy
- for AML 3-4 cycles of intensive, in-patient chemo
when is a bone marrow transplant recommended for children with leukemia?
-when they have a high-risk disease at diagnosis or are not responding to standard treatment or if they experience relapse
which type of leukemia has a better survival rate?
ALL - it has a 5 year survival rate of 90%
while AML has a 5 year survival rate of 65%
