Clinical Manifestation of Cancer Flashcards

1
Q

Cancer effect on tissue integrity

A

Tumor growth compresses and erodes blood vessels

Tissue ulceration & necrosis -> blood in stool/urine

Cancer produces tissue-destroying toxins and enzymes

-Tissue destroyed by cancer doesn’t heal properly

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2
Q

Normal tissue effects secondary to cancer

A

Bowel obstruction from abdominal tumor/mass

Effusion of pleural/pericardial/peritoneal space with accumulation of fluid in serous layer buildup

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3
Q

Pleural and peritoneal effusions common cancer causes

A

Pleural: think lung cancer, lymphoma, breast cancer

Peritoneal: ovarian, colorectal, stomach, pancreatic cancer

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4
Q

Anorexia

A

Weight loss due to decreased caloric intake

Primarily fat store lost w/ protein loss equal between skeletal and visceral proteins

Liver shrinks

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5
Q

Cachexia

A

Involuntary weight loss 5% mass secondary to hypermetabolic state and altered nutrient metabolism

Tumors consume glucose under anaerobic metabolism -> get build up of lactate

Liver enlarged due to visceral protein accumulation

To Tx cachexia, you have to Tx the tumor

Cachexia is a poor prognosis factor

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6
Q

Fatigue

A

Peripheral: in neuromuscular junction and muscles

-Neuromuscular apparatus fails to perform - ATP deficit w/ lactic acid buildup

Central: arises in CNS

  • Difficult initiating/maintaining voluntary activities
  • secondary to serotonin and proinflammatory cytokine dysregulation

Cancer pts also report poor sleep quality

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7
Q

Anemia

A

Blood loss, hemolysis, impaired rbc production

-nutritional deficit, BM failure, blunted EPO response/production

Tx: Epogen or transfusion

-BBW: increased mortality in cancer patients - complications or decreased clearance rate

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8
Q

Fever

A

Common with lymphoma (HL), leukemia, renal cell, hepatocellular carcinoma

Atrial myxomas - while rare, often present w/ fever

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9
Q

Paraneoplastic Syndromes

A

Symptoms caused by substance produced by tumor or abnormal hormone increase in response to cancer cells

Most common w/ lung, breast, hematologic cancer

Often a 1st symptoms - always r/o CA w/ paraneoplastic syndrome

Effects endocrine, neuro, heme, derm, and rheumatologic systems

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10
Q

SIADH

A

Small cell lung cancer most common

ADH increases free water absorption - get water retention and dilutional hyponatremia

Sx: gait disturbances, falls, HA, fatigue, seizure, respiratory depression, confusion

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11
Q

Hypercalcemia

A

One of the most common paraneoplastic syndromes

MM, bony metastasis

Secondary to PTHrP (80% - SCLC), or osteolytic activity (breast, MM, lymphoma), Vitamin D secretion, or ectopic PTH secretion from tumor

Sx: AMS, weak, ataxia, lethargy, ovarian, endometrial cancer

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12
Q

Cushing’s Syndrome

A

Small cell lung cancer or bronchogenic carcinoid

Get hypokalemia, elevated cortisol w/ no response to dexamethasone (tumor), elevated abnormal ACTH

Sx: muscle weakness, peripheral edema, HTN, wt. gain, centripetal fat distribution

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13
Q

Hypoglycemia

A

Rare tumor association

Usually insulin-producing islet cell tumor or non-islet cell tumor

Sx: recurrent or constant hypoglycemia

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14
Q

Paraneoplastic Neurological Syndromes

A

Immune cross-reactivity between tumor and nervous system causes permanent damage

Tx is immunosuppressive therapy - tumor Tx doesn’t resolve neurological impairment

Lymphoma, MM, SCLC

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15
Q

Paraneoplastic Neurological Syndrome manifestations

A

SCLC causes limbic encephalitis, paraneoplastic cerebellar degeneration, autonomic neuropathy, subacute sensory neuropathy

-Thymoma = myasthenia gravis w/ central presentation (eye weakness)

Lambert-Eaton Syndrome is reverse of MG w/ peripheral weakness of limbs

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16
Q

Acanthosis Nigricans

A

Dark, velvety patches in skin folds

Adenocarcinoma (GI most commonly, or hematologic cancers

17
Q

Hematologic syndromes and common causative cancers

A

Eosinophilia - tumor releases growth factor

-Lymphoma, leukemia or paraneoplastic lung/GI/GYN

Granulocytosis - solid tumors, commonly large cell lung cancer

Pure Red Cell aplasia - Thymoma

Thrombocytosis - tumor-produced cytokine IL-6

-Cancer, infection, splenectomy, blood loss/iron deficiency

18
Q

Most common paraneoplastic syndromes and associated tumors

A

SIADH - SCLC

Cushings - SCLC/Bronchogenic cancer

Hypercalcemia - MM, bony metastases

19
Q
A