Clinical Manifestations of Cancer Flashcards
- Tumor growth can compress and erode what?
- Tissue ulceration and necrosis: What are signs of this? 2
- Cancer can produce what? 2
- Tissue damaged by cancer heals how?
- blood vessels
- Blood in the stool can be an early warning sign of colorectal cancer
- Painless hematuria may be the only sign of bladder cancer
- Cancer can produce
- tissue destroying toxins and
- enzymes - Tissue damaged by cancer does not heal properly
Effects on the normal tissue secondary to cancer
1. Mass of an abdominal tumor can cause a what?
- Development of what in the lungs and mediastinum? 3
- bowel obstruction
- Effusions
- Pleural,
- pericardial or
- peritoneal spaces
- Pleural effusion think what cancers? 2
2. Peritoneal fluid think what cancer? 1
- lung cancer or lymphoma
2. ovarian cancer
Anorexia
Due to decreased caloric intake
from what?
6
- physical obstruction of the gastrointestinal tract
- Pain
- Depression
- Constipation
- Malabsorption
- Debility or the side effects of treatment such as opiates, radiotherapy, or chemotherapy
- Weight loss is primarily from the what?
- Protein loss is equally divided among what? 2
- This causes a decreased what?
- fat stores then muscle
- skeletal muscle and visceral proteins
- liver mass
Cachexia
- What is it?
- Can be secondary to what?
- Tumors consume large amounts of _______ and increase ________ formation
- Further abnormalities in _____ and _______ metabolism
- ________ proteins are preserved and the liver recycles the nutrients and _________ occurs
- Involuntary loss of at least 5% body mass
- Not just related to decreased food intake - Secondary to a hypermetabolic state and altered nutrient metabolism
- glucose, lactate
- fat and protein
- Visceral, hepatomegaly
Whats the different between Cachexia and Anorexia?
- Anorexia- decreased caloric intake but an increase can reverse it. Liver shrinks
- Chachexia- cant be reversed. Liver enlarges
Cancer anorexia-cachexia syndrome
1. Common manifesation of ________ tumors except for breat cancer?
- More common in what populations? 2
- Weight loss from what? 2
- _____ or ________ nutritional supplementation does not reverse cachexia
- solid
- children
older adults - fat and skeletal muscle
- Oral or parenteral
Cancer anorexia-cachexia syndrome
- Involuntary loss of what?
- Shorter median ______?
- Do not respond well to what?
- Have more problems with what?
- Involuntary loss of 5% of body weight
- Shorter median survival
- Do not respond as well to chemotherapy
- Have more problems with toxicity
Fatigue
- Can be secondary to what?
- Cancer fatigue is characterized by what? 3
- Not relieved by what?
- How long can it last?
- Causes are?
- Secondary to
- the cancer or
- it’s treatment - Cancer fatigue is characterized by
- tiredness,
- weakness and
- lack of energy - Not relieved by sleep or rest like that of normal healthy persons
- Fatigue can precede diagnosis and can last months after cancer treatment
- Cause is likely multifactorial
Fatigue can be categorized into what categories? 2
central or peripheral
- Peripheral fatigue occurs where?
2. What is the PP behind this? 2
- occurs in the neuromuscular junctions and muscles
- Inability of the peripheral neuromuscular apparatus to perform a task in response to stimulus
- Lack of ATP and build up of lactic acid
- Central fatigue arises where?
- What do they have difficulty initiating?
- May be secondary to what?
- Central fatigue arises in the CNS
- Difficulty in initiating or maintaining voluntary activities
- May be secondary to dysregulation of serotonin and proinflammatory cytokines
- Cancer patients report poor ______ quality
2. Sometimes secondary to what? 2
sleep: Trouble falling asleep, staying asleep, nighttime awakenings and restless sleep
- to pain or
- side effects of treatment such as nausea and vomiting
Anemia
- May be related to what? 4
- Often treated with what? 2
- Malignancies can decrease RBC production by? 4
- May be related to
- blood loss,
- hemolysis,
- impaired RBC production or
- treatment effects - Often treated with
- Epogen but
- may require transfusion - Malignancies can decrease RBC production by
- Nutritional deficiencies
- Bone marrow failure
- Blunted EPO response
- Inflammatory cytokines produced by tumors decrease EPO production
Fever
1. Most common malignancies that present with fever? 5
- Lymphoma (esp. Non-Hodgkin’s)
- Leukemia
- Renal cell (20% present with fever)
- Hepatocellular carcinoma
- Atrial myxomas (Uncommon tumor type- Up to 30% present with fever)
- Paraneoplastic syndromes are defined as?
- Caused by?
- Most common in these cancers? 3
- Collections of symptoms that result from substances produced by the tumor and occur remotely from the tumor itself
- Caused by abnormal increases in hormones secondary to the effects of the cancer cells
- Most common in these cancers
- Lung
- Breast
- Hematologic
Paraneoplastic Syndromes
1. May be what manifestation?
- When a patient without a known cancer presents with one of the “typical” paraneoplastic syndromes, a diagnosis of________must be ruled out
- May be the first or most prominent manifestation
2. Cancer