Communication - Diagnosis of Cancer Flashcards
Rough framework
Brief Hx Understanding Condition Explanation Summary
What is cancer - explanation
All the cells in our body grow, divide, die at varying rates and function in different ways depending on the type of cell they are.
In cancer, the speed of growth and division is sped up, , they don’t die when they are supposed to and they don’t function how they are supposed to.
These abnormal cells form a mass, called a tumour and can damage the surrounding cells and structures around them
Some cells can break off from the mass and move to other parts of the body via our blood and start new growths there, this is what happens when we say a cancer has spread
Causes of cancer
We don’t really know what causes cancer but we do know that there are some things, both within and out of our control that can increase our risk of developing cancer
Older age
FHx - particularly in younger relatives
Smoking
Excess alcohol
Not enough physical activity
Some health conditions - IBD
Investigations for cancer
Diagnosis - Hx, examination, imaging, biopsy
Imaging - assess for presence in organs or lymph nodes
- mammogram/MRI
- CXR
- CT
- CT-PET HCAP - staging
Biopsy - definitive
-confirm or deny suspicions
-support with treatment decisions
Done with US/scope
Lymph nodes are small bean-shaped structures that contain white blood cells. Sometimes, cancer cells can spread from the organ, into the lymph nodes
Possible treatment options
Depends on the location, size and degree of spread
-may be in isolation or in combination
Surgery - remove the cancer, perhaps some of the nearby lymph nodes
Radiotherapy - very targetted beams of radiations that kills the cancer
Chemotherapy - use of anticancer drugs
Immunotherapy - medications that enhance your immune system’s ability to kill the cancer cells
If it has only spread to your nearby lymph nodes, we may be able to remove the cancer and those affected LN
Purposes of treatment
Curative - get rid of the cancer
Symptomatic/palliative - we cannot get rid of the cancer as it has spread but our aim is to alleviate your symptoms
We are not giving up on you, we will continue to support and treat you but it is with the aim to improve or maintain your current quality of life
Screening for cancer - Bowel
- who
- what and how
- results
60-74 men
FIT test - tests for hidden blood in stool
All the instructions are in the kit
-put the test stick into your stool sample, place it in the sample tube and send it back in the envelope included
Possible results
No further testing - no blood was found => repeat in 2 years time
-this does not mean that you will never develop bowel cancer, it just means that at this point, you are very unlikely to have cancer
-if you have symptoms like abdo pain, changes in bowel habits, weight loss, fatigue, lost appetite => GP
Further testing - blood was found
- this does not mean that you have cancer, there are other conditions that leads to blood in the stool (piles, IBD,
- however if it is cancer, finding it at an earlier stage means that treatment is more likely to work
- you will be contacted about your next steps => colonoscopy
Pros and cons of screening
Pros
-the earlier we catch cancer, the more likely it is to be treated successfully
Cons
-no screening test is 100% reliable
Cancer may be missed => falsely reassured
The test may also come back positive from non cancerous causes, like piles. The need for further testing could cause uneccassery stress
There is also a possibility that we will overtreat someone by removing a growth that would not have become cancerous within your lifetime
If Xray used - regular screening may increase your risk of developing cancer within your lifetime slightly
Explanation of colonoscopy
- what is it
- what for
- before during after
- results
- risks
What is it - endoscope is a thin tube with a camera on the end that we use to have a look inside your body.
-we can also take samples, biopsies which we can analyse further in a lab
What for
- identify cause of symptoms
- look for small growths which may turn into cancer
Before - empty bowels
- 2days before - low fibre (white rice, bread, pasta, plenty of clear fluids
- laxatives
During
- you will be awake
- painkillers, meds to help you relax
- procedure 45mins ish
- some air pumped into bowels to open them up
- they may take samples, you will be told
After
- you will be monitored to make sure you’re doing ok, no side effects from the meds
- bloating, cramps, blood in stools are normal
- cannot drink, drive, operate heavy machinery 24hrs after being sedated
Results - up to 2wks
SE -bloating, stomach cramps -bleeding from back passage, stool Risk of -perforation => surgical repair -reaction to medications used => you will be monitored closely by the nurses throughout your visit
PSA test
- what is it
- why can it be high
- results interpretation
- possible treatments
NOT A SCREENING TEST
-PSA test is a blood test that looks for a molecule only made by your prostate
PSA can be high for many reasons
- enlarged prostate (BPH) which just happens with age
- prostatitis, UTI
- prostate cancer
- recent sexual activity, vigorous exercise
High => biopsy
- is it cancer
- how likely is it to grow?
Watchful waiting/active surveillance - cancer not progressing or not likely to cause problems during your lifetime
Surgical removal
Radio, hormone therapy
-urinary, sexual problems
Screening for cancer - breast
- who
- what and how
- results
Who - 50+ mammogram
30+ MRI if increased risk annually
What and how - Xray of your breast to detect cancer that is too small to feel or see
Results Normal - repeat in another 3years -GP if symptomatic Called back - images unclear/abnormal findings -further imaging and biopsy
Screening for cancer - cervical
- who
- what and how
- results
- risks and benefits
Who - 25-64 every 3-5years
What - gently inserts a plastic instrument into vagina to see cervix clearly
-take a soft brush to take some cell samples from cervix
Results - few weeks Normal - no HPV, repeat in 3-5years Positive - HPV found -cell changes => colposcopy -no cell changes => earlier smear
