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intro to cancer Flashcards

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1
Q

what is cancer?

A

uncontrolled and unregulated cell growth

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2
Q

what is the biological process of cancer?

A

proliferation followed by differentiation

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3
Q

what are the stages of cancer?

A

1) initiation
2) promotion
3) progression

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4
Q

what causes cancer?

A

the interaction between a persons genetic factors, external agents and promoting agents with time:

carcinogens (radiation, chemical, biological) + promoting agents +/- time = cancer

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5
Q

bening vs malignant tumor?

A

Benign tumors tend to grow slowly and do not spread. Malignant tumors can grow rapidly, invade and destroy nearby normal tissues, and spread throughout the body.

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6
Q

what are risk factors for cancer? out of them, which ones are modifiable/avoidable?

A
  • genetics
  • age
  • weight
  • environment (exposure to radiation, chemicals, pollution)
  • personal factors (lifestyle: diet, smoking, inactivity)
  • drugs and alcohol
  • viruses (hep b, hep c, hpv, hiv)
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7
Q

what are 7 early warning signs of cancer?

A

CAUTION
C: changes in bowel/bladder habits
A: a sore that does not heal
U: unusual bleeding/discharge
T: thickening or lump in breast, testicles, elsewhere
I: indigestion or difficulty swallowing
O: obvious change in size, color, shape or thickness of a wart, mole or mouth sore
N: nagging cough or hoarseness

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8
Q

what is the screening recommendation for breast cancer?

A

between the age of 50-69, q2 years

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9
Q

what is the screening recommendation for cervical cancer?

A

pap test starting 21 q1-3years

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10
Q

what is the screening recommendation for colorectal cancer? what about ppl at higher risk? what is you have a positive test?

A

age 50-70 and not a high risk for colorectal cancer = stool test q 2 years

ppl at higher risk should be tested more often and at younger age

positive test -> f/u w colonoscopy or flexible sigmoidoscopy

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11
Q

what are the diagnostic tests of cancer?

A
  • cytology studies (exam of single cells type)
  • blood serum analyses
  • scoping exam
  • radiological studies
  • radioisotope scans
  • assays for genetic markers
  • bone marrow examination
  • biopsies
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12
Q

how do you classify a tumor?

A

1) anatomical site
- solid: originating from a specific tissue or organ
- hematological: originating from blood forming
cells
- bone marrow = leukemia
- lymphoid tissue = lymphoma
- plasma cell = myeloma

2) grading : degree of cell differentiation
3) staging : classifying the extent and spread

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13
Q

what are the treatment modalities for cancer?

A

1) surgery
2) radiation therapy
3) chemotherapy
4) biological therapy
5) bone marrow transplant

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14
Q

what is the treatment goal in cancer?

A

1) to cure
2) to control
3) palliation

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15
Q

surgery in cancer?

A

removal of the tumor and a margin of the surrounding tissue

inneffective if cancer has metastasized

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16
Q

radiotherapy in cancer?

A
  • local treatment that targets the area closest to the tumor
  • emits energy: break chemical bonds in dna
  • repetitive doses lead to cell death
  • normal cells affected

cure: alone or in combo w another modality
control: shrink tumor pre/post op to destroy any remaining cells or to reduce size of inop tumor
palliation: control symptoms and QOL

17
Q

types of radiation? is the patient radiocative?

A

external:
- external beam radiation
- pt is not radioactive

internal radiation:
- brachytherapy: radioactive implant or material inserted on/close to tumor
- temporary or permanent
- pt is radioactive
- fewer side effcst
- can deliver high dose of radiation with less radiation to adjacent tissues

18
Q

what are side effects of radiation?

A
  • fatigue
  • anorexia
  • anxiety/depression
  • stomatitis
  • xerostomia
  • myelosupression
  • dry cough
  • changes in skin (color, thinner, dry, puritis)
  • pain (deep tissue damage)
  • lack of hair growth
19
Q

what can you to puritis related to radiation?

A
  • no scratching/rubbing
  • anti-puritic agent
  • authorized lotion or talc
20
Q

what teaching can you give regarding fatigue related to radiation therapy?

A
  • occurs 3-4wk after onset of tx
  • eventually improves - gradually subsides
  • may be d/t accumulation of metabolites that occur because of cell destruction
  • may interfere w adls
  • take short naps
  • diary of fatigue
  • plan: do important things at times of high energy
  • rely on help
  • try to remain active: gentle exercises decreases stress and improves well-being
21
Q

low dose vs. high dose brachytherapy?

A

low dose:
- applicator inserted in or radioactive source is loaded in pt room
- continuously/slow delivery to site (2-5 days)
- may be on complete bedrest
- pt is radioactive

high dose:
- pt imobilized on table. radiation is burried in closed space
- radiation is closer to tumor site
- less side effects
- fewer tx
- pt Not radioactive

22
Q

what is unsealed brachytherapy?

A
  • systemic radiation
  • pill or iv inj
  • uses radioactive isotopes that travel through pt and target certain tissues
  • radioactive source excreted through bodily fluids
  • pt + all articles = radioactive
23
Q

nursing care related to radiation?

A
  • hospitalized till radioactivity is diminished
  • private room far away
  • limit visitores
  • staff: time, distance and shielding
24
Q

what is chemotherapy?

A
  • chemical therapy
  • given PO, CVAD, IV, directly into region
    administered systemically or regionally (intraperitoneal, intratheccal, intravesical)
  • given in cycles (one cycle = days to week)
  • spill kit!
  • use mask gloves and gown when handling
    intrathecal = to spine
25
Q

side effects of chemo?

A
  • vomiting
  • allergic recations
  • arrythmias
  • mucositis
  • alopecia
  • diarrhea
  • anorexia
  • loss of appetite
  • fatigues
  • bone marrow depression
  • damge to organs: kidneys, heart, lung, liver
26
Q

teaching regarding fatigue r/t chemo?

A
  • expected
  • might become chronic after chemo
27
Q

teaching regarding anorexia r/t radiation and chemo?

A
  • common
  • excarcerbated by eating difficulties
  • high cal and high protein +supplements
  • keep track of wt (twice a wk)
  • loss of more than 5% = nutritional consult
  • smaller freq meals
  • eat in presence of company
  • exercise lightly -> stimulates appetite
  • mask metallic tast w lemon/flavoring
28
Q

N and V teaching r/t to radiation and chemo?

A
  • if severe = dehydration, electrolyte imbalance, decreased appetite and altered nut
  • some chemo are emetogenic (dose dependent)
  • key = prevention (treat even before occurence)
  • light meal before chemo
  • assess food tolerance, smells, balnd foods
29
Q

diarrhea teaching r/t chemo?

A
  • chemo destroys gi epithelial cells
  • dehydration and electrolyte imbalances
  • decreased absorption of food/fluids = wt loss
  • skin care: protective barriers , sitz bath
  • stool cultures
  • antidiarrheal (octreotide)
30
Q

mucositis teaching?

A
  • starts as dry mouth
  • mouth care = prevention
  • bleeding = infection
  • anywhere from mouth to anus
  • pain management (analgesia, MMW, reduce talking and swallowing)
  • maintain nutrition: soft food
  • avoid extreme temp, alcohol, tobacco
31
Q

what is biological therapy?

A
  • agents that modify relationship between host and tumor
  • target cancer cells without damaging normal cells
  • functions by stimulating body’s immune and inflammatory response
  • side effects (decrease over time)
    = fever, chills, myalgias (msk ache), headaches, photosensitivity, anorexia
32
Q

types of bone marrow transplant?

A

1) allogenic: donor w tissue match (GVHD)
2) autologous: pt’s own marrow is removed, treated, stored and reinfused
3) syngeneic: from identical twin = perfect match (harvesting)

33
Q

complication of cancer?

A
  • infection
  • neutropenic pt dont display classic s and s
  • tumor lysis syndrom
34
Q

what is tumor lysis syndrome?

A
  • cancer cells destroyed at rapid rate, resulting in ARF
  • signs (4H):
    1) Hyperuricemia
    2) Hyperphosphatemia
    3) Hyperkalemia
    4) Hypocalcemia
  • occurs during first 24-48h of chemo, last 5-7 days
  • goal = save kidneys + prevent electrolyte imbalance (allopurinol (build up uric acid from chemo)+ hydration)

nursing (13 decks)

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