Intro to Oncology & Survivorship Flashcards
Define the key elements of cancer on a cellular level
- uncontrolled cell division
- deregulation of cellular processes
- uncontrolled growth
- lack of apoptosis
Define a tumor and a few types
mass of cells resulting from abnormal cell division
- benign (lipoma, fibroid, hemangioma)
- malignant (carcinoma/skin, sarcoma/bone, leukemia/marrow)
Describe the diagnostic testing used in oncology
- biopsy almost always done (not HCC or RCC)
- imaging useful for staging
Describe clinical staging for solid tumors
What are the components of TNM cancer staging (clinical)
- T: tumor size (Tx, T0, Tis, T1-T4)
- N: lymph node involvement (Nx, N0-N3)
- M: metastasis (Mx, M0, M1)
What is pathological stage vs clinical stage of cancer
Clinical stage = Stage 0-4 of location of cancer (can go up but not down)
Pathological stage = histology after biopsy/surgery
Describe the tumor grading system
classification of tumors by how the cells look on microscopy & how likely the tumor is to spread/grow
- grade X = cannot be assessed through grade 4
What are the 4 major components to consider in cancer staging
- cell type/histology
- tumor location & margins
- angiolymphatic invasion
- molecular markers (genetic/tumor)
What staging systems are used in hematologic malignancies
- lymphoma: Ann Arbor staging
- myelodysplastic syndrome: international staging system (IPSS)
- leukemia: depends on type
Describe chemotherapy
systemic therapy that arrests the cell cycle in rapidly dividing cells
- not specific to cancer cells
- many AEs & risks of secondary malignancy
Describe radiation treatment
megavoltage x-rays that damage DNA & cause focal cancer cell death
- external or internal beam
- can be enhanced by chemo
- AEs: local symptoms, fatigue, risk of secondary malignancy
Describe neoadjuvant vs adjuvant therapy
- Neoadjuvant: therapy before the cure/surgery (ex. chemo)
- Adjuvant: therapy after the cure/surgery (ex. hormone therapy)
Describe targeted therapy in cancer treatment
therapy that specifically targets specific characteristics of the tumor
- usually less toxic than chemo
Describe immunotherapy treatment in cancer
stimulates the immune system tot target cancer cells
- can overshoot and cause secondary autoimmune disorder
Describe bone marrow transplant
use of chemo +/- radiation to wipe out bone marrow then replace it
- hematologic malignancies
- autologous (from pt) or allogeneic (matched donated)
- high mortality
Define cancer survivorship
an individual from the time of cancer diagnosis, during, and after treatment - lifelong (free of cancer or living with it)
Describe the late effects of cancer treatment
- cost
- secondary malignancies
- cardiac risks
- fertility & sexual health effects
- neurocognitive effects
- psychosocial distress
Describe the demographics at higher risk for secondary malignancy in adults vs kids
Kids: younger age at treatment, female
Adults: head & neck cancer, Hodgkin’s lymphoma
Describe some of the cardiac risks of cancer treatment
- arrhythmias
- cardiomyopathies
- arterial/vascular disease
- venous thromboembolism
- pulmonary/systemic HTN
- pericardial disease
- valvular disease
What risk factors increase your cardiac risks after cancer treatment
- chemo, radiation, combo therapy
- comorbidities
- age
- lifestyle
- stress
- SDoH
Describe the risk factors associated with sexual health effects following cancer treatment
- surgery/radiation to the pelvis
- chemo
- hormone therapy
- permanent ostomy
- age/comorbidities
Describe some ways to mitigate sexual health impacts of cancer treatment
- assess reversible contributing factors
- advice on lubrication/etc.
- refer to uro/gyn/center for sexual health PRN
- MH/support regarding body image
Describe the neurocognitive effects associated with cancer treatment
- slow processing speed
- problems with sustained attention
- problems with executive functioning
- problems with short term memory
- “chemo brain”
What factors are considered when summarizing and treating cancer
- location/type
- potential physical impairment
- associated cancers/genetic patterns
- rate of recurrence
- type of treatment
- ongoing or continuing
- screening for treatment effects
- tests/referrals PRN
What factors are considered when developing an individualized cancer care plan
- cancer treatment & concerns
- routine screening
- comorbidities
- immunizations
- SDoH
- family
- resources
