Oncologic Disease Flashcards
5 most common sites for Metastasize
Lung, Lymph Nodes, Liver, Bone, Brain
4 subcategories of malignancy- specific aspect
Carcinoma- Skin & visceral/Exoderm
Sarcoma- CT/mesoderm
Lymphoma- lymphoid cells
Leukemia- blood/bone marrow
Epidemiology of CA
2nd leading cause of death in US
Lung/bronchus- ♂ & ♀
Colon/rectum- ♂ & ♀
Prostate-♂; Breast-♀
Screening RISK factors for CA include
age >50
previous hx (can metastasize 15-20 ys later)
Gender
♀-unknown cause for shld/chest pain; abnormal menses
♂-sciatica
General c/o in hx
- unexplained wt gain/loss
- constant pain
- pain worse @ night
- proximal mm/tendon wk
- failure to progress/improve esp back pain
C.A.U.T.I.O.N
Changes in Bowl/Bladder A sore that doesn't heal w/ 6 wk Unusual bleeding/discharge Thickening/lump Indigestion/ dysphagia Obvious change in wart/mole Nagging hoarseness/cough
5 Clinical manifestations of Malignancy
1) early warning signs (CAUTION; change in vital signs, prox mm wk, hypo/hyperreflexia)
2) Skeletal- deep/bone pain; hypercalcemia⟶hypertension, wk, headache, N&V
3) Neurologic- nerve/cord compression; brain tumor; paraneoplastic syndromes/remote effects
4) Pulmonary- Dyspnea
5) Hepatic- Bilat CTS, abd pain, ascites
What are “Remote Effects”; give examples
tumpr producing S&S at a distance from the site; wt loss, fever, anorexia, progressive mm wk
5 Biologic mechanism of CA pain
1) bone destruction
2) skin distention
3) visceral obstruction
4) nerve compression
5) tissue inflammation/infection/necrosis
S&S associated w/ Mild-moderate-superficial pain
(sympathetic- acute type pain)
-hypertension, tachycardia, tachypnea
S&S associated w/ Severe/visceral pain
(parasympathetic)
-hypotension, bradicardia, N&V
Cardinal Symptoms post CA Tx
N&V, headaches, fatigue, dyspnea
Contraindications to exercice post CA Tx
WBC, Platelet, Hgb, Absolute granulocytes
??PT??
WBC <2.5x (12-15 sec)
16 specific CA
- Skin
- Breast
- Endometrial/Uterine
- Ovarian
- Cervical
- Leukemia
- Multiple myeloma
- Hodgkin’s disease
- non-hodgkin’s Lymphoma
- AIDS-non-hodgkin’s Lymphoma
- soft tissue (mm)
- bone
- chondrosarcoma
- brain tumors
- SC tumors
3 types of Skin CA
Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma
S&S of Breast CA; Risk factors
- lump esp an axillary mass, shoulder/arm pain
- Gender, age, race, fam/previous hx, ↑estrogen, abortion
S&S of Endometrial CA; Risk factor
- Pelvic pain
- 75% post menopausal
40-70y/o, nulliparous, hx CA, pelvic pain, GI problem
Risk factor for Ovarian CA
Risk factor for Cervical CA
30-40 (preinvasive)
>40 (invasive)
hx sexual activity
no early symptoms
children/young adults, bleeding (petechaie, epistaxis), fatigue, infection, hemarthrosis
S&S of Leukemia
♂, AA, 50-70y/o, Insidious, bone type pain, CTS, fatigue, recurrent infections (esp ribs & spine)
S&S of Multiple myeloma
adolescent/older, ♂, painless enlarged lymph nodes, wt loss, fevers, night sweats, pruritus
Hodgkins disease or Non Hodgkins Lymphoma- Difference between is the age (NHL is middle aged)
One distinctive difference btw non & hodgkins is:
- infection w/ Epstein-Barr virus~MONO?
- Leads to hodgkins up to 40%
S&S of AIDS-non-hodgkin’s lymphoma
♂, early 40’s, AIDS
Which Specific CA is rare; in extremities; in early adolescence/middle aged
Soft tissue tumors
Which Specific CA is rare; bone pain described as “boring”; most common CHILDHOOD sarcoma of the bone
Osteosarcoma
Ewings Sarcoma
Located usually where epiphyses/active growth occurs due to osteoblasts being the ones affected
Osteosarcoma
Which CA: young, ♂, growth spurt, loss of motion, pain may be intermittent, swelling
Ewings Sarcoma
Which CA are typically found in the young
Leukemia, Hodgkin’s disease, Soft tissue tumors, Osteosarcoma, Ewing’s sarcoma
Which CA: older >40, back pain, sciatica, more common in axial
Chondrosarcoma
Which CA: headache, seizures, CNS changes, 1〫 malignant, metastic
Brain tumors
Which CA: Back pain is worse w/ lying down, wt bearing, ↑thoracic pressures; Rest pain, altered sensation, cauda equine signs
Spinal Cord Tumors
Which CA are typical for older people
Skin CA, breast CA, Endometrial CA, Ovarian, Cervical CA, Multiple Myeloma, Non-Hodgkin’s Lymphoma, AIDS-Non-Hodgkin’s Lymphoma, Chondrosarcoma
