Oncology Flashcards
0
Q
What is the number two killer in the US?
A
Cancer
1
Q
What is the number one killer in the US?
A
Heart disease
2
Q
What is the number one cancer killer among both men and women?
A
Lung and bronchus cancer
3
Q
What ethnicity is most likely to develop cancer?
A
African Americans
4
Q
What percentage of men develop cancer?
A
50%
5
Q
What is the highest probability of developing cancer in men?
A
Prostate cancer
6
Q
What percentage of women develop cancer?
A
33%
8
Q
What is important about cancer incidence in children?
A
Incidence is higher than the mortality rate
9
Q
What are the two most common types of cancer in children?
A
Leukemia and brain cancer
10
Q
Why do kids have a lower death rate than adults?
A
Tend to bounce back quicker
11
Q
What can a sedentary lifestyle lead to?
A
Cancer
12
Q
What can smoking lead to?
A
Heart disease and a higher risk for cancer
13
Q
What can a high BMI lead to?
A
Cancer
14
Q
What sex and ethnicity has the highest prevalence of sunburn?
A
Sex = males Ethnicity = Caucasians
15
Q
What can sun exposure lead to?
A
Skin cancer
16
Q
What is important about getting adequate fruits and vegetables?
A
Can prevent cancer, but prevalence of those getting actual daily amount needed is very low
17
Q
What is cancer?
A
An abnormal growth of cells - cancer cells do not have normal triggers to stop dividing
18
Q
What are three important characteristics of cancer?
A
- Lack of senescence
- Loss of contact inhibition
- Ability to divide without anchorage
19
Q
How are tumors classified?
A
- Size of tumor
- Where tumor originated
- Cell type
- Location
- Degree of differentiation
- Benign vs. malignant
- Cellular characteristics
- Hormone production or sensitivity
20
Q
What does the treatment of cancer depend on?
A
Morphology of the tumor
21
Q
What are the different cell types of cancer?
A
Epithelial, connective, muscle, nerve, lymph, and hematopietic
22
Q
Differentiate benign tumors vs malignant tumors.
A
Benign - does not spread
Malignant - spreads
23
Q
What is a type of cell/cancer that is fed by a hormone and what is the effect?
A
Breast cels are fed by estrogen which can cause the cells to grow and get bigger
24
Q
What are different treatment options for cancer?
A
- Do nothing
- Surgery
- Radiation
- Chemotherapy
- Biological therapy
- Hormonal therapy
25
What is an example of a slow growing cancer?
Prostate cancer
26
What is biological therapy?
Targeted therapy - creates antibodies that are specific to the tumor type
27
What is the main type of treatment for cancer?
Surgery
28
What are the functions of surgery regarding cancer?
Debulk tumor, remove precancerous lesions, control symptoms, and create a clean margin
29
What is a clean margin?
Goal of surgery in order to have an area of healthy tissue surrounding the tumor to ensure that all of the tumor was removed
30
What is radiation therapy?
Localized non-selective treatment to cancer (does not care that the skin it is going through is healthy)
31
What are the goals of radiation therapy?
Pain relief, prevention of fracture, and decrease tumor size
32
What is important about radiation therapy?
There are many types
33
What are the side effects of radiation therapy?
Fatigue, skin can become dry or reddened, decreased ROM, nausea, vomiting, infertility, etc
34
What is the medical term for radiation therapy?
XRT
35
What are the two types of chemotherapy and what do they target?
1. Cell specific - targets a specific phase of the growth cycle
2. Non-cell specific - does not target a specific phase
36
Are chemotherapy agents specific or non-specific?
Non-specific - does not target a specific cell, attacks the whole body
37
What are the side effects of chemotherapy?
Acute toxicity, specific organ toxicity, and long term complications
38
What is the goal of chemotherapy?
Maximize tumor kill while minimizing side effects, cure, slow progression, shrink tumor to ease surgical approach, and palliation
39
What are PT implications regarding chemotherapy drug classes?
PT's should understand how the classes of drugs work and their main side effects
40
What are long term complications associated with chemotherapy?
Early onset cardiac issues, pulmonary fibrosis, learning disabilities, hearing loss, neuropathy (pain and balance), and secondary cancers
41
What types of cancers are sensitive to hormones?
Breast cancer, testicular cancer, and prostate cancer
42
What is the treatment for hormone sensitive cancers?
Hormone therapy - block receptors for hormone
43
What are side effects of hormone therapy?
Hormonal changes, hot flashes, edema, decreased bone density, sexual dysfunction, and some have an increased risk for blood clots
44
What is monoclonal antibodies (MAB's)?
A cancer treatment that targets specific antigens or proteins on the surface of the cancer cells - helps the body recognize these cells as foreign
45
Describe the staging regarding cancer.
Staging according to size and mestastasis:
0 - pre-cancerous
1 - small tumor that has not spread
2,3 - intermediate size that has spread
4 - large tumor that has spread to a different area of the body
46
What is TNM?
T - tumor (# tells the size of the cancer)
N - node (spread to lymph, # tells how much and size)
M - mestastasis (spread, # tells how much and size)
47
What is the importance of developing a malignant tumor in the brain or spinal cord?
Chances are very low: <1%
48
What sex is more likely to develop a malignant brain or spinal cord tumor?
Males
49
What is the relationship between secondary tumors and brain and spinal cord tumors?
Brain and spinal cord tumors are more likely to be caused by secondary tumors
50
What are risk factors for brain and spinal cord tumors?
Genetics, family history, rare genetic disorders, environment (pesticides), and radiation
51
What are the two types of space occupying lesions for CNS tumors?
1. Benign
| 2. Malignant
52
What are characteristics of space occupying lesions of CNS tumors?
Direct compression (nerve symptoms), block CSF (increase in intracranial pressure), and destruction of bone (nerve compression)
53
What do the symptoms of brain tumors depend on?
LOCATION
54
What are some symptoms associated with brain tumors?
Seizure, loss of movement or sensation in the arm. imbalance, loss of vision or hearing, confusion, or nausea
55
What is a supratentorial brain tumor?
Located between the two hemispheres above the brainstem and the cerebellum
56
What is the main symptom of supratentorial brain tumors?
Focal deficits
Also: seizures, headaches, mental status changes, and similar symptoms of TIA
57
What are symptoms associated with brainstem and cerebellum tumors?
Vomiting, ataxia, facial droop, dysphagia, dysarthria, and visual changes
58
What are symptoms associated with frontal lobe brain tumors?
Personality changes, hemiplegia, seizures, anosmia (smell), and visual changes
59
What are symptoms of spinal cord tumors?
Valsalva - pain around thorax when holding breath, sneezing, etc
60
What are the main categories of brain and spinal cord tumors?
Gliomas, astrocytomas, oligodendroglioma, meningiomas, meduloblastomas, and schwanomas
61
What is a glioma?
Tumor that starts in the glial cells
62
What fraction of brain tumors are gliomas?
3/10
63
Are glioma's bimodal?
Yes: seen in both children and adults
2-10 years
45-55 years
64
What are the three support neurons for glioma's?
1. Astrocytes - nutritional support
2. Oligodendrocytes - produce myelin
3. Ependymal cells - line ventricles of brain
65
What is a malignant glioma?
Glioblastoma multiform
66
What population is most likely to develop a malignant glioma and what is the prognosis?
Adults 50-60 years old
50% 1 year survival rate
<15% 2 year survival rate
67
What are the most common brain tumors in adults?
Meningiomas - begin in the meninges
68
What sex is more likely to develop a meningioma?
Women
69
What is a neurinoma?
Tumor of the Schwann cells
70
What population is most likely to develop neurinomas?
Middle aged adults 40-50 years old
71
What is the most common manifestation of neurinomas?
Acoustic neuroma (CN 8) - progressive hearing loss, balance dysfunction, facial numbness, and headache
72
What type of malignant tumor is most common in children?
Medulloblastoma - originates in vermis of cerebellum
73
What is the prognosis of medulloblastoma?
Can spread to spine
>60% 5 year survival rate
74
What are the diagnostic tools for brain tumors?
MRI (best), fMRI, CT scan, cerebral angiography (use of dye to see blood vessels in brain), chest x-ray/body scan, and CT guided sterotactic needle biopsy
75
What are treatment options for brain tumors?
Craniotomy - remove piece of bone to access tumor
76
What are the complications with surgery regarding brain tumors?
Edema, infection, hemorrhage, and hydrocephalus
77
What is the difference between chemotherapy and radiation therapy regarding the BBB?
Specific agents are permitted to cross - BBB blocks off chemo agents
78
What is the incidence of musculoskeletal neoplasms?
Not very common
79
Where can musculoskeletal tumors occur?
Muscle, cartilage, nerve, collagen, skin, or bone
80
What is the ratio of MS tumors for males and females?
3:1 - males more common
81
Are MS tumors benign or malignant?
Both: can spread to lungs, liver, and bone
82
What are risk factors for MS tumors?
Radiation, pesticides, and chemotherapy
83
What are the two characteristics of MS tumors?
1. Osteoblastic - forms new bone
| 2. Osteolytic - lesions where there is bone/areas in the body with more bone formation
84
What are signs and symptoms of MS tumors?
Pain with weight bearing, edema, or lumps
85
What are the diagnostic tools for MS tumors?
Radiograph, MRI, bone scans, CT scans, biopsy, or lab tests (CRP)
86
How are MS tumors staged?
TNM system
87
What is the treatment of MS tumors?
Marginal excision, wide excision, or limb salvage/sparing
88
What is the order of treatment regarding MS tumors?
Surgery first followed by radiation therapy (most of the time not effective) or chemotherapy
89
What is a type of malignant bone tumor?
Osteosarcoma - 15-20% of all malignant tumors - most common in femur - develop from osteoblast cells
90
What is the incidence of osteosarcomas in males and females?
Equal until adolescence and then males increase in incidence
91
Are osteosarcomas bimodal?
Yes: peak 15 year olds
50
92
What are risk factors for osteosarcomas?
Paget's disease, radiation, and chromosomal abnormalities
93
What are signs/symptoms of osteosarcomas?
Pain, arthralgia's, joint effusion, ROM deficits, and fractures
94
Where is a common site for osteosarcomas to spread to?
Lungs
95
What is the prognosis for osteosarcomas?
5 year cure rate 70-80% (may go down if spread to the lungs)
96
What is the treatment for osteosarcoma?
Chemotherapy and limb salvage
97
What is Ewing's sarcoma?
Malignant bone tumor due to a genetic abnormality (translocation of chromosome 11 and 22)
98
What population is most likely to get Ewing's sarcoma?
<20 years old
99
Where are Ewing's sarcomas usually found?
Pelvis and LE
100
What are signs/symptoms of Ewing's sarcoma?
Pain, edema, fracture, flu-like symptoms
101
What is the diagnostic tool for Ewing's sarcoma?
Radiograph
102
What is the treatment for Ewing's sarcoma?
Radiation, chemotherapy, and limb salvage
103
What is the prognosis for Ewing's sarcoma?
5 year survival >70%
104
What is rhabdomyosarcoma?
Malignant soft tissue tumor that originates from a primitive muscle
105
What sex and population is more likely to develop rhabdomyosarcomas?
```
Sex = males
Population = children (2-6 and 15-19)
```
106
Where do rhabdomyosarcomas occur?
Head/neck, GI tract, extremities, and lungs - may spread to lungs and bone
107
What is a major sign/symptom of rhabdomyosarcomas?
Painless soft tissue lump
108
What is the treatment for rhabdomyosarcomas?
Chemotherapy and surgery
109
What is the prognosis for rhabdomyosarcomas?
50% 5 year survival rate
110
What is the highest probability of developing cancer in women?
Breast cancer
