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Pathophysiology - Test 2 > Oncology > Flashcards

Oncology Flashcards

0
Q

What is the number two killer in the US?

A

Cancer

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1
Q

What is the number one killer in the US?

A

Heart disease

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2
Q

What is the number one cancer killer among both men and women?

A

Lung and bronchus cancer

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3
Q

What ethnicity is most likely to develop cancer?

A

African Americans

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4
Q

What percentage of men develop cancer?

A

50%

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5
Q

What is the highest probability of developing cancer in men?

A

Prostate cancer

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6
Q

What percentage of women develop cancer?

A

33%

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8
Q

What is important about cancer incidence in children?

A

Incidence is higher than the mortality rate

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9
Q

What are the two most common types of cancer in children?

A

Leukemia and brain cancer

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10
Q

Why do kids have a lower death rate than adults?

A

Tend to bounce back quicker

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11
Q

What can a sedentary lifestyle lead to?

A

Cancer

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12
Q

What can smoking lead to?

A

Heart disease and a higher risk for cancer

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13
Q

What can a high BMI lead to?

A

Cancer

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14
Q

What sex and ethnicity has the highest prevalence of sunburn?

A 
Sex = males
Ethnicity = Caucasians
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15
Q

What can sun exposure lead to?

A

Skin cancer

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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

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17
Q

What is cancer?

A

An abnormal growth of cells - cancer cells do not have normal triggers to stop dividing

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18
Q

What are three important characteristics of cancer?

A
  1. Lack of senescence
  2. Loss of contact inhibition
  3. Ability to divide without anchorage
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19
Q

How are tumors classified?

A
  1. Size of tumor
  2. Where tumor originated
  3. Cell type
  4. Location
  5. Degree of differentiation
  6. Benign vs. malignant
  7. Cellular characteristics
  8. Hormone production or sensitivity
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20
Q

What does the treatment of cancer depend on?

A

Morphology of the tumor

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21
Q

What are the different cell types of cancer?

A

Epithelial, connective, muscle, nerve, lymph, and hematopietic

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22
Q

Differentiate benign tumors vs malignant tumors.

A

Benign - does not spread

Malignant - spreads

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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

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24
Q

What are different treatment options for cancer?

A
  1. Do nothing
  2. Surgery
  3. Radiation
  4. Chemotherapy
  5. Biological therapy
  6. Hormonal therapy
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25
Q

What is an example of a slow growing cancer?

A

Prostate cancer

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26
Q

What is biological therapy?

A

Targeted therapy - creates antibodies that are specific to the tumor type

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27
Q

What is the main type of treatment for cancer?

A

Surgery

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28
Q

What are the functions of surgery regarding cancer?

A

Debulk tumor, remove precancerous lesions, control symptoms, and create a clean margin

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29
Q

What is a clean margin?

A

Goal of surgery in order to have an area of healthy tissue surrounding the tumor to ensure that all of the tumor was removed

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30
Q

What is radiation therapy?

A

Localized non-selective treatment to cancer (does not care that the skin it is going through is healthy)

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31
Q

What are the goals of radiation therapy?

A

Pain relief, prevention of fracture, and decrease tumor size

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32
Q

What is important about radiation therapy?

A

There are many types

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33
Q

What are the side effects of radiation therapy?

A

Fatigue, skin can become dry or reddened, decreased ROM, nausea, vomiting, infertility, etc

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34
Q

What is the medical term for radiation therapy?

A

XRT

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35
Q

What are the two types of chemotherapy and what do they target?

A
  1. Cell specific - targets a specific phase of the growth cycle
  2. Non-cell specific - does not target a specific phase
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36
Q

Are chemotherapy agents specific or non-specific?

A

Non-specific - does not target a specific cell, attacks the whole body

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37
Q

What are the side effects of chemotherapy?

A

Acute toxicity, specific organ toxicity, and long term complications

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38
Q

What is the goal of chemotherapy?

A

Maximize tumor kill while minimizing side effects, cure, slow progression, shrink tumor to ease surgical approach, and palliation

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39
Q

What are PT implications regarding chemotherapy drug classes?

A

PT’s should understand how the classes of drugs work and their main side effects

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40
Q

What are long term complications associated with chemotherapy?

A

Early onset cardiac issues, pulmonary fibrosis, learning disabilities, hearing loss, neuropathy (pain and balance), and secondary cancers

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41
Q

What types of cancers are sensitive to hormones?

A

Breast cancer, testicular cancer, and prostate cancer

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42
Q

What is the treatment for hormone sensitive cancers?

A

Hormone therapy - block receptors for hormone

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43
Q

What are side effects of hormone therapy?

A

Hormonal changes, hot flashes, edema, decreased bone density, sexual dysfunction, and some have an increased risk for blood clots

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44
Q

What is monoclonal antibodies (MAB’s)?

A

A cancer treatment that targets specific antigens or proteins on the surface of the cancer cells - helps the body recognize these cells as foreign

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45
Q

Describe the staging regarding cancer.

A

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
Q

What is TNM?

A

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
Q

What is the importance of developing a malignant tumor in the brain or spinal cord?

A

Chances are very low: <1%

48
Q

What sex is more likely to develop a malignant brain or spinal cord tumor?

A

Males

49
Q

What is the relationship between secondary tumors and brain and spinal cord tumors?

A

Brain and spinal cord tumors are more likely to be caused by secondary tumors

50
Q

What are risk factors for brain and spinal cord tumors?

A

Genetics, family history, rare genetic disorders, environment (pesticides), and radiation

51
Q

What are the two types of space occupying lesions for CNS tumors?

A
  1. Benign

2. Malignant

52
Q

What are characteristics of space occupying lesions of CNS tumors?

A

Direct compression (nerve symptoms), block CSF (increase in intracranial pressure), and destruction of bone (nerve compression)

53
Q

What do the symptoms of brain tumors depend on?

A

LOCATION

54
Q

What are some symptoms associated with brain tumors?

A

Seizure, loss of movement or sensation in the arm. imbalance, loss of vision or hearing, confusion, or nausea

55
Q

What is a supratentorial brain tumor?

A

Located between the two hemispheres above the brainstem and the cerebellum

56
Q

What is the main symptom of supratentorial brain tumors?

A

Focal deficits

Also: seizures, headaches, mental status changes, and similar symptoms of TIA

57
Q

What are symptoms associated with brainstem and cerebellum tumors?

A

Vomiting, ataxia, facial droop, dysphagia, dysarthria, and visual changes

58
Q

What are symptoms associated with frontal lobe brain tumors?

A

Personality changes, hemiplegia, seizures, anosmia (smell), and visual changes

59
Q

What are symptoms of spinal cord tumors?

A

Valsalva - pain around thorax when holding breath, sneezing, etc

60
Q

What are the main categories of brain and spinal cord tumors?

A

Gliomas, astrocytomas, oligodendroglioma, meningiomas, meduloblastomas, and schwanomas

61
Q

What is a glioma?

A

Tumor that starts in the glial cells

62
Q

What fraction of brain tumors are gliomas?

A

3/10

63
Q

Are glioma’s bimodal?

A

Yes: seen in both children and adults

2-10 years
45-55 years

64
Q

What are the three support neurons for glioma’s?

A
  1. Astrocytes - nutritional support
  2. Oligodendrocytes - produce myelin
  3. Ependymal cells - line ventricles of brain
65
Q

What is a malignant glioma?

A

Glioblastoma multiform

66
Q

What population is most likely to develop a malignant glioma and what is the prognosis?

A

Adults 50-60 years old

50% 1 year survival rate
<15% 2 year survival rate

67
Q

What are the most common brain tumors in adults?

A

Meningiomas - begin in the meninges

68
Q

What sex is more likely to develop a meningioma?

A

Women

69
Q

What is a neurinoma?

A

Tumor of the Schwann cells

70
Q

What population is most likely to develop neurinomas?

A

Middle aged adults 40-50 years old

71
Q

What is the most common manifestation of neurinomas?

A

Acoustic neuroma (CN 8) - progressive hearing loss, balance dysfunction, facial numbness, and headache

72
Q

What type of malignant tumor is most common in children?

A

Medulloblastoma - originates in vermis of cerebellum

73
Q

What is the prognosis of medulloblastoma?

A

Can spread to spine

> 60% 5 year survival rate

74
Q

What are the diagnostic tools for brain tumors?

A

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
Q

What are treatment options for brain tumors?

A

Craniotomy - remove piece of bone to access tumor

76
Q

What are the complications with surgery regarding brain tumors?

A

Edema, infection, hemorrhage, and hydrocephalus

77
Q

What is the difference between chemotherapy and radiation therapy regarding the BBB?

A

Specific agents are permitted to cross - BBB blocks off chemo agents

78
Q

What is the incidence of musculoskeletal neoplasms?

A

Not very common

79
Q

Where can musculoskeletal tumors occur?

A

Muscle, cartilage, nerve, collagen, skin, or bone

80
Q

What is the ratio of MS tumors for males and females?

A

3:1 - males more common

81
Q

Are MS tumors benign or malignant?

A

Both: can spread to lungs, liver, and bone

82
Q

What are risk factors for MS tumors?

A

Radiation, pesticides, and chemotherapy

83
Q

What are the two characteristics of MS tumors?

A
  1. Osteoblastic - forms new bone

2. Osteolytic - lesions where there is bone/areas in the body with more bone formation

84
Q

What are signs and symptoms of MS tumors?

A

Pain with weight bearing, edema, or lumps

85
Q

What are the diagnostic tools for MS tumors?

A

Radiograph, MRI, bone scans, CT scans, biopsy, or lab tests (CRP)

86
Q

How are MS tumors staged?

A

TNM system

87
Q

What is the treatment of MS tumors?

A

Marginal excision, wide excision, or limb salvage/sparing

88
Q

What is the order of treatment regarding MS tumors?

A

Surgery first followed by radiation therapy (most of the time not effective) or chemotherapy

89
Q

What is a type of malignant bone tumor?

A

Osteosarcoma - 15-20% of all malignant tumors - most common in femur - develop from osteoblast cells

90
Q

What is the incidence of osteosarcomas in males and females?

A

Equal until adolescence and then males increase in incidence

91
Q

Are osteosarcomas bimodal?

A

Yes: peak 15 year olds

50

92
Q

What are risk factors for osteosarcomas?

A

Paget’s disease, radiation, and chromosomal abnormalities

93
Q

What are signs/symptoms of osteosarcomas?

A

Pain, arthralgia’s, joint effusion, ROM deficits, and fractures

94
Q

Where is a common site for osteosarcomas to spread to?

A

Lungs

95
Q

What is the prognosis for osteosarcomas?

A

5 year cure rate 70-80% (may go down if spread to the lungs)

96
Q

What is the treatment for osteosarcoma?

A

Chemotherapy and limb salvage

97
Q

What is Ewing’s sarcoma?

A

Malignant bone tumor due to a genetic abnormality (translocation of chromosome 11 and 22)

98
Q

What population is most likely to get Ewing’s sarcoma?

A

<20 years old

99
Q

Where are Ewing’s sarcomas usually found?

A

Pelvis and LE

100
Q

What are signs/symptoms of Ewing’s sarcoma?

A

Pain, edema, fracture, flu-like symptoms

101
Q

What is the diagnostic tool for Ewing’s sarcoma?

A

Radiograph

102
Q

What is the treatment for Ewing’s sarcoma?

A

Radiation, chemotherapy, and limb salvage

103
Q

What is the prognosis for Ewing’s sarcoma?

A

5 year survival >70%

104
Q

What is rhabdomyosarcoma?

A

Malignant soft tissue tumor that originates from a primitive muscle

105
Q

What sex and population is more likely to develop rhabdomyosarcomas?

A 
Sex = males
Population = children (2-6 and 15-19)
106
Q

Where do rhabdomyosarcomas occur?

A

Head/neck, GI tract, extremities, and lungs - may spread to lungs and bone

107
Q

What is a major sign/symptom of rhabdomyosarcomas?

A

Painless soft tissue lump

108
Q

What is the treatment for rhabdomyosarcomas?

A

Chemotherapy and surgery

109
Q

What is the prognosis for rhabdomyosarcomas?

A

50% 5 year survival rate

110
Q

What is the highest probability of developing cancer in women?

A

Breast cancer

Pathophysiology - Test 2 (4 decks)

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