oncology Flashcards
whats cancer
abnormal cell growth
ignores growth regulation signals
whats benign mean
tumor but not cancer yah know
whats malignant neoplasms
cancer cells
whats a tumor
can be cancer or can not be cancer
just a little abnormal tissue growth
whats metastasis
teehee
spread from original site to another one
are medical screenings important
sure are
what are the 3 leading causes of cancer death for men
- prostate
- lung
- colorectal
what are the 3 leading causes of cancer death for women
- breast
- lung
- colorectal
what factors can affect cancer death rates
- attitudes/lifestyle choices
- cultural beliefs
- socioeconomic status/insurance
- misconceptions
whats a carcinogen
factors associated with cancer causation
read this
exposure -> alteration og genetic material of cell -> oncogenes -> produce abnormal cells -> eventually become cancer cells
what causes cancer
- most causes are unknown
- carcinogens
- failure of immune system
- specific risk factors associated: smoking, UV, obesty, alcohol, sedentary ppl, and diet increased in red meat and processed shit
name some different carcinogens
- viruses (herp, hep, and HPV)
- physical agents (UV and pollution)
- chemicals (asbestos)
- genetics
- lifestyle factors (tobacco, piercings?)
- hormones (child birth and menopause)
whats the G0 phase and how does it relate to cancer
- resting phase of cell cycle, no reproduction happening here
- cancer cells are less likely to enter this phase
describe cancer cells
- complete cell cycle quicker
- less likely to enter G0 phase
- uncontrolled growth patterns and immortality (lack p53 gene)
- rapidly growing and reproducing cells are the targets of chemo and radiation
describe primary prevention of cancer
- before cancer happens
- reducing risks
- example: HPV immunization
describe secondary prevention of cancer
- early detection and screening
- screening efforts -> inspction, palpation, and diagnostics
describe tertiary prevention of cancer
- after diagnosis
- prevention of complications
- treatments considered therapeuti to eradicate or arrest disease and/or prevent further complications
which of the following would be considered primary prevention for cancer?
- yearly colonoscopy
- yearly CT scnas after diagnosis
- HPV vaccine
- genetic testing
HPV vaccine
primary is all about reducing risks
describe the diagnosis of cancer
- multidisciplinary
- physical exam findings during examination
- diagnosis of malignancy: tissue biopsy, cytology results, lab results (heme malignancies), CT, Xrays, MRI
must have cells/tissue to make diagnosis
when is staging and grading of cancer done
immediately after diagnosis and prior to treatment
what is staging and grading of cancer
categorize tumors accoding to extent of disese and organs involved
what is staging
determines size, invasion, lymph node involvement, mets
TNM system (tumor, nodes, mets)
whats grading
pathologic classification
type of tumor cells and differentiation
higher the stage/grade =…
decerased prognosis for cure and less chance of successful treatment
name and describe some staging of cancers
0: insitu CA/very early lesions
I: early invasion/no mets
II: limited local extension of tumor/minimal node involvement
III: extensive local and nodal invasion
IV: distant mets/other organs involved
name some grades and what they mean
grades 1 and 2: well differentiated and deviated minimally from normal cells
high grades (grades 3-4): poorly differentiated and most aberrant compared with normal cells
what are some cancer treatment goals
- cure: ereadicate the cancer
- palliation: alleviation of symptoms when disease is beyond treatment
describe surgery as a cancer treatment
can be:
primary tx: just cut it out
palliative: make em more comfy
prophylactic: take out the body part b4 it gets there
used alone or with radiation and chemo
what are the goals of radiation
cure, control, or prophylactic
what cells does radiation affect
rapidly dividing cells like:
- bone marrow
- lymph tissue
- GI lining
- hair
- gonads
describe radiation dosage
- super specific
- uses BSA
- person has to try to maintain weight
name three types of radiation
- external beam
- internal radiation
- radioactive isotopes
describe external beam radiation
- source outside the body
- provides direct hit for local tx (doesnt really attack cells outside of radiated area)
- ALL tissue in pathway is affected
- limited amount the body can tolerate
- given in divided doses over several days-wks
describe internal radiation
brachytherapy = use of implants at treatment site
radioactive implants/”seeds”:
- sealed source
- site specific (prostate, lungs, thyroid)
- little exposure to nursing staff
- no isolation needed
describe radioactive isotopes
- systemic treatment - inject or swallow
- unsealed source
- patient and body radioactive
- time, distance, and shielding for staff safety
- body fluid precautions
- isolation precautions
- used for super extensive CA, hospitalized for tx
what are some adverse effects of radiation
- skin reactions at entry and exit site of external beam
- bone marrow suppression
- fatigue
- alteration in nutrition (mucositis and stomatitis)
onset may take several days/wk to begin and may last 2-4wks after tx
describe skin care for external radiation
- NO ointments, powder, soaps, deodorants, or perfurmes
- NO shaving with razor blade
- protect skin from cold, heat, and sun
- loose fitting clothing
- only lotions, etc approved by radiology for skin irritations
- DO NOT wash off markings
whats included in nursing management of radiation
- skin care
- monitor CBC
- manage sx
- maintain nutrition
your chmotherapy pt has the following lab values: WBC 2.5, plts 300,000, and RBC 4.5. which type of precaution would be appropriate?
infection, don’t let ppl in there
what kind of cells do antineoplastic drugs work on
rapidly dividing cells
what are the principles of chemo
- disrupts reproduction of cells by altering biochemical processes
- destroys malignant cells without excess destruction of normal cells
- given in repeated doses or cycles
- functional assessment and other clearance tests done before drugs begin
what is chemotherapy
use fo cytotoxic drugs
describe the use of chemotherapy
- if widespread/systemic disease
- high risk of undetectable disease
- tumor cannot be resected and is resistant to RT
- primary or combination treatment
what are the goals of chemotherapy
- cure
- control
- palliative
if gicing chemo IV, what are you gonna watch for
watch for extravasation
chemo adverse effects
hematopoietic changes
- leukplakia
- anemia
- thrombocytopenia
- may interrupt treatment schedule
chemo adverse effects
nausea and vomiting
- fewer episodes than years ago
- major fear of pts and fams
- give antiemetic -> ondansetron
chemo adverse effects
mucositic/stomatitis
- oral, rectal, vaginal
- can effect entire GI tract - severe diarrhea
- irritated and painful
- might need feeding tube
chemo adverse effects
skin changes
- hair loss (alopecia) -> hair will return but no the same
- skin reactions
- nails will fall off???
what are some possible major system toxicities
- cardiac: drug thats dose is limited to once in a lifetime bc it sucks ass so bad
- hepatic: liver takes a hit
- renal: need hydration
- neurologic: get some neuropathies goin on
- reproductive: save those eggs and sperm bc theyre not gonna last and your sex drive will be GONE
describe nursing management of chemo
- use PPE
- dispose of shit properly and handle spills
- complete special education (how to handle, safe admin, side effects, emergencies, shit like that)
what do nonspecific biologic response modifiers do
stimulate the immune system generally (ex, BCG)
what do monoclonal antibodies do
destroy specific malignant cells and spare normal cells (MABs)
name and describe some cytokines
- interferons: antiviral, antitumor, immunomodulatory
- colony stimulating factors: treat myelosupression (erythropoietin and fligrastim)
- interleukins: immunomodulatory
what can gene therapy do for cancer
can have super targeted therapies
controversial tho
describe nursing management of the chemo patient
- assess, educate, and evaluate patient and fam understanding
- monitor labs and pts status
- precautions r/t neutropenia, anemia, thrombocytopenia
- assess self care needs and assistance
- nutritional needs
nursing management of onc patients
fatigue
- varies from person to person
- teach energy conservation methods
- encourage rest between activities
- educate on expected fatigue
- educate on safety precautions r/t weakness, falls, and driving
nursing management of onc patients
pain
- pharm and nonpharm treatment
- leads to anxiety
- monitor labs for med choice
nursing management of onc patients
nutritional needs
- administer anti-emetics (before and/or on schedule)
- small frequent meals
- supplemental feedings
- educate on taste and small alterations
- meticulous oral care (rinses with sodium bicarb)
- pain meds if stomatitis
- bland, non acidic foods
describe neutropenia
- increased frequency of infection
- symptoms of infection may not appear
- fever is cardinal symptom (>38)
- meticulous handwashing
- staff wears mask in room and place on patient when patient is leaving room - check agency policy
- NO fresh flowers, fruits, veggies, yogurt with active cultures
- may need colony stimulating factors (filgrastim) with bone pain expected
describe anemia
- fatigue and decreased O2 carrying capacity
- erythropoietin
- watch Hgb/Hct
- may require blood transfusions
describe thrombocytopenia
- monitor for bleeding and bruising ( esp GI and oral)
- no razors/toothbrushes
- no aspirin products
- no IM injections
- may require platelet transfusions
what are some oncology complications
- infection secondary to neutropenia
- spetic shock
- pain
- bleeding/thrombocytopenia
- hypercalcemia
- tumor lysis syndrome
- SIADH
- DIC
- spinal cord compression
