oncology Flashcards
carcinoma
- malignancy originating from epithelial cells of organs
- ex: lung carcinoma subsets - large cell carcinoma, adenocarcinoma, squamous cell carcinoma
- most cx in US is carcinoma
general s/s of cancer
C - change in bowel/bladder
A - a sore that will not heal
U - unsual bleeding/discharge
T - thickening/lump develops
I - indigestion or difficulty swallowing
O - obvious change in wart/mole
N - nagging cough/hoarseness
- unexplained weight loss, fatigue, anorexia, anemia, pain, weakness
cancer prevention
- primary prevention: elimination of modifiable risk factors
- secondary: early detection, preventatives
- tertiary: prevent disability that can occur secondary to cx treatment
types of tissue and tumor
- epithelium - carcinoma, adenocarcinoma: in skin, mucous membrane, lining of bladder
- pigmented cells - malignant malenoma: moles
- connective tissue - sarcomas: striated muscle, blood vessels, fat, bone
- nerve tissues - astrocytoma, glioma, blastoma: brain, nerves, SC, retina
- lymhoid tissue - lymphoma: lymph, spleen
- hematopoietic - leukemia, myelodysplasia
TNM staging
- T - primary tumor size and extent
- N - lymph node involvement
- M - metastasis presence
- can correspond to stage designation that further defines severity
national cancer institue staging
- stage 0: early melignancy, present only in layer of cells in which it began - not in all cancers
- stage 1: malignancy limited to tissue of origin w/ no lymph node involvement or metastasis
- stage 2: malignancy spreading into adjacent tissues, lymph nodes can show signs of micrometastases
- stage 3: malignancy that has spread to adjacent tissue showing signs of fixation to deeper structures - high likelihood of lymph node involvement
- stage 4: malignancy metastsaize beyond primary site, to bone or other organ
other staging
- clinical - based on findings of a patient’s physical exam, lab values, imaging tests, biopsy
- pathologic: based on tissue samples in surgery
bronchial carcinoma
- any epithelial carcinoma occurring in bronchopulmonary tree
one of the most curable cancers
hodgkin lymphoma
skin cancers
- basal cell carcinoma: slow growing, rarely metastazies; originates in epidermis, most common form; good prognosis
- malignant melanoma: originates from malnocytes and can be superficial, nodular, acral; early diagnosis vital - metastasizes quickly; 100% curable with early diagnosis
leukemia
- cancer of blood when leukocytes change into malignant cells
- acute lymphoblastic leukemia and acute myelogneous leukemia
most common malignant tumor in children
neuroblastoma
- wilms’ tumor - embyonal neuroblastoma found in kidney btw 1-4 YO
anemia
- low levels of hemoglobin or hematrocrit
thrombocytopenia
- low platelet counts
neutropenia
- neutrophil count below normal laboratry reference values placing patient at risk for serious infection
oncology treatment options
- surgery
- radiation - ionizing radiation or particle radiatoin
- chemotherapy - group of drugs to destroy malignant cells; not for metastatic
- biotherapy (immunotherapy) - uses agents to change relationship btw malignancy and host; stregnthen pt biological response to malignant cells
- antiangiogenic therapy - use of thalidomide and suppression of blood supply formation
- other pharm therapies: hormone therapy
- palliative treatment - symptom management
guidelines for patients undergoing cancer treatment
- check physician orders fot pts with bone metastasis for WB status and mobility precautions
- monitor blood values - platelet and hematocrit
- exercise should be 40-65% of peak HR, heart rate reserve, VO2 max
- RPE should not > 12
- treatment visits should be scheduled for when pt E is max
- treatment should be modified as needed to accommodate side effects
- no massage or heat over irritated areas
heat and electrotherapeutic modalities and cx
- contraindicated for use over active malignancy but not necessarily contraindicated elsewhere on body d/t potential for facilitating growth
- can be overlooked for pts with palliative goals or terminal illness
alkylating agents
- bind DNA strands together to prevent replication
- mustargen, busulfex, leukeran
antiobiotic agents
cancer
- d/t high toxicity and ability to interfere with DNA and RNA synthesis and subsequent cell division
- adriamycin, mithracin, cosmegen
antimetabolite agents
cancer
- impair biosynthesis of genetic material and interrupt cellcular pathways that synthesize DNA and RNA
- create imposter to endogenous metabolites in body to form nonfunctional genetic production incapable of reproduction
- esp used for rapidly dividing neoplastic cells
- leustatin, adrucil, fludara, trxall
biologic response modifier agents
- interferons, interluekin 2, and monoclonal antibodies that are responsible for enhancing body’s own ability to respond to neoplastic growth
- not cytotoxic but facilitate immune response to destroy malignant tissues
- proleukin, avastin, intron A
heavy metal compounds
cancer
- platinum coodination complexes
- act as alkylating agents that inhibit DNA translation and replication
adjuvant
- treatment provided in addition to other cure-focused interventions with intention of preventing cancer recurrence