Oncology Flashcards by Nikolas Leventis

Cancer causing the most deaths in men and women

Lung and bronchus

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Normal tissue

uniform size, shape, maturity and nuclear structure

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differentiation

normal cells undergo physical and structural changes as the form different tissues on body
malignant cells become undifferntiated

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benign neoplasm

harmless
small and slow
well differentiated
can become large enough to disrupt function

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malignant neoplasm

large and rapid\
poor differentiation
invade other tissue
spread from primary site

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Primary tumor

arises from cells local to given structure

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Secondary tumor

arises from cells that have metastasized from another area of the body

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carcinoma in situ

localized, preinvasive, possible malignant tumor contained within host organ
can be removed before entering blood

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Carcinoma neoplasm

most common cancer
formed by epithelial cells

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Sarcoma neoplasm

formed in soft tissue and bone
rare

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most common bone cancer?

osteosarcoma

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leukemia neoplasm

begins in bone marrow
does not form solid tumors
large #s of WBCs build up in blood and bone marrow

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lymphoma neoplasm

begins in lymphocytes (T cells or B cells)
abnormal lymphocytes build up in lymph nodes and vessels and organs

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multiple myeloma neoplasm

cells grow too much plasma cell, crowding out cells that RBCs, WBC, and platelets

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melanoma neoplasm

forms in melanocytes

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Brain and SC tumors

normally benign, but very dangerous

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Germ cell tumors

form in cells that become sperm or egg
can occur almost anywhere

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neuroendicrine tumors

form from cells that release hormones into blood
can result in high levels of hormones from tumors

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Tumor grading

classifies degree of malignancy and differentiation
estimates growth

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which tumors have better prognostic clinical outcomes

low-grade

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Grade I

low grade
well differentiated
slow growth

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Grade II

intermediate grade
moderately differentiated
slightly faster growth

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Grade III

high grade
poorly differentiated
aggressive growth and spread

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Grade IV

high grade
undifferentiated

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TNM system (T)

Tumor size location and depth of invasion

TNM system (N)

lymph node involvment postive/total

TNM system (M)

Distant metastasis present/absent

no evidence of primary tumor

Tis

carcinoma in situ site of origin

T1-4

progressive increase in tumor size and involvement locally

no evidence of metastases to regional lymph nodes

N1-3

increasing involvement in regional lymph nodes

no evidence of metastasis

distant metastasis is present

Stage 0 Tumor

carcinoma in situ

Stage 1 Tumor

Localized tumor less than or equal to 2 cm no spread to lymph

Stage 2 Tumor

Locally advanced 2-5 cm w or w/o lymph spread

Stage 3 Tumor

Tumor is more locally advanced spread to lymph

Stage IV

Tumor has metastasized/spread to other organs

Steps of metastasis

1. Continuous extension of local invasion 2. Penetration into lymphatics, blood vessels, or body cavities 3. Release into lymph or blood 4. Transport to secondary sites 5. Entry and growth in secondary sites

Provide example of naming metastasis

Primary breast cancer that spreads to the lungs is metastatic breast cancer

Most common metastasis

lymph node, liver, lung bone, brain

Incidence of metastasis

30% have clinically detectable metastases 30-40% have hidden metastases

When does spread occur in metastasis

within 3-5 years

low grade lesions may spread when?

15-20 years after

Metastases most commonly observed in PT

pulmonary hepatic skeletal cns

Pulmonary metastases incidence

most common lungs are first organ to filter malignant cells

Pulmonary metastses are asymptomatic until... (list why and symptoms)

tumor cells have obstructed bronchi or reached parietal pleura dry cough (1st) Pain Dyspnea Hemoptysis

Lung cancer is the most common primary to tumor to metastasize to the...

Brain

Liver metastases are signs of

advanced cancer

Liver filters blood coming from GI tract, making it a 1 metastatic site of tumors of...

stomach, colorectum, and pancreas

Hepatic System symptoms

AP and tenderness fatigue weight loss fever

Bone metastases common sources

women-breast men-prostate

Bone metasteses other sources

lung, thyroid, kidney

Skeletal system complications

Pain from WB Long bone fracture Vertebrae involvement (epidural spinal compression) Radiation Fibrosis (pain, weakness, atrophy, sensory, loss, fatigue as side effect of radiation) Lymphedema

Primary tumors that lead to CNS metastases

Lung carcinomas (50%) Brain carcinoma (15%)

Metastatic disease in the brain is life-threatening and can lead to

Increased ICP Obstruct CSF flow Change mentation Reduce sensory and motor function

Is it rare or common for primary tumors to metastasize outside the CNS?

Rare

Primary brain tumors are likely to be benign or malignant?

Benign

Which is more common: Primary brain tumor or brain metastases

Brain metastases

Deficits of nervous system complications

Impaired cognition (80%) Weakness (78%) Visual-perceptual impairment (53%)

CIPN

chemotherapy induced peripheral neuropathy stocking and glove distribution gait abnormalities

Cancer Pain Syndrome

Nerve Pain-pressure on nerves Ischemic Pain- interference with blood supply or blockage within hollow organs Bone-pain with weight bearing

Cancer drug therapy

cytotoxic drugs hormones biologic response modifiers

Healthy High Growth Fraction Cells

Hair GI Skin Reproductive Bone

Anemia Neutropenia Thrombocytopenia myopathy cardiomyopathy neuropathy contracture fatigue thromboembolism nause edema

chemo complications

skin changes fatigue hair loss low blood count

radiotherapy complications

Thromboembolism

CAT carry higher risk of recurrence, bleeding, and mortality

Surgery for cancer

may compromise nerves, muscles, bone, and lymphatics localized or systemic impairments

Cancer Fatigue

not proportional to exertion not relieved by rest

best treatment for cancer fatigue

aerobic exercise

ACSM recommends ___ minutes of moderate level of physical activity with slow progression of resistance exercise

150

Early signs of cardiopulmonary complications

dyspnea, pallor, sweating, fatigue

monitoring leukopenic patients

avoid anything fresh eat well done meat avoid fresh fruit veggies and flowers

Thrombocytopenic patients monitoring

avoid risk of bleeding

Anemic patient monitoring

conserve energy

Head and neck cancers often spread to ___ and lead to

lymph nodes; shoulder dysfunction lymphedema neck and face pain impaired jaw next extensor weakness and atrophy breathing, speaking, swallowing dysfunction

Breast cancer rehab considerations

adhesive capsilitis tendinopathies of RC and biceps cervical radiculopathy chest wall hypomobility myofascial pain syndromes