Oncology Flashcards
What race is most likely to die from cancer
African Americans
Among cancers what type is the leading cause of death
lung cancer
What is the chance of men getting cancer
1 in every 2 men
What is the chance of men getting prostate cancer
1 in every 6 men
What is the probability of a woman to develop cancer
1 in every 3 woman
what is the chance of a woman to develop breast cancer
1 in every 8 women
What is cancer
cellular DNA becomes damaged. Normal mutations occur daily but cancer is not corrected
Cells mutated by DNA may…
be unresponsive to signals of apoptosis
be insensitive to normal cellular suppressor genes
make their own signals that perpetuate growth
What are carcinoma cells
they occur in the lining of epithelium of passages/organs (adenocarcinoma occurs in gland cells or cells that secrete substances)
What are sarcoma cells
bone, carilage, fat, muscle, or other connective tissue
What are lymphoma and multiple myeloma cells
immune system cancers (MM= cancer of the plasma cell)
What are leukemia cells
cancer of the blood forming cells in the bone marrow
What three ways can cancer spread
direct extension into surrounding tissue
Lymphatic spread
hematologic spread
What are the treatments for cancer
surgery, radiation therapy (XRT), Chemotherapy, Hormonal Treatments, biological therapy
What are the goals of surgery in cancer patients
debulk tumor, diagnose tumor, remove pre-cancerous lesions, correct life threatening conditions caused by tumor, palliation
Clean margin: have an area of healthy tissue surrounding tumor to “ensure” that all of tumor is removed
What is radiation therapy
beam of photons hits the tumor cells and excites them which can damage bonds in the tumor
rapidly proliferating cells respond quickly to radiation (Skin, GI tract, Bone marrow, tumors)
slowly proliferating cells will show effects week to years after (heart lungs, kidneys, musculoskeletal tissue
Is radiation therapy selective
No
What does the impact of radiation depend on
dose, radiation field
What are the three main types of radiation
external beam
internal or brachytherapy
systemic
Is chemotherapy selective
no
what is adjuvant chemotherapy
therapy that follows surgery
what is neoadjuvant chemotherapy
therapy given before surgery
Which type of cancer treatment is given in cycles with multiple drugs in each regimen
chemotherapy
What is the point of giving cycles with multiple drugs in each regimen
approach reduces side-effect profile or each drug/reduces dose needed
each drug targets cells in different parts of their cell cycle
What are the side effects of chemotherapy
rapidly dividing cells are damaged, peripheral neuropathy
What are the long term impacts of chemotherapy
early onset of cardiac issues pulmonary fibrosis learning disabilites hearing loss neuropathy (pain, balance) secondary cancers
When are hormonal treatments for cancer used
if the tumor grows in response to certain hormones, drugs to block hormonal receptors on target organ can be used. Drugs to reduce circulating hormones can also be used (comes with more side effects)
How does biological therapy for cancer work
utilizes the patients own immune system to help fight cancer
What two types of biological therapy exist
vaccines, monoclonal antibodies
What are monoclonal antibodies
immunoglobulin sequences that recognize a specific antigen or protein on the surface of cells, some target receptors ad some target the growth factor
What are the risk factors for cancer
inactivity, age, obesity, hormones, viruses, tobacco, alcohol, poor diet, family history
Will cancer patients typically respond to PT
no, condition will not improve and they will not “fit” typical presentation of original diagnoses
Do children typically respond well to cancer
yes
what cancer are children most likely to get
leukemia
What is the chance of developing a malignant brain tumor
<1%
Are primary or secondary brain tumors more common
Secondary
What are the risk factors for CNS neoplasms
genetics, rare genetic disorders, neuromuscular disorders, environment (pesticides), radiation, cell phones (non-conclusive)
What problems can a CNS neoplasm cause
direct compression, block CSF causing pressure build up (vasogenic edema), destruction of bone –> nerve compression
What determines the symptoms of a brain tumor
location of tumor
What are some common symptoms of brain tumors
seizure, gradual loss of movement or sensation, unsteadiness, loss of vision, hearing loss, speech difficulty, morning nausea, confusion
What is a supratentorial lesion
a lesion located between the hemispheres, above brainstem and cerebellum
What can supretentorial lesions cause
focal deficits, seizures, headache, mental status changes, mimics TIA
What are the symptoms of brainstem and cerebellum lesions
vomiting (early in morning), ataxia, facial droop, dysphagia, dysarthria, weakness, visual changes
What do lesions to the frontal lobe cause
personality changes, hemiplegia, seizures, anosmia (smell), visual changes (blurriness)
What do spinal cord tumors cause
pain in a band with valsalva, pain that worsens in supine, dependent of level affected (bowels/bladder, weakness/atrophy, sensory changes)
What are types of brain and spinal cord tumors
gliomas, astrocytomas, oligodendroglioma, meingiomas, meduloblastomas, schwanomas
What are gliomas
a group of tumors that start in glial cells
What are types of gliomas
glioblastoma multiforme
astrocytoma
olgiodendroglioma
ependymoma
When are the peak incidence of gliomas
2-10 and 45-55
What is the most common brain tumor in adults
Meningiomas
Which sex normally gets meningiomas
women
Are neurinomas benign or malignant and where are they normally located
benign, CN8
What are neurinomas, and who gets them
Tumors of the schwann cells, 40-50 year old
Where are medulloblastomas located
vermis of cerebellum
Are medulloblastomas benign or malignant
malignant
What is the most common malignant tumor in children
medulloblastomas
How are brain tumors diagnosed
MRI (best tool) fMRI (functional MRI) CT scan Cerebral angiography Chest x-ray, body scan CT guided sterotactic needle biopsy
What are treatment options for brain tumors
surgical resection, craniotomy, chemotherapy, radiation,
What complications can come with surgery of the brain
edema, ICP
infection
hemorrhage
hydrocephalus
What are the risk factors for musculoskeletal tumors
radiation, toxins (pesticides), chemotherapy
Signs and symptoms of musculoskeletal tumors
vague
pain
edema
lump
How are musculoskeletal tumors diagnoesed
radiograph, MRI, Bone scans, CT scan, biopsy, lab tests (erythrocyte sedimentation rate)
Is there a uniform staging system for musculoskeletal tumors
no
What is the treatment for musculoskeletal tumors
marginal excision, wide excision, limb salvage or limb-sparing, radiation, chemotherapy
what is the name for a malignant bone tumor
osteosarcoma
When is the peak incidence of osteosarcomas
15 y.o. (growth spurts)
What do osteosarcoms develop from
osteoblast cells
What are the risk factors for osteosarcomas
pagets disease, radiation, chromosomal abnormalities
Signs and symptoms of osteosarcoms
pain, arthralgia, joint effusion, ROM deficit, warm temp, fracture
Where can osteoscarcomas metastasize
lungs
What are the treatments for osteosarcoma
chemotherapy & limb salvage
Where do Ewings sarcomas generally form
pelvis, LE
What are the signs and symptoms of ewing sarcomas
pain, edema, fracture, flu-like
how are ewings sarcomas diagnosed
radiographs (lytic lesion)
What is the treatment for ewings sarcomas
radiation, chemotherapy, limb salvage
what is the prognosis for Ewings sarcoma
5 yr survival > 70%
what is hematopoesis
formation of blood cells
What type of cell generates all other cells
stem cells
What are the possible causes of leukemia
genetic predisposition, environment
What is acute leukemia
abnormal production of immature myelocyte or granulocyte
Signs and symptoms of acute leukemia
recurrent infections, frequent fevers, tachycardia, general malaise, thrombocytopenia, bone pain, anemia
Who normally gets acute leukemia
children < 15 peak 2-4 y.o.
