Oncology Flashcards
Cancer is the ___#____ leading cause of death in the US.
2nd
Leading cause of cancer death in men and women (2) are…?
Lung cancer, bronchus cancer
The 3 most common cancers in men are…?
1) Lung 2) Prostate 3) Colorectal
The 3 most common cancers in women are…?
1) Lung 2) Breast 3) Colorectal
Are benign tumor cells differentiated (resemble tissue of origin) or undifferentiated?
Benign tumor cells are well differentiated and resemble normal cells of the tissue from which they arose.
Are malignant tumor cells differentiated (resemble tissue of origin) or undifferentiated?
They are undifferentiated and do not resemble normal cells
What is the rate of growth (slow or fast) in a benign tumor?
Slow
What is the rate of growth (slow or fast) in a malignant tumor?
Rate of growth varies
Describe the growth pattern of malignant tumors. Describe the growth pattern of malignant tumors.
Growth occurs at the periphery of the tumor. The tumor sends out processes into surrounding tissues.
Describe the growth pattern of benign tumors.
They grow by expansion.
Which type of tumor will metastasize, benign or malignant?
Malignant tumors metastasize.
What happens when a malignant tumor outgrows it’s blood supply?
The tissue is damaged because of hypoxia, also the tumor may encroach on blood flow to the surrounding area.
What is a TSA?
Tumor Specific Antigen – protein on the membrane of the cancer cell that distinguishes malignant cell from benign cell of the same tisue type
Where is a TSA located
It is on the membrane of a cancer cell
How does the body differentiate between the cell membrane of a malignant tumor cell and a benign tumor cell?
Using Tumor-Specific Antigens, which are proteins on the membrane of the malignant cancer cell membrane
What is formation of new blood vessels called?
Angiogenesis
What is the spread of cancer cells from the primary tumor to distant sites called?
Metastasis
Can a hormonal agent be the cause of a cancer?
Yep
What happens if you eat a SALTY, RED STEAK, that has been PROCESSED, and SMOKED, and you don’t trim all the FAT off it, and then you eat 10 OF THEM, and then drink a BEER?
You get cancer
What are 7 dietary factors that appear to increase the risk of cancer?
Fats, alcohol, salt-cured/smoked meats, nitrate or nitrite containing foods, red meats, processed meats, high caloric intake
What level of prevention is this: Reduce risk of cancer through health promotion strategies
Primary
What level of prevention is this: Promote screening and early detection activities such as self-breast-exams
Secondary
What level of prevention is this: Monitor for and prevent recurrences of cancer, and lessen the severity of long term effects
Tertiary
What is the purpose of staging a tumor?
It classifies the extent of the disease.
What are the 3 criteria described by tumor staging?
Tumor SSSSize, tumor SSSSSpread, metaSStaSSSssSsisSSS.
What is the purpose of grading a tumor?
It defines the type of tissue from which the tumor Grew from. GGGGGGGGGGGGGGG for Grading, G for Grew from. Also G for oriGinated.
What does TNM stand for?
Tumor, nodes, and metastasis
What are the 3 treatment goals of cancer?
Cure, control, palliate
At what age should testing for cervical cancer begin?
Age 21
At what age, should adults recieve screening for colon cancer?
50 years of age
What time of the month should a woman perform a self-breast exam?
3-5 days after her period starts.
How often should women have a mammogram? At what age should they commence?
At age 40; annually.
Which race is at greater incidence of cancer, black or white?
Black
What does neoplasia mean?
Tumor (abnormal growth of cells)
What is the number 1 COD? What is the number2?
1 = cardiovascular disease 2 = cancer
At what age does cancer risk increase?
65+ have greater incidince of cancer
Are women or men more at risk for cancer?
Males
Adeno
gland
chondro
cartilage
erythro
red blood cell
hemanglo
blood vessels
hepato
liver
lipo
fat
melano
pigment cell
myelo
bone marrow
myo
muscle
osteo
bone
Tobacco use, diet, lifestyle choices, occupational exposures, environmental exposures are all MODIFIABLE/NONMODIFIABLE risk factors of cancer.
Modifiable
Environmental exposure is a MODIFIABLE/NONMODIFABLE risk factor of cancer.
Modifiable
Women between ages ____ - ____ should have a pap test every 3 years.
21-29
Women ages 30-65 should be receiving what two tests every 5 years?
HPV test, papa test
Women over what age should no longer be tested for cervical cancer? (If they have had normal results in the past)
Age 65
At what age should men start receiving prostate cancer screening?
age 50
What is the PSA test for men?
Prostate specific antigen test
What determines the frequency of prostate cancer screening in men?
The levels of PSA found
The Fecal Occult Blood Test is performed yearly to test for ……????????
Colorectal cancer
Should men or women have the FOBT for colorectal cancer?
Both men and women should get the Fecal Occult Blood Test yearly
Another screening that is available for colorectal cancer is the Flexible Sigmoidoscopy (FSIG). How often should adults be screened?
Every five years
At what age range should females perform self-breast exams?
20-39
After age ____, women should get a clinical breast exam every year.
age 40
At ages 20-39, how often should women receive a clinical breast exam?
every 3 years
After age 40, how often should women receive a mammogram?
Q yr
PSA, CEA, HCG, CA-125 are all…
Tumor Markers
What is pathology testing?
A surgical procedure to get a tissue sample
Which type of tumor cells (benign or malignant) grow only locally and cannot spread by invasion?
Benign
This type of cell can invade neighboring tissue, enter blood vessels, and metastasize to different sites.
Tumor/malignant/cancer Cell
Which type of tumors have an extensive vascular system? (Benign/Malignant)
Malignant
A higher grade on a tumor (IV) indicates what?
That the tumor is more aggressive, poorly differentiated, and can’t determine tissue of origine
What does a grade of G X on a tumor indicate?
The grading cannot be determined.
What does a grade of GII indicate?
Cells are moderately differentiated, vary from normal cells in the area, and have some malignant characteristic
What does a grade of GIII mean?
Cells are poorly differentiated but retain some normal cell qualities
What does a grade of G I mean?
The cells are well differentiated, slow-growing, and look like normal/parent cells.
Classifying the size and extent of metastasis of a tumor is called…?
Staging
What does N stand for in the TNM classification of cancer staging?
Extent of regional lymph NODE involvement
What does T stand for in the TNM classification of cancer staging?
Extent of primary tumor
What does M stand for in the TNM classification of cancer staging?
Absence or presence of distant METASTASIS
What does a dx of “TX” indicate?
The primary tumor cannot be assessed.
What does a dx of “T0” indicate?
There is no evidence of primary tumor
What does a dx of “Tis” indicate?
Carcinoma in situ (in situ = on site, original position)
Which is the larger tumor, and has extended more? A T1 or a T4 tumor?
T4
A T3 tumor is how large (in cm)?
Greater than 5 cm
A T2 tumor is how large (in cm)?
2-5 cm
A T1 tumor is how large (in cm)>
2 cm or less
What does “NX” indicate?
Regional lymph nodes cannot be assessed
What does “N0” indicate?
No regional lymph node metastasis.
Is brachytherapy internal radiation or external radiation?
Internal radiation; an injection of radioactive iodine
If a patient has had “unsealed” therapy, what should the nurse do regarding their waste products? Why?
The nurse should ask the patient to take care of his own waste products as they are considered radioactive.
Why film badge?
Measure amount of radiation that the nurse is exposed to.
When caring for a patient who has had radiation therapy?, what three things should the nurse consider?
Time, Distance, Sheilding
If a patient’s implant has fallen out on the floor, should you pick it up?
Use long handled forceps and place the implant in a lead lined container.
What three factors determine how much radiation a nurse is exposed to?
Time, Distance, Sheilding
What is a skin ADR common to all types of Radiation Therapy?
Sunburn look – skin is dry, cracked, and broken open. There is risk for infection r/t skin breakdown
Does Radiation Therapy cause excess hunger?
No it can cause Altered nutrition less than body requirements r/t anorexia.
What effect does RT have on bone marrow?
Suppression —irradiation of the areas
What is osteoradionecrosis?
Bone death following RT – destruction of small blood vessels
What are 3 learning concerns for the patient recieving radiation therapy?
- Length of treatment
- Good skin/oral care
- Safety concerns with implants
What percent of tumor cells should be eliminated during a round of radiation therapy?
At least 95%.
Any chemo/bio drug should be considered hazardous to health. T/F?
True
When during administration of Chemo meds is double gloving recommended?
Drug preparation, handling contaminated waste.
In what order should PPE be applied?
Gloves, gown, gloves.
If the nurse handles body fluids of someone who has received agents in the past 48 hours, should PPE be required?
Yes
What is the risk to the patient when they receive a CVAD (Central Vascular Access Device)?
Risk for infection
How soon after chemotherapy with N/V Result?
First 8 hours
How far down the GI tract does mucositis extend?
it can affect the mouth but extend all the way down the GI tract.
In the case of a hypersensitivity reaction from chemo, what is the nurse’s first action?
Stop the treatment.
How soon into RT does skin breakdown occur?
It can occur as soon as 2 weeks but it is dose dependant..
What is a nursing intervention for skin breakdown?
Moisturizer, sunscreen
How often should the nurse inspect the mouth of a patient receiving RT or chemo? For what?
Daily, look for yeast infection, or altered oral mucous membrane
What should the diet be of a patient receiving RT or chemo?
Soft, bland, maintain hydration.
What happens to normal oral flora during chemotherapy?
It is destroyed, causing mucositis
What happens to saliva consistency during xerostomia? What does it create risk of?
It becomes thick, sticky, and acidic and puts the pt at risk for dental caries.
A person with xerostomia should not be given what type of swabs? And what type of mouthwash?
Lemon/Glycerin
No mouthwash containing alcohol
When the patients ANC is <1000, should treatment be halted?
Paused
What happens to cell count after the NADIR? What does this indicate
The patient starts to recover/it indicates the tx is working.
Is the patient immunocompromised before the NADIR or after?
Both
At what number of platet levels may the patient require a transfusion?
10-20,000/mm3
What is a normal platelet count?
150-450k
What do CSF (colony stimulating factors) do to WBC counts?
Builds them up
What are Filgrastim and Pefilgrastim used for?
They are colony stimulating factors used to increase WBC counts
What is Epogen used for?
It is a CSF used to increase RBC count
What is a common complaint of patients recieving colony stimulating factors? What should the nurse rxn be?
bone pain. It is seen as a good sign because cells are being formed.
What type of foods are good for the patient experiencing n/v after RT and chemo?
Cold, salty, dry crackers and toast
What happens to the pt with Anorexia-cachexia syndrome?
Wasting, increased nutrient intake does not always reverse the process.
How soon before meals should Magic Mouthwash be given to promote comfort?
15 min before meals
What should the nurse encourage the patient to do when they complain of fatigue?
Encourage exercise as it can reduce fatigue sometimes
