Oncology Flashcards
Cancer
indicates any of various types of growths that are uncontrolled by normal cellular mechanisms
Malignant Neoplasm Synonyms
- Tumor
- malignancy
- carcinoma
Types of Cancer
- Primary
- Secondary
- Carcinoma in situ
Primary Cancer
- arising from cells local to the structure
- primary cell usually determines behavior of cancer
Secondary Cancer
-arising from cells that have metastasized from other sites
Carcinoma in Situ
-malignant cell changes in epithelial tissue that do not extend beyond the basement membrane (pre-invasive)
Metaplasia
-Reversible change in cell
Dysplasia
-permanent abnormal changes in cells
Classifications of Neoplasms
- Epithelial
- Connective/Muscle Tissue
- Lymphoid
- Hematopoietic
- Miscellaneous (reproductive glands, placenta, thymus)
Staging of Cancer
- distinct phase or period in development of disease
- what is the EXTENT of the disease?
Grading of Neoplasms
- degree of malignancy and differentiation of malignant cells
- Grade I-IV
- less differentiated=worse
- what is the severity of the tumor?
TNM System
- Classifies cancer based on Tumor size, lymph Node status, Metastases presence
- Tumor, Node, Metastases
Grade I
well-differentiated cells
Grade II
moderately-differentiated cells
Grade III
poorly-differentiated cells
Grade IV
Undifferentiated
worst
Sources of Cancer (2)
- Endogenous
- Exogenous
Endogenous Origin
- factors that are outside the patient’s control
- familial pattern/genetic
Exogenous Origin
- risk factors, within patient’s control
- chemical agents, physical agents, drugs/EtOH, hormones
- inflammatory disease
Risk Factor Examples
- Age
- Lifestyle (tobacco, diet, nutrition, sexual behaviors)
- Geography
- Ethnicity
- Stress
What are oncogenes?
-gene that is likely to produce or is a marker of cancer
What are tumor suppressor genes?
-genes that are good at minimizing tumor growth
What are the mechanisms of the spread of cancer?
- Metastasis
- Invasion
Invasion
-growth by direct or continuous extension of the tumor into neighboring tissue
Metastasis
-growth of neoplastic cells at a remote or non-contiguous site in the body
How do metastasis cells travel to new sites?
- bloodstream
- lymphatic system
Angiogenesis
-creation of new circulation (for secondary tumor)
Most common sites of metastasis
(L3B2)
-Lymphnodes, lungs, liver, bone, brain
Other sites of metastasis
-skin, ovaries and adrenal glands
Most metastases occur within ________
- 3-5 years;
- but can occur 15-20 after original appearance of disease
Common Manifestations of Cancer
- NVR
- Anorexia and weight loss
- Pain
- Fever
- Cancer related fatigue
Primary Prevention
- decrease number of cases/prevalence of cancer
- risk reduction
Secondary Prevention
- prevent morbidity and mortality of cancer
- early detection
Tertiary Prevention
- managing symptoms, limiting complications, preventing disability disability
- palliative treatment
CAUTION: clinical manifestations of cancer
C-change in bowel/bladder A-a sore that doesn't heal in 6 weeks U-unusual bleeding/discharge T-thickening or lump in breast or elsewhere I-indigestion or difficulty swallowing O-obvious changes in wart or mole N-nagging cough/hoarsness
Diagnostics
- Biopsy, endoscopy (invasive)
- CT, MRI (radiologic/noninvasive)
Types of Treatment
- Surgery
- Radiation
- Chemotherapy
- Biotherapy
- Immunotherapy
- Hormonal therapy
Medical Management of Cancer Tx
- Medications other than chemo
- Alternative care
- Hospice
PT management of cancer treatment
- positioning
- relaxation techniques
- biofeedback
- manual therapy
Goals of Intervention
- cure the cancer
- control the cancer
- palliative care
Progression of Cancer
- complete remission/response
- partial response
- no response
- survival
Complete Remission/Response
-disappearance of clinically evident disease
Partial Response
-more than 50% reduction in tumor size
No Response
-no response to treatment
Survival=
time from diagnosis to death
Prognosis affected by:
- type, stage, grade of cancer
- type/effectiveness of therapy
- pt’s general health status
- age
Winningham Precautions:
Platelets
<50,000/ml
Winningham Precautions:
Hb
<10g/ml
Winningham Precautions:
Absolute Granulocytes
<500/ml
Winningham Precautions
-precautions to aerobic exercise in chemotherapy patients
Winningham Precautions:
WBC
< 3,000/ml ; 10,000 with fever (no exercise)
Side effects of Chemo
fatigue, GI, anxiety/depression, hepatotoxicity, hemorrhage, bone marrow suppression, anemia, infection, neutropenia, thrombocytopenia, muscle weakness, decreased bone density, rash, neuropathies, hair loss, sterilization, sexual dysfunction, weight loss/gain
Side Effects of Radiation
fatigue, radiation sickness, immunosuppression, decreased platelets/WBC, infection, fibrosis, burns, mucositis, diarrhea, edema, hair loss, ulceration, CNS/PNS effects, Malignancy
Symptoms of Metastasis: Lung
-cough, pleural pain, SOB
Symptoms of Metastasis: Liver
-abdominal pain, RUQ pain, malaise, fatigue, anorexia, weight loss, fever
Symptoms of Metastasis: Bone
-deep pain worsening with activity, pathologic fractures
Symptoms of Metastasis: Brain
-cognitive impairment, headache, reduced sensory/motor function
Symptoms of Metastasis: Lymphnodes
-lymphedema
