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Medical Nursing > Oncology > Flashcards

Oncology Flashcards

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1
Q

How to approach the cancer patient client?

A 
Compassionate 
Facts and evidence not opinions
Knowledgable 
Honest 
Communication
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2
Q

What is cancer?

A

Persistent purposeless proliferation of host cells malignant tumour

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3
Q 
Define 
Tumour
Neoplasia
Malignant
Benign
Metstasis
Oncology
A

Tumour-a swelling
Neoplasia- a new growth
Malignant-Neoplasm with the capacity for local invasion and metastasis
Benign- Neoplasm forms solid cohesive tumour that does not metastasises
metastatic- development of a tumour remote from the primary tumour
Oncology-the study of any of the above

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4
Q

Nomenclature tumours are described according to two features

A 
Benign Oma 
Malignant carcinoma sarcoma
Tissue origin 
Epithelial 
Squamous, glandular (adenoma)
Mesenchymal 
Fibro 
Lipo
Haemangio 
Osteo
Lymphoma
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5
Q

Discuss the characteristics of a benign tumour

A 
Non invasive into local tissue
No metastasis 
Capsulated 
Slow rate of growth
Minimal effects on adjacent tissues 
Minimal effects on host(depends on anatomical location)
Pareneoplastic effects can occur
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6
Q

Discuss the characteristics of a malignant tumour

A 
Rapid growth 
Invades local tissue 
Metastasis occurs
Effects local tissues (ulceration lysis of bone)
Life threatening distrust give nature 
Paraneoplastic effects possible
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7
Q

When is a tumour detectable?

A

1cm in diameter already done the majority of its growing by that point. Not as susceptible to drugs when not rapidly dividing

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8
Q

Describe the two clinically important features of cancer

A

Effect on the host

Effects of cancer treatment on the host

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9
Q

What is metastatic potential and describe how it may take place?

A

The ability to spread to distant tissues.
Via the blood (liver and lungs)
Via the lymphatics ( first to local then regional lymph nodes)
Transcoelomic across pleural or peritoneal space
Iatrogenic FNA or tru cut biopsy bleeding

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10
Q

What characteristics grade a tumour?

A

Growth rate, ability to metastasise, location is it close to lymph nodes, location, cellular and nuclear characteristics

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11
Q

What are paraneoplastic effects?

A

The production of physiological substances that effect distant organs

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12
Q

Name the four types of paraneoplastic effects and describe each of them

A

Haematological
Non regenerative anaemia
Leukopenia
Thrombocytopenia

Hyperhistaminaemia 
Mast cell tumours release histamine, heparin, pro teases when handled 
Local effects-swelling pruritus 
Localised bleeding(heparin) 
Delayed wound healing (proteases) 
Systemic effects-anaphylactic shock 
Gastroduodeanl ulceration

Immune mediated reactions
iMHA ITP(immune mediated thrombocytopenia)
Neuropathies and myasthenia graves
Skin disease

Hypercalcemia
Parathormone-like substance increases calcium concentrations
Tumours that cause these include-lymphosarcoma, anal sac adenocarcinoma, multiple myleoma

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13
Q

What are the aims of diagnostic investigations?

A

Grade tumour and type (histological)
Has it spread where to how far
Treat and investigate tumour related or concurrent complications
Inflated radiographs should be taken to rule out lunge metastasis

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14
Q

Why is microspoci evaluation so important?

A

Do not know the diagnosis of malignant or begnin, or type of tumour until evaluation using this method

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15
Q

What are the three possible aims of cancer treatment?

A

Cure-all cancer cells eradicated
Remission-more achievable all clinical evidence of cancer gonesome cancer cells remain
Palliative- reduce pain/improve sense of wellbeing and correct physiological malfunction

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16
Q

What are the three main methods of cancer treatment and what do they involve?

A

Surgical complete removal of the tumour or debulking(encourages proliferation)
Radiation two types Brachytherapy- radioactive substance emits gamma or beta particles directly next to the tumour
Teletherapy- applied externally beam directed at tissue either from fixed radioactive source or linear accelerator
Chemotherapy- cytotoxic drugs kill cancer cells
Best methods often use a combination

17
Q

What are the main principles of chemotherapy?

A

Highest possible dose that has the maximal acceptable side effects to effect maximum fraction.
Repeated dosing as will not kill all cancer cells on first does
Institute treatment when tumour burger is lowered
Unlikely to be effective in advanced disease
Combination chemotherapy is more effective

18
Q

Name the types of alkylating agents and there mode of action

A

Cyclophosphamide chlorambucil melphalan

Cross link DNA stop jreplication

19
Q

Name the types of anti-metabolites and their mode of actions

A

Cytarabine 5-Fluorouracil Methotrexate Azathioprine

Stop single stranded DNA from replication

20
Q

Anti-tumour antibiotics (chemotherapy)

A

Doxorubicin Epirubicin

21
Q

Name the types of Vinca alkaloids and describe their mode of action

A

Vincristine Vinblastine

Interfere with microtubules during division

22
Q

Name the types of tyrosine kinase inhibitors

A

Martinib Torecarnib

23
Q

Platinum compounds (chemotherapy)

A

Cisplatin Carboplatin act at cell surface receptors to block signals

24
Q

Enzymes (chemotherapy)

A

L-asaraginase damages DNA

25
Q

Response to chemotherapy depends on two factors?

A

Growth rate and drug resistance

26
Q

WHich tumours are responsive to chemotherapy?

A

Lymphoma myeloma leukaemia
Moderately sensitive- scar I as mast cell tumours
Poorly sensitive- carcniomas melanomas sarcomas slow growing

27
Q

How is dosing calculated for chemotherapy?

A

Calculated using surface area rather than weight as dosing is very sensitive

28
Q

What is the time period between chemotherapy dosing and why is it set this way

A

3 weekly treatment cycles as myleosupression lasts for 7-10 days with recovery at 21 days

29
Q

What are the three phases of the chemotherapy protocol dedcribe the aims of each of them

A

Induction-reduce tumour burden to undetectable levels, very rarely a cure
Maintenanc- less intensive regime to maintain remission (debatable)
Rescue- resources to more aggressive chemotherapy regime

30
Q

When is first line chemotherapy used?

A

Rapidly dividing cancers
Lymphosarcoma
Leukemia
Systemic cancers

31
Q

What types of combination chemotherapy regimes used for lymphosarcoma?

A 
COP
Cyclophosphamide 
Vincristine 
Predinsalone 
CHOP
Cyclophosphamide 
Doxorubicin 
Vincristine 
Prednisalone
32
Q

Side effects of chemotherapy?

A

Effects normal tissues with high turnover skin intestine bone marrow

33
Q

GI chemotherapy toxicity; how is it treated?

A

Antiemetics iv fluids
Gastroprotectants Chlorhexidine mouth wash
Parental antibiotics if haemorrhaging diarrhoea and myleosupressed

34
Q

Phlebitis and tissue necrosis and perivascualr leakage treatment chemotherapy

A 
Adequate restraint of patient, administration through iv catheter and flushing with saline before and after 
Perivascular leakage:
Stop infusion(do not remove catheter) 
Aspirate drug give intralesional saline 
Draw back blood then remove catheter 
Iv hydrocortisone 
Cold compress 
Dexarazoxane (specific antidote for doxorubicin)
35
Q

Name the specific drug toxicities generate from cyclophosphamide Doxorubicin
Cisplatin, carboplatin

A 
Cyclophosphamide 
Sterile haemorrhagic cystitis 
Doxorubicin 
Cardiotoxicity (cumulative dose) 
Cisplatin carboplatin nephrotoxicity
36
Q

What is the response to chemotherapy like for lymphosarcoma?

A

High growth rate no plateau very susceptible to chemotherapy
Resistance may develop
Smaller percentage of cats respond than dogs

37
Q

Treatment options for canine multicenteric lymphoscarcoma

A

No treatment-live 4-6 weeks
Palliative prednisalone-may induce partial or complete remission 2-3 months may induce resistance
Prednisalone and cyclophosphamide
No survival advantage over pred alone
Single agent- doxorubicin every 3 weeks similar 6-12 month survival
Multi drug chemotherapy COP CHOP 6-12 months depending on protocol

38
Q

What does rescue of lymphosarcoma entail?

A

Repeating induction regime use of additional agents not used during induction
Use of rescue protocols with novel cytotoxic

39
Q

What happens when resistance occurs in lymphosarcoma chemo treatment?

A

All cases patient will come out of remission and is resistant to all treatment
Euthanasia

Medical Nursing (22 decks)

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