Oncology Flashcards
Signs and Symptoms of Cancer
Change in bladder/bowel routine A sore that will not heal Unusual bleeding/discharge Thickening/lump develops Indigestion or difficulty swallowing Obvious change in wart/tissue Nagging cough/hoarseness
Unexplained weight loss, fatigue, anorexia, anemia, pain, or weakness.
Stage 0
Early malignancy that is present only in the layer of cells where it began. Usually referred to as carcinoma in situ. Not all cancers have a stage 0.
Stage 1
Malignancy limited to tissue of origin with no lymph node involvement or metastasis.
Stage 2
Malignancy spreading into adjacent tissues; lymph nodes may show signs of micrometastases.
Stage 3
Malignancy has spread to adjacent tissue showing signs of fixation to deeper structures. Likelihood of metastatic lymph node involvement is high.
Stage 4
Malignancy has metastasized beyond primary site, to bone or other organ.
Brain cancer
Symptoms depend on location of tumor and usually progress rapidly. Can include headache, seizures, increase ICP, cognitive and emotional impairment, decreased motor and sensory function.
Treatment includes surgical resection with radiation
Breast cancer
Most common female malignancy and 2nd most common cause of female death from cancer. If cancer recurs, it is usually within 2 years of initial dx.
Symptoms include lump/mass that is typically firm, irregular, and non-painful. May present with nipple discharge, erythema, or change in breast shape.
Treatment may include surgery, radiation, chemotherapy, or hormonal manipulation. Curable if diagnosed prior to metastasis.
Bronchial carcinoma
Divided into 2 main groups: small cell lung carcinomas and non-small cell lung carcinomas.
Primary cause is smoking but can occur in those who have never smoked where exact etiology unknown.
Signs/symptoms include new cough or changes in chronic cough, coughing up blood, SOB, wheezing, weight loss, and bone pain. Signs/symptoms usually not present until disease is advanced.
Treatment includes surgery, chemotherapy, and radiation.
Cervical cancer
Diagnosis made through pap smear.
Human papilloma virus (HPV) is primary cause of cervical cancer.
Signs/symptoms: asymptomatic during early stages. Can include abnormal bleeding, pelvic and low back pain, impairment with bladder/bowel function.
Treatment may include laser therapy, excision, cryotherapy, or hysterectomy with adjunct chemotherapy or radiation.
Colorectal cancer
Risk factors include increasing age, hx of polyps, ulcerative colitis, Crohn’s disease, family hx, diet high in fat and low in fiber.
Usually no early signs of disease. Most prominent symptom is continuous change in bowel habits. Bright red blood from rectum. May experience fatigue, weight loss, anemia.
Treatment may include surgical resection or tumor and possibly bowel with subsequent radiation/chemotherapy. Colostomy may be required.
Lung cancer
Most frequent cause of death from cancers.
Risk factors include smoking, environment, geography, occupational hazards, age, and family hx.
Early symptoms include cough, sputum, and dyspnea. Progression may include adventitious breath sounds, chest pain, and hemoptysis.
Lymphoma (Hodgkin, non-Hodgkin disease)
Cancer found in lymphatic system and lymph tissues.
Risk factors for Hodgkin disease includes associated with Epstein-Barr virus, drug abuse, immunosuppressant use, obesity, autoimmune disease, chronic disease.
Risk factors for non-Hodgkin lymphoma includes exposure to benzene (cigarette smoke), auto emissions, and pollution.
Painless lump usually first sign. Fever, chills, and fatigue. Hodgkin disease distinguished by presence of Reed-Sternberg cancer cells.
One of the most curable cancers. Includes chemotherapy, radiation, stem cell transplant, antiretroviral therapy.
Pancreatic Cancer
High mortality rate.
Risk factors include tobacco use, gender, increasing age, and cholecystectomy.
Symptoms are vague during initial stages. Common symptoms include weight loss, jaundice, and epigastric pain that can radiate to thoracic region.
Treatment directed in relief of symptoms. Surgical resection, chemotherapy, and radiation.
Prostate cancer
Typically affects men over 50 years old. About 10% fatality rate.
Risk factors include age, high fat diet, genetic predisposition, African American descent, exposure to cadmium.
Usually asymptomatic until advanced stages. Urinary obstruction, pain, urgency, and decreased stream/flow of urine.
Treatment may include surgical incision of prostate gland, radiation, or hormonal therapy.
Basal cell carcinoma
Slow growing form of skin cancer that rarely metastasizes. Most common form of skin cancer.
Sun exposure most common cause. Risk factors include light eyes and fair skin.
Signs and symptoms include open sores that can bleed or crust and remain for 3 or more weeks. Reddish patches of skin, shiny bump on skin that is often pink, scar-like area that has poorly defined borders.
Prognosis is good. Surgical excision may be required.
Malignant melanoma
Originates from melanocytes and can be classified as superficial spreading, nodular, lentigo maligna, or acral lentiginous melanomas. Peak incidence is between 40-60 yo. Can metastasize quickly to brain, lungs, liver, bone, and skin.
Risk factors include hx of blistering sunburns prior to 20 years of age, family hx, immunosuppression, light eyes, fair skin, previous hx of cancer.
Lesions can be elevated on the surface of the skin and appear keratotic or scaly. Mole may be asymmetric, irregular borders, varied color, and diameter greater than 6 mm.
Curable with early diagnosis and treatment. Excision may be required with early treatment. Surgical intervention and other therapies if metastasis has occurred.
Astrocytoma
Accounts for 50% of pediatric brain tumors.
Etiology includes genetic and environmental influence, radiation and toxin exposure, and certain childhood disorders.
Two types:
- Cerebellar: clumsiness, ataxic gait, headache, change in personality, and vomiting
- Supratentorial: headache, seizures, change in personality, visual impairments, and vomiting
Treatment includes surgical resection with radiaiton/chemotherapy.
Leukemia
Leukocytes change into malignant cells.
Etiology unknown but may be due to environment, chemical/toxin exposure, genetics, viral association.
Signs/symptoms include abrupt onset with high fever, bleeding, enlarged lymph nodes and spleen, progressive weakness, fatigue, and painful joints.
Treatment includes immunotherapy, cytotoxic agents, chemotherapy or radiation, and bone marrow transplant.
Neuroblastoma
Most common malignant tumor seen in children. Seen in sympathetic nervous system, adrenal glands or paraspinal ganglia.
Etiology may be due to genetics, environment, and radiation/toxin/viral exposure.
Treatment includes surgical resection, chemo or radiation.
Osteogenic Sarcoma
Occurs in epiphyses of long bones. Most common form of bone cancer in children with peak incidence between 10-20 yo.
Association between immunoincompetence and rate of tumor progression.
Presence of a mass, rapid metastases, and associated pain.
Treatment includes amputation. Chemotherapy but not radiation effective.
Wilms’ Tumor
Embryonal nephroblastoma found in the kidney. Most cases diagnosed between 1-4 yo.
Genetic inheritance as autosomal dominant disease or non-inherited from unknown etiology.
Abdominal mass, pain, hematuria, fever, nausea, and vomiting.
Resection of kidney and associated lymph tissue followed by chemo or radiation. Dactinomycin also administered.
Radiation Treatment
Destroys hydrogen bonds between malignant cells.
Most useful with localized malignancy.
Side effects include headache, bone marrow suppression, skin reactions, neuropathy, visual disturbances, nausea, vomiting, urinary frequency, diarrhea, delayed wound healing and infection.
Chemotherapy
Most often used with widespread and metastatic malignancies.
Common side effects include nausea, vomiting, electrolyte imbalance, sexual dysfunction, hair loss, pain, and decrease in platelet, red, and white blood cell count.
