Oncology Flashcards
What is the oncology care program in Edmonton called?
Regional Palliative Care Program
What is the Pain and Symptom Team in CCI?
Multidisciplinary team for people who are actively receiving treatment from CCI and have complex/extreme symptoms
What is the Regional Palliative Care Team?
The community equivalent of the Pain and Symptom Team in CCI
For people who are not receiving treatment from CCI
What is the Palliative Home Care?
Multidisciplinary community-based care for patients at home with ongoing symptom management needs
What is the Tertiary Palliative Care Unit, Station 43 in the Grey Nun Hospital?
For people whose symptoms cannot be stabilized at another hospital or at home.
Main purpose is to stabilize the patient so that they can return to home or hospice care.
Admission through referral from the Regional Palliative Care Team or Pain and Symptom Team.
What is hospice care?
End-of-life care for people with life expectancy of 2 months or less and with stable symptoms but needing consistent care
Which cancers cause the most cancer deaths every year?
Lung, stomach, liver, colon, breast
What percentage of cancer deaths can be prevented?
~30%
What is the single most important risk factor for cancer?
Tobacco use
Death from cancer worldwide is projected to [increase/decrease].
Increase
What is cancer?
The common term for a complex group of malignant neoplasms
What is the overall mechanism of cancer?
The normal mechanism for controlling cell growth and proliferation is disturbed, allowing cell growth to continue beyond normal boundaries.
What is neoplasm?
New growth
What is malignancy?
The tendency of a medical condition (esp. a tumor) to become progressively worse and potentially result in death.
What are the 2 characteristics of malignancy?
- Anaplasia – Reverse in differentiation of cells
2. Metastasis – Spread of anaplasia
Compare growth control in normal vs. cancer cells?
Normal cells: New cell growth = Cell death. Damaged cells self-destruct.
Cancer cells: Damaged cells do not self-destruct, and there is uncontrolled growth.
What is carcinogenesis?
A series of events that transform a normal healthy cell into a cancer cell
What are some causes of carcinogenesis?
Spontaneous errors in gene replication and recombination
Genetic predisposition
Carcinogenic exposure
Viruses
What are some internal factors that cause cancer?
Hereditary
Diet
Hormones
What are some external factors that cause cancer and their mechanisms?
Chemicals – Damage DNA
Radiation – Damage DNA
Viruses or bacteria – Introduce their own genes into cells
Which substances are commonly considered to be carcinogens?
Chemicals and radiation
What are the 3 prime suspects in gene mutation that lead to cancer?
Oncogenes
Tumor suppressor genes
DNA repair genes
What are the two types of growth regulatory genes?
Proto-oncogenes
Oncogenes
What are proto-oncogenes?
Growth regulatory gene that promotes cellular proliferation during normal growth and development.
What are oncogenes?
Mutated proto-oncogenes that remain in the “on” mode, allowing indefinite cellular proliferation.
What are tumor suppressor genes?
Genes that regulate growth during normal development by blocking growth promoting proteins.
How do mutated tumor suppressor genes contribute to uncontrolled cell growth in cancer?
They are unable to turn off the cellular proliferation because their function has been inactivated
What are the 7 warning signs of cancer?
- Unusual bleeding or discharge
- A sore that doesn’t heal
- Lump
- Nagging cough
- Obvious change in a mole
- Difficulty swallowing
- Changes to bowel or bladder routine
What are the ABCDE of mole changes?
A: Asymmetry B: Border irregularity C: Colour D: Diameter E: Evolving
What are the characteristics of cancer cells?
Uncontrolled cellular proliferation Reduced cell death Invasiveness -- Migration Destruction of normal tissue Atypical tissue structure -- Anaplasia Variable cellular shape and size Abnormal chromosome number Metastases -- Spreading to other areas in the body
What is metastasis?
Spread of cancer cells from a primary tumor to organs and distant sites in the body
What percentage of people have a metastatic disease when diagnosed with cancer?
~60%
What are the two mechanisms by which cancer spreads throughout the body?
- Invasion: Local penetration in neighbouring cells. A necessary characteristic of cancer.
- Metastasis: Penetration through the blood and lymphatic vessels and systemic circulation. Usually seen in advanced cancer.
What are the necessary factors for metastases?
Tumor angiogenesis Mechanical pressure Cell motility Loss of cellular adhesion Proteolytic enzymes -- Helps degrade cellular adhesion Immunogenicity
When a tumor’s size is ≥ __ mm, it needs its own blood vessel.
2 mm
True or False: A highly vascularized tumor has a higher risk of metastasis.
True
What is immunogenicity?
Ability for cancer cells to move through blood vessels and invade the immune system without detection by the immune system
What is the difference between benign and malignant tumors?
Benign: Cannot spread by invasion or metastasis
Malignant: Spreads by invasion or metastasis
True or False: Cancer includes both benign and malignant tumours.
False. Cancer only includes malignant tumours.
How are metastases named, and why?
Metastases always share the name of the primary tumor, so that the name indicates the cell type that was originally mutated, as well as the metastatic state and advancedness of the cancer.
What are the signs and symptoms of metastases?
Bone pain or movement pain Constant unrelenting pain Nocturnal pain Severe spasm Expanding pain Empty end feels in ROM Shortness of breath Lack of appetite and weight loss Neurological symptoms (weakness, vomiting, ataxia, seizure, drowsiness, headache, dizziness, confusion)
What is a new pain in cancer patients always presumed to be?
Metastases