Oncology and Chemotherapy (Exam III) Andy's Cards Flashcards
What are tissue changes are seen in cancer cells? (2)
- Number of cells increases (hyperplasia).
- Organizational changes (dysplasia)
cells survive when they should die and form when they are not needed
What is the progression from normal cells to cancerous cells?
Characteristics of Cancer Cells (4)
- Less specialized
- Can ignore pre-programmed apoptosis signals
- Abnormally influence normal cells (ex. can make normal cells form blood vessels which feed a tumor - angiogenesis)
- Can evade the immune system
What are the three “drivers” that increase the proliferation of cancer cells?
-
Proto-oncogenes
Involved in normal cell growth and division
Become cancer-causing…allow cells to grow and survive -
Tumor suppressor genes
Alterations allow genes to divide uncontrollably -
DNA repair genes
Incorrect damage repair; cause other mutations
How many types of cancers are there? How are they typically named?
More than 100
- named for organs, tissues, type of cells originated
Where do basal cell cancers originate from?
Basal (base) layer of the epidermis
Where do squamous cell cancers originate from?
Epithelial cells, just beneath skin
Also lining:
- GI tract (stomach, intestines)
- Bladder
- lung
.
Where do adenocarcinoma’s originate from?
Mucous producing cells
- Gland tissue (breast, prostate)
Where do sarcoma’s originate from?
Bone and soft tissue
Where do leukemia’s originate from?
blood-forming tissue of Bone marrow
Where do lymphoma’s originate from?
Lymphocytes (T or B cells)
These tend to build up on lymph nodes and lymph vessels.
This list includes general risk factors for cancer:
review list
What are some problems in cancer screenings? (3)
- Can cause problems: ex: Colonoscopy ⇒ perforation
- Can have false-positives
- Can have false-negatives
Screenings are working if statistics show: (3)
- More early-stage cancers found
- Less late-stage cancers found
- Less deaths occur
What is absolute risk?
Absolute risk
- How many people get “x” in a certain period.
Ex. If 4 people out of a group of 100,000 get “x” then risk is 4 in 100,000
Explain relative risk, explain the results.
% of people in exposed group with dz divided by
% of people in unexposed group with dz
- RR>1: trait linked to increased risk of dz
- RR=1: trait not linked to dz
- RR<1: trait linked to decreased risk of dz
Give an example of a relative risk that is greater than 1.
Smoking
Smoking increases risk relative to the rest of the population.
Give an example of a relative risk that is less than 1.
Exercise
Exercise decreases risk relative to the rest of the population.
What 3 cancer screenings are typically standard now?
- Colonoscopy
- Mammograms
- Pap Smears
What are the factors measured in tumor staging?
- T: size/extent of primary tumor
- N: # of nearby lymph nodes which are (+)
- M: is there metastasis
The staging is done at time of diagnosis only. No later evaluation.
What would a tumor measurement of TX mean?
- TX: tumor cannot be measured.
What would a tumor measurement of T0 mean?
- T0: tumor cannot be found.
What would a tumor measurement of T1 - T4 mean?
- T1= least invasive
- T4 = most invasive
↑# = larger tumor
What does NX mean?
NX: cancer in nearby lymph nodes cannot be measured.
What does N0 mean?
N0: no cancer in nearby lymph nodes.
What does N1-N3 mean in regards to tumor staging?
- N1 = limited cancer found in regional lymph nodes
- N3 = cancer is all up in these lymph nodes
↑# = more lymph nodes with cancer
How is metastasis measured in the tumor staging system?
- MX:cannot be measured.
- M0: has not spread to other parts of the body.
- M1: has spread to other parts of the body.
What are other staging system terminology? (5)
- In situ: abnormal cells are present but have not spread to nearby tissue
- Localized: limited to place where it started; no sign of spread
- Regional: has spread to nearby lymph nodes, tissues, or organs
- Distant: spread to distant parts of body
- Unknown: not enough information to figure out the stage
For median survival of 6 months or less what two factors are more important that type of cancer?
- Functional status
- Laboratory values
What factors are associated with a survival rate that is 6 months or less?
What type of cancers will frequently radiate to the bone? (4)
- Breast
- Lungs
- Kidney
- Prostate
Osteolytic, osteoblastic or both lesions
What can be helpful in treating cancer metastasis to the bone? (3)
- Radiotherapy/chemotherapy
- NSAID +/- opioids
- Vertebroplasty
Hormonal therapy is often helpful for what types of cancer? (4)
Breast
Lung
Kidney
Prostate
.
Why does cancer typically cause pain? (2)
- Invasion of tumor into tissues innervated by afferent neurons
- Directly invades nerve plexus
Pain is mostly d/t cancer itself not treatment
WHO recommendations that provide 80-90% effective cancer pain treatment: (3)
- Prompt administration
- On schedule; not prn
- Add antianxiety drugs as necessary
Common nerve blocks used to treat cancer patients: (3)
- Celiac plexus for unresectable pancreatic cancer, hepatic cancer, or gastric cancer
- Intercostal nerves for rib metastasis
- Lumbar sympathetic ganglion for pelvic tumors
What areas are anesthetized with a celiac plexus block? (2)
- Sympathetic fibers of T5-T12
- Parasympathetic celiac plexus fibers
For what types of cancer are celiac plexus blocks typically performed? (3)
Unresectable:
- Pancreatic
- Hepatic
- Gastric
What injection is used with a neurolytic celiac plexus block?
How long does this typically last?
Isopropyl alcohol
Destruction of nerves (neurolysis) typically provides pain relief for 3-6 months.
