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1Fall24 PoA II > Oncology and Chemotherapy (Exam III) Andy's Cards > Flashcards

Oncology and Chemotherapy (Exam III) Andy's Cards Flashcards

1
Q

What are tissue changes are seen in cancer cells? (2)

A
  • Number of cells increases (hyperplasia).
  • Organizational changes (dysplasia)

cells survive when they should die and form when they are not needed

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2
Q

What is the progression from normal cells to cancerous cells?

A
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3
Q

Characteristics of Cancer Cells (4)

A
  • 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
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4
Q

What are the three “drivers” that increase the proliferation of cancer cells?

A
  • 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
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5
Q

How many types of cancers are there? How are they typically named?

A

More than 100

  • named for organs, tissues, type of cells originated
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6
Q

Where do basal cell cancers originate from?

A

Basal (base) layer of the epidermis

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7
Q

Where do squamous cell cancers originate from?

A

Epithelial cells, just beneath skin

Also lining:

  • GI tract (stomach, intestines)
  • Bladder
  • lung

.

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8
Q

Where do adenocarcinoma’s originate from?

A

Mucous producing cells

  • Gland tissue (breast, prostate)
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9
Q

Where do sarcoma’s originate from?

A

Bone and soft tissue

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10
Q

Where do leukemia’s originate from?

A

blood-forming tissue of Bone marrow

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11
Q

Where do lymphoma’s originate from?

A

Lymphocytes (T or B cells)

These tend to build up on lymph nodes and lymph vessels.

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12
Q

This list includes general risk factors for cancer:

A

review list

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13
Q

What are some problems in cancer screenings? (3)

A
  • Can cause problems: ex: Colonoscopy ⇒ perforation
  • Can have false-positives
  • Can have false-negatives
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14
Q

Screenings are working if statistics show: (3)

A
  • More early-stage cancers found
  • Less late-stage cancers found
  • Less deaths occur
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15
Q

What is absolute risk?

A

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

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16
Q

Explain relative risk, explain the results.

A

% 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
17
Q

Give an example of a relative risk that is greater than 1.

A

Smoking

Smoking increases risk relative to the rest of the population.

18
Q

Give an example of a relative risk that is less than 1.

A

Exercise

Exercise decreases risk relative to the rest of the population.

19
Q

What 3 cancer screenings are typically standard now?

A
  • Colonoscopy
  • Mammograms
  • Pap Smears
20
Q

What are the factors measured in tumor staging?

A
  • 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.

21
Q

What would a tumor measurement of TX mean?

A
  • TX: tumor cannot be measured.
22
Q

What would a tumor measurement of T0 mean?

A
  • T0: tumor cannot be found.
23
Q

What would a tumor measurement of T1 - T4 mean?

A
  • T1= least invasive
  • T4 = most invasive

↑# = larger tumor

24
Q

What does NX mean?

A

NX: cancer in nearby lymph nodes cannot be measured.

25
Q

What does N0 mean?

A

N0: no cancer in nearby lymph nodes.

26
Q

What does N1-N3 mean in regards to tumor staging?

A
  • N1 = limited cancer found in regional lymph nodes
  • N3 = cancer is all up in these lymph nodes

↑# = more lymph nodes with cancer

27
Q

How is metastasis measured in the tumor staging system?

A
  • MX:cannot be measured.
  • M0: has not spread to other parts of the body.
  • M1: has spread to other parts of the body.
28
Q

What are other staging system terminology? (5)

A
  • 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
29
Q

For median survival of 6 months or less what two factors are more important that type of cancer?

A
  • Functional status
  • Laboratory values
30
Q

What factors are associated with a survival rate that is 6 months or less?

A
31
Q

What type of cancers will frequently radiate to the bone? (4)

A
  • Breast
  • Lungs
  • Kidney
  • Prostate

Osteolytic, osteoblastic or both lesions

32
Q

What can be helpful in treating cancer metastasis to the bone? (3)

A
  • Radiotherapy/chemotherapy
  • NSAID +/- opioids
  • Vertebroplasty
33
Q

Hormonal therapy is often helpful for what types of cancer? (4)

A

Breast
Lung
Kidney
Prostate

.

34
Q

Why does cancer typically cause pain? (2)

A
  • Invasion of tumor into tissues innervated by afferent neurons
  • Directly invades nerve plexus

Pain is mostly d/t cancer itself not treatment

35
Q

WHO recommendations that provide 80-90% effective cancer pain treatment: (3)

A
  • Prompt administration
  • On schedule; not prn
  • Add antianxiety drugs as necessary
36
Q

Common nerve blocks used to treat cancer patients: (3)

A
  • Celiac plexus for unresectable pancreatic cancer, hepatic cancer, or gastric cancer
  • Intercostal nerves for rib metastasis
  • Lumbar sympathetic ganglion for pelvic tumors
37
Q

What areas are anesthetized with a celiac plexus block? (2)

A
  • Sympathetic fibers of T5-T12
  • Parasympathetic celiac plexus fibers
38
Q

For what types of cancer are celiac plexus blocks typically performed? (3)

A

Unresectable:

  • Pancreatic
  • Hepatic
  • Gastric
39
Q

What injection is used with a neurolytic celiac plexus block?
How long does this typically last?

A

Isopropyl alcohol

Destruction of nerves (neurolysis) typically provides pain relief for 3-6 months.

1Fall24 PoA II (34 decks)

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