Oncology Pt. 3 (Exam 4) Flashcards
What is the leading cause of cancer related death
Lung cancer
70% of lung cancer patient present with
advanced or metastatic cancer
What is the key to Lung Cancer Treatment?
Early diagnosis
Who is most affected by lung cancer
> 65 years
African Americans
Lung Cancer Etiology
Cigarette smoking = 85% are current of former
The risk increase with the total number of cigarettes smoked “pack year”
Pack Year Calculations
60 year old who smokes 2 pack per day since the age of 20
40x2 = 80 pack year smoking history
Lung Cancer Pathophysiology
Overload of carcinogens from smoking plus some sort of genetic pre-deposition from parents
Smoke paralyze cilia and cilia typically sweep away carcinogens.
Lesions develop and genetic structure changes occur
Other Risk Factors for Lung Cancer
Passive smoke
COPD (Chronic Inflammation)
Asbestos (Construction)
Radon (common in ky)
Arsenic
Genetics
Types of Lung Cancer
Non Small Cell Lung Cancer (NSCLC): Makes up 85% - Slow growing
Small Cell Lung Cancer (SCLC): Rapidly growing tumor that tends to metastasize quickly
Signs and Symptoms of Lung Cancer
Cough
Hemoptysis
Wheeze or stridor
Chest pain
Dyspnea
Weight loss
Fatigue
Weakness
Hoarseness
Obstruction in the lungs can
cause accumulation of secretions in the bronchioles which can appear as pneumonia
How is lung cancer usually found
Via CXR. Lung cancer is typically asymptomatic
Paraneoplastic ACTH in Lung Cancer
A common paraneoplastic syndrome involves lung tumor secretion of ACTH
Lung tumors can inappropriately secrete ACTH, which chemically resembles MSH
Melanocytes are stimulated giving the patient with lung cancer a tanned appearance
Second most common cancer in the US
Breast Cancer
One in Eight women
Most breast cancer develops in
The lining in the ducts from overexpressed
Estrogen Receptors (ER-pos)
or overexpressed
Human Epidermal Growth Factor Receptor (HER2)
Breast cancer receptors
Estrogen receptors
Human epidermal growth factor receptor
Breast Cancer RF
Age greater than 50
Prolonged reproductive life
Hormone replacement therapy
Obesity (estrogen storage)
Late childbirth
Nulliparous (no pregnancies)
Family history of breast or ovarian cancer
Ashkenazi Jewish Women
BRCA1 and BRCA2 mutation
BRCA Genes
Genetic testing for BRCA 1 and BRCA 2 mutations can be preformed in high risk patients with strong Fx of breast or ovarian carcinoma
Genetic counseling should be available for patients undergoing this test
Many women with these gene mutation opt for preventative mastectomy and oophorectomy
Individuals with the BRCA 1 and BRCA 2 gene mutations have an increased risk of which cancers?
Breast
Ovarian
Colon
Pancreatic
Prostate
Breast Cancer Signs and Symptoms
Nontender
Firm
Irregular borders
Adherence to skin or chest wall
Upper, outer quadrant of breast
Nipple discharge
Swelling in one breast
Nipple or Skin retraction
Peau d’orange
Paget’s disease
Peau d’orange
A thickening of skin that resembles an orange peel
Paget’s disease
Disease of breast which involves redness, crusting, pruritus, and tenderness of the nipple
3rd most common cancer in the US
Cervical Cancer
Cervical Cancer: RF’s
Smoking
History of STD’s
HPV infection
Two or more lifetime sexual partners
Immunosuppression
Genetics
Types of HPV
The high risk type of HPV causes persistent infection that progresses to cervical cancer
The low risk type of HPV causes condylomata (genital warts) but does not cause cervical cancer
Almost 100% of cervical cancer test + for HPV
Patients should have Pap
Every 3 years
Colorectal Cancer
The second leading cause of death because of cancer
Beginning at age 50 all adults should have colonoscopy every 10 years
Polyps
A tumorous mass that projects into the intestinal lumen. This is what colon cancer usually starts as
Familial adenomatous polyposis and Hereditary Non-Polyposis coli
FAP: A well defined hereditary disorder that predisposes an individual to intestinal polyps. (100% of time turn into colon cancer)
HNPCC (not likely to develop into colon cancer)
Colorectal Cancer RF’s
Obesity
Tobacco use
Physical inactivity
Insulin resistance
Low fiber in the diet
High amount of animal fat in the diet
Diets low in Vit A-C-E
Ulcerative colitis
Heavy alcohol use
Symptoms of Colorectal Cancer
Fatigue
Weakness
Weight loss
Iron deficiency anemia
Changes in bowel habits
Melena (blood in stool)
Diarrhea
Constipation
Hematochezia (rectal bleeding)
