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oncology review Flashcards

1
Q

cancer is the ___ leading cause of mortality in the US

A

2nd

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2
Q

neoplasia

A

any new or continued cell growth that occurs which is not necessary for normal development and replacement cells

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3
Q

characteristics of malignant cells

A 
demonstrate rapid cell division 
show anaplastic morphology
have a large nuclear cytoplasmic ratio
lose some  or all differentiated functions
adhere loosely together
able to migrate
grow by invasion
are not contact inhibited
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4
Q

MALIGNANT vs benign tumors

A 
rapid growth
not encapsulated
irregular shape
poorly differentiated cells
recurrence is common
harmful
variable prognosis
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5
Q

malignant vs BENIGN tumors

A 
slow growth 
encapsulated
round shape
differentiated cells
recurrence is unusual
less harmful
good prognosis
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6
Q

intrinsic risk factors for cancer

A

immune function (ie HIV)
age (the single most significant risk factor for cancer)
genetic predisposition

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7
Q

extrinsic risk factors for cancer

A

chemical carcinogens
physical carcinogens (radiation exposure-ionizing and UV)
viruses (oncoviruses-HBV & liver)
Dietary factors (excessive animal fats, red meats, nitrates, alcohol)

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8
Q

Reducing risk factors

A 
adopt a physically active lifestyle
maintain a healthful weight and diet
avoid tobacco products
wear sunscreen
avoid environmental exposures; asbestos, pesticides, etc
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9
Q

7 warning signs of cancer

A 
change in bowel/bladder habits
a sore that does not heal
unusual bleeding/discharge from body or orifice
thickening/lump in breast
ingestion/difficulty swallowing
obvious change in wart/mole 
nagging cough/hoarseness
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10
Q

normal cell cycle

A 
mitotic phase 
gap 1 interphase
s phase
gap 2 
gap 0
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11
Q

mitotic phase

A

cell divides into 2 identical cells

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12
Q

gap 1 interphase

A

from end of mitosis to beginning of DNA synthesis “active state” RNA/Protein synthesis

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13
Q

S phase

A

synthesis of DNA

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14
Q

Gap 2

A

premitotic phase, end of DNA synthesis

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15
Q

Gap 0

A

quiescent phase or resting phase

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16
Q

initiation

A

mutation occurs causing irreversible damage (carcinogen-chemicals, viruses, radiation)

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17
Q

promotion

A

promote or enhance; initiates cell growth, repeated exposure (smoking)

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18
Q

progression

A

uncontrolled growth of cancer growth, need for TAF (tumor angiogenesis factor)

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19
Q

metastasis

A

cancer cells move from their original location and establish remote colonies (cancer still named after primary site of invasion)

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20
Q

routes for metastatic spread

A

direct invasion
local seeding
blood borne metastasis
lymphatic spread

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21
Q

local seeding

A

distribution of shed cancer cells in local are of primary tumor

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22
Q

blood borne metastasis

A

most common route of spread; tumor cells are released into the blood and travel

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23
Q

lymphatic spread

A

primary site that has many lymph nodes proximal to tumor, tumor cells are released into the lymphatic system and spread

24
Q

grading

A

rates tumor cells according to cellular characteristic (G1-G4)

25
Staging
TNM determines cancers location and degree of metastasis at diagnosis for treatment and diagnostic purposes
26
current cancer treatments
``` surgery radiation therapy chemotherapy hormone therapy immunotherapy/biotherapy ```
27
goals of treatment
cure/control adjuvant palliative
28
cure/control
removal of all cancer from the body - varies for different cancers
29
adjuvant
treatment administered in conjunction with other treatment with the goal of destroying micro-metastasis
30
palliative
relieving symptoms
31
considerations for treatment
type of tumor location of tumor rate of growth stage, size, metastasis
32
criteria for radiation
- must be rapidly dividing - tissue of origination must be sensitive - degree of cell differentiation, rate of mitosis, degree of oxygenation/vascularization are all considered - used for primary, adjuvant, or palliative therapy
33
types of radiation
internal (brachytherapy, radiopharmaceutical) | external beam
34
brachytherapy
(implants) uses sealed sources to place radioactive material close to tumor for 1-3 days (prostate, cervical, breast cancers)
35
radiopharmaceutical therapy
radioactive material is given by injection or ingestion (thyroid cancers)
36
external beam
initial stimulation (placement of tattoo/dye markings) session take about 30 minutes usually given in daily "fractions" based on the phase of cells
37
side effects of radiation
``` (often dependent on the site of radiation) fatigue GI reactions myelosuppression alopecia respiratory complications sexual problems skin (limited to tissue directly exposed to radiation) ```
38
growth fraction | chemotherapy
ratio of cells in growth vs resting
39
increased percentage of cells in growth phase
high growth fraction | chemo is generally more toxic to tissue that have a high growth fraction
40
solid tumors | chemotherapy
generally have a low growth fraction
41
disseminated cancer
generally have a high growth fraction
42
tissues with high growth fraction
bone marrow hair follicles GI Epithelium Sperm forming cells
43
effects of chemotherapy on hair follicles
alopecia
44
effects of chemotherapy on GI epithelium
n/v, anorexia, diarrhea, stomatitis (mouth inflammation)
45
effects of chemotherapy on sperm forming cells
decreased fertility
46
effects of chemotherapy on bone marrow
myelosuppression (depression of bone marrow which produces red blood cells)
47
meds to treat chemo causing n/v/diarrhea
antiemetics as ordered- zofran (ondansetron), anzemet (dolasetron) also used: decadron (glucocorticoid), ativan (sedative), marino (marijuana)
48
myelosuppression affects
all cells erythrocytes (anemia) thrombocytes (thrombocytopenia) leukocytes (leukopenia)
49
greatest effects of chemo
7-10 days following treatment (outpatient) | hospitalization for side effects not treatment of chemo
50
interventions for anemia
monitor Hgb, Hct, | transfuse if Hgb
51
Interventions for thrombocytopenia
Monitor thrombocytes 150,000 to 400,000 Transfuse platelets less than 10,000 to 20,000 Monitor for bleeding (gums, epistaxis, hematuria, melena, spontaneous bruising, ecchymosis) Avoid injections (apply pressure if injection is given) Avoid rectal temps/trauma
52
Interventions for leukopenia
Monitor wbc's 5000 to 10,000 Determine ANC = absolute neutrophil count ANC= WBC x %Neutrophils + %Bands/100
53
Neutropenic precautions
Initiate precautions for ANC less than 1000 Private room keep door closed Restrict visitors (no kids less than 12, Persons with cold, URIs etc) Meticulous hand washing Monitor temp Q4 hours Notify Dr. for a temp greater than 101 Avoid rectal temps, exams, or enemas Teach patients not to floss Inspect orifices or signs of breakdown or superinfection
54
Management of oral candidiasis (thrush)
Medications include Diflucan (fluconazole), Mycostatin (nystatin), baking soda rinses or saline rinses
55
Biologic therapy
Agents that alters the response of the host to the tumor cells; example into look into stimulates T and B cells and activate NK cells

chronic (17 decks)

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