Oncology Study Questions Flashcards
Test for childhood cancer
- CT/MRI/PET/MRA to locate/stage tumors
- Bone marrow aspiration/biopsy to diagnose leukemia
- Lumbar puncture to assess CNS involvement
- CBC/Electrolytes/BUN/Cr for baseline and tumor impact
- Ultrasound for wilms tumor
Nursing responsibilities for childhood cancer test
- Prepare child/family emotionally (age-appropriate explanation)
- Monitor for bleeding/infection post-biopsy
- Manage sedation, pain control
- Support positioning, observe for CSF leaks or neuro changes
Leukemia definition
a type of cancer that effects the blood and bone marrow
S/S of leukemia
Fever (61%)
Bleeding/petechiae/purpura (48%)
Bone pain, pallor, fatigue
Hepatosplenomegaly
Onset of leukemia
Peaks 2-3 years
Patho of leukemia
- Immature WBCs (blasts) crowd out healthy cells → pancytopenia
- Creates dysfunctional immune system
Diagnosis of leukemia
CBC: Abnormal counts (↑ blasts, ↓ Hgb, ↓ platelets)
Bone marrow aspiration: Confirms leukemia, % of blasts
LP: Rules out CNS involvement
Immunophenotyping: B-cell (more common) or T-cell (worse prognosis)
Treatment of leukemia
4 chemo phases: Induction, Consolidation, Delayed Intensification, Maintenance
Radiation: For CNS/testicular involvement or T-cell disease
Stem cell transplant: If relapse/chemo failure
Route: IV, PO, IM, IT
Treatment length of leukemia
2 years for girls, >3 years for boys
Complications of leukemia
Infection, anemia, hemorrhage
Side effects from chemo: mucositis, N/V, alopecia
CNS toxicity, long-term growth delay
Relapse (15–20%)
Worse prognosis in leukemia
High WBC count (>50,000)
T-cell leukemia
CNS/testicular involvement
Age <1 or >10
Types of brain tumors
Medulloblastoma
Astrocytoma
Ependymoma
Brainstem glioma
S/S of brain tumor
Morning headache, vomiting, abnormal gait, vision changes, fatigue, behavior changes
Diagnosis of brain tumor
CT, MRI, PET, MRA
LP for CSF cytology (if safe)
Treatment of brain tumor
Surgery: Remove/debulk tumor, relieve ICP
Radiation: Post-op, esp. medulloblastoma, ependymoma
Chemo: Limited efficacy due to blood-brain barrier
Monitor for: seizures, hydrocephalus, infection, growth/cognitive delay
Post-op complications of brain tumor
Neuro checks: ↓ LOC, unequal pupils, posturing
Vital signs: bradycardia, widened pulse pressure, irregular respirations (Cushing’s triad)
Risk for seizures, SIADH, infection, bleeding
Wilms tumor definition
rare kidney cancer
S/S of wilms tumor
Asymptomatic abdominal mass (often found during bath)
May have hematuria or HTN (due to renin)
Diagnosis of wilms tumor
Ultrasound (first), then CT/MRI
Lab: CBC, BUN/Cr, Electrolytes
Diagnosis of wilms tumor
Surgery: Remove affected kidney
Chemo ± Radiation depending on stage
Do NOT palpate abdomen → risk of rupture!
Complications of wilms tumor
Post-op liver damage (R-sided tumors), cirrhosis
Radiation → skeletal deformities
Remaining kidney: risk for glomerular damage
Osteosarcoma definition
bone cancer
Common age in osteosarcoma
Adolescents during growth spurts (13–17 yrs)
S/S of osteosarcoma
Bone pain, swelling, limp
Night pain or referred hip/back pain
Diagnosis of osteosarcoma
Bone scan, MRI, CT
Labs: CBC, elevated LDH
Treatment of osteosarcoma
Surgery (limb salvage or amputation)
Chemo before and after surgery
Watch for lung metastasis (20% risk)
Complications of osteosarcoma
Phantom limb pain
Lung metastasis
Chemo side effects (n/v, myelosuppression)
Psychosocial needs of childhood cancer
Body image concerns
Peer support and counseling
Functional limitations and grief support
Lymphoma (Hodgkin & Non-Hodgkin) risk/etiology
Teens (esp. Hodgkin), immunocompromised (NHL)
Viral exposures (EBV), genetic predisposition
S/S of lymphoma
Painless lymphadenopathy
B symptoms: fever, night sweats, weight loss
Diagnosis of lymphoma
Lymph node biopsy, imaging
Retinoblastoma S/S
Often first noted as leukocoria (“white pupil”/absent red reflex)
May also present with strabismus
Treatment of retinoblastoma
Enucleation, radiation, chemotherapy depending on severity
Febrile neutropenia
Medical emergency—Immediate eval and empiric broad-spectrum antibiotics
Workup: CBC, cultures, possibly CXR/UA
ANC <500 → high risk
Hyperleukocytosis
WBC >100K, risk of leukostasis
Causes ↓ perfusion, CNS or pulmonary failure
Worse prognosis with WBC >300K
Tumor Lysis Syndrome
Labs: ↑ K⁺, ↑ uric acid, ↑ phosphate, ↓ calcium
Highest risk: large tumor burden (e.g., leukemia, lymphoma)
Peaks 24–48 hrs after treatment starts
Treat with hydration, allopurinol, rasburicase
Discharge considerations in childhood cancer
Infection prevention (hand hygiene, avoid sick contacts)
Nutrition support
Pain management
Immunization guidance (no live vaccines during/after chemo)
School reintegration
Long-term follow-up for growth, cognition, and secondary malignancies
