Osteopathic Considerations in Oncology (Jons-Cox) Flashcards
what are the 5 cancers that have bone metastases
BLTKP
Breast Prostate Lung Kidney Thyroid
what cancers are dermatomyositis and polymyositis associated with
lung and gastric cancer 50% of time
acanthosis nigricans is associated with what cancer
gastric or abdominal malignancies
adolescent
pain around knee
pallor fatigue
osteosarcoma
diaphysis of bone
ewing’s sarcoma
what are the pediatric cancers that metastasize to bone
neuroblastoma- skull wilms tumor osteosarcoma ewing sarcoma rhabdomyosarcoma
bone metastases
present with what symptoms
pain
localized constant bone pain
begins dull and intermittent and worsens steadily, often over several days or weeks
pain at night and at rest is common
common sites are the vertebral column (esp thorax), skull, humerus, ribs, pelvis, femur
(rich blood supply)
what are your red flags for bone mets/ or bone cancer
unexplained MSK pain
pain in spine or proximal extremities (Hips, thighs, shoulders) that doesn’t correlate with a known injury
night pain or at rest
where does pain refer if they have mets in high cervical spine
posterior headaches
where does pain refer if they have mets in C7-T1
interscapular pain
where does pain refer if they have mets in T12-L1
flank, iliac crest, or sacroiliac joint
could look like kidney stone
where does pain refer if they have mets in sacral
saddle distribution
what is the most specific imaging study for mets
plain film radiography (detects 70% of vertebral tumors)
but is not the most sensitive (40-50% of the bone must be eaten away to see it on X-ray)
see multiple lesions, its most likely mets
follow up with bone scan even if their Xray is negative and you are suspicious
why do we measure alk phos is suspecting mets
evaluate bone turnover
pain at rest? yes
radiography with suspicious lesion? yes
mets workup
CT
lab evaluation
