Ready To Study: The Cancer Patient Part 2 Continued Flashcards
Often times we will do tumor removal or debulking before we try another modality because obviously ________ and ______ are going to be more effective if there’s less tumor there that needs to be removed. Palliation is relieving symptoms.
chemotherapy and radiation
The type of surgery chosen for cancer is determined by the ________ of the disease. if it’s a small tumor and it has well defined margins we are going to be able to remove the entire thing.
extent
The type of surgery chosen for cancer is determined by the _______ and ______ involved. Patients can have tumors that are growing around their trachea or around a major vessel like their aorta and obviously we aren’t going to be able to cut that out because we can’t get it and not damage something the pt needs to survive.
location and structures
The type of surgery chosen for cancer is determined by the _______. This is the speed of proliferation and reproduction.
tumor growth rate
The type of surgery chosen for cancer is determined by the __________. It’s going to be harder to get the whole tumor if it’s deep within the tissues. Is the patient a good risk for surgery.
tumor invasiveness
The type of surgery chosen for cancer is determined by the ______ of the patient. People don’t have cancer alone. People have usually have cancer and COPD or cancer and cardiac disease. They might be a very high surgical risk or they might have no other options.
surgical risk
Study Tip: Liver cancer pt and she was fine in 50’s until she did a physical for life insurance and found she had liver cancer. She never had anything else going on, so had she been a candidate for surgery she would be a GOOD low surgical risk since she had no co-morbidities.
The type of surgery chosen for cancer is determined by the________. Sometimes it really is between does my pt want to have surgery and if so will they survive the surgery. Is there a possibility that their lungs are so compromised that their is a risk that they may never come off the ventilator? There are a lot of things you have to consider.
Quality of life expected post-op.
Surgery is used to ______. This is used to remove the entire cancer.
cure
Surgery is used as a component of ______ therapy, when used in addition to chemotherapy or radiation therapy.
adjuvant
Surgery is used to control oncologic emergencies like a _____ bleed.
GI bleed
Surgery can be done as ______. This can prevent the growth of cancer cells when genetic precursors have been detected.
prophylaxis.
Study Tip: Women have both breasts removed to prevent them from getting breast cancer since they have such a strong family history of breast cancer.
__________ uses cutting and coagulating high frequency current to remove the malignancy or cancerous growth by needle, blade, or electrode.
Electrosurgery
__________ involves the insulation of very cold liquid nitrogen into the tumor and she had a lady w/ cancer and they injected her kidney w/ this very cold liquid nitrogen and it froze the kidney and it just dissolved in her body.
Cryosurgery
Surgery is by far the most prevalent intervention for cancer 90% of all cancer patients undergo surgery. What is surgery used for?
Diagnosis
Staging
Tumor removal also called debulking
Palliation
___________ is used in skin cancer so there’s a very corrosive paste that they will put on to the malignancy and remove it that way.
Chemosurgery
_________ they use a beam of laser energy to eliminate and to cut out a cancer.
Laser surgery
Used by > 50% of cancer patients it can be used alone or it can be used w/ other forms of treatment. It’s also used in conjunction with surgery it can be administered pre-op or post-op. ________ therapy can be used w/ chemo so we can use any combination of chemo, surgery, and this form of non-invasive therapy.
Radiation
In patient’s with ________ the primary treatment is radiation but it might also be used to treat the CNS blood brain barrier because chemotherapy has some difficulty crossing this blood brain barrier. If we use radiation therapy on the CNS it can help the chemotherapy to cross easily into the blood brain barrier. Radiation therapy is used palliatively in about 50% of the patients who have advanced cancer.
acute lymphocytic leukemia
________ can reduce the size of a tumor, sometimes tumors grow and press on nerves which cause a lot of pain and it can be used palliatively for that and if a tumor is close to the spinal column it might threaten to compress on the spinal column and the pt would be paralyzed. Then they are going to be dying from cancer and be paralyzed from the waist down. A lot of times they will use radiation for that too.
Radiation
There’s some oncologic emergencies like ________ where a tumor is growing around the superior vena cava, you can imagine the problems that’s going to cause. It’s going to interfere w/ blood returning to the heart, spinal cord compression which she already mentioned, bronchial obstruction, and hemorrhage.
superior vena cava syndrome
Radiation can be used to treat all of these things. For what 6 cancers listed may this be the primary treatment.
List: Hodgkin’s Early-stage breast cancer Laryngeal Prostate Vaginal Cervical
_________works by killing cells, it delays or halts the cell cycle, and it damages nucleus leading to cell death after replication. Rapidly proliferating cells are more vulnerable so we have the cancer cells that just keep going and going and going (like energizer bunny :P) they are going to be more vulnerable. However, you have to remember that normal tissue is vulnerable to treatment also. Normal tissue usually recovers between doses, the cancerous tissue cannot recover but still it’s very important to remember normal tissue is being affected by this treatment also.
Radiation
Radiation is curative it can be used alone to cure some cancers or in conjunction with chemotherapy. It can be a ______ which means it’s done before surgery. _________ means it’s done post-surgery.
neo-adjuvant
Adjuvant
Radiation can be used ________, some cancer cells have places they can go where they’re not accessible to chemotherapy or surgery.
An example like we mentioned earlier is the CNS it’s hard to get chemotherapy past the blood brain barrier so radiation is used to help that happen.
prophylactically
Radiation therapy is the ______ the dose and the _____ the intervals, the more likely it is to kill the cancer.
If we are just trying to palliate it’s just going to be a _____ dose over a shorter period of time. Radiation can be used palliatively, in lower doses over ______ intervals.
higher
longer
lower
shorter
Different types of radiation delivery and we don’t necessarily have to remember the different types like the EBRT vs. the SRT vs. the IMRT.
Those are all things that are administered externally so what we need to remember the difference between are those externally administered radiations vs. the other 2 the brachytherapy or systemic radiation?
External Beam Radiation Therapy (EBRT) Sterotactic Radiation Therapy (SRT) Brachytherapy: temporary or permanent Systemic Intensity Modulated Radiation Therapy (IMRT)
FYI
