Study Guide Leftovers 2 Flashcards
What are the 5 most common sites of metastasis in order?
- pulmonary
- skeletal
- hepatic
- neurologic
- lymphatic
These tumors metastasize first to the lung
primary bone tumors
Why do primary bone tumors metastasize to the lung first?
- venous drainage passes through superior and inferior venae cavae into the heart
- lungs are the first organ to filter malignant cells
What is often the first symptom of a lung met?
dry, persistent cough
Bone mets are very common, especially to this bone type
vascular
Most common sites of bone mets
- vertebrae
- pelvis
- ribs
- skull
- proximal femur
skeletal metastases: What are some of the qualities of pain?
- deep
- intractable
- poorly localized
- episodic “stabbing” pain
- worst at night
- wakes person up
What problems can occur from osteolytic lesions?
- pathologic fx
- back pain
- hypercalcemia
Why is there an increase in bone resorption with bone mets?
hormonal stimulus of protein that stimulates osteoclastic bone resorption
What type of metastasis is among the most ominous signs of advanced cancer?
liver mets
Because the liver filters blood from the GI tract, it is the primary metastatic site for tumors originating in these locations
- stomach
- colorectum
- pancreas
s/s liver met
- RUQ pain
- malaise
- fatigue
- may refer to R shoulder
- bilateral carpal tunnel syndrome
Why would you get carpal tunnel with a liver met?
It’s actually an ammonia abnormality due to liver dysfunction
% of individuals with primary sites outside the CNS that develop brain mets
20-25%
Most common primary cancers with mets to brain
- lung
- colon
- kidney
- skin (melanoma)
- breast
Brain tumors may be asymptomatic, or vary widely, depending on
- location
- size
What are the s/s of cauda equina syndrome?
- LBP
- saddle paresthesia
- LE weakness
- sexual dysfunction
- etc
What is a major neuro side effect of chemo?
chemotherapy-induced peripheral neuropathy
What are two factors with cancer that may result in dysfunction presenting as lymphedema?
- previous cancer-related surgery
- adverse effects involving radiation fibrosis
What is paraneoplastic syndrome?
- tumors produce s/s at a distance from the tumor or its metastasized sites
- these “remote effects” are collectively called paraneoplastic syndromes
Is paraneoplastic syndrome common?
No, rare
What is a likely cause of paraneoplastic syndrome?
- altered immune system
- tumor elsewhere, possibly not diagnosed
paraneoplastic syndrome: sx resemble those of these types of disorders
- primary endocrine
- metabolic
- hematologic
- NM
What sorts of nonspecific symptoms will be seen with paraneoplastic syndrome?
- skin changes
- anorexia
- malaise
- etc.
