week 1 - cancer pt.3 Flashcards by Christina Fiorelli

what 2 things are the biggest risk factors of developing heart cancer?

HIV + smoking

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What is the gene called that will tell you if you’ve genetically inherited heart cancer?

POT1 protein

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What are 2 oncological emergencies related to heart cancer?

pericardial effusion -which requires pericardiocentesis

cardiac tamponade - which requires pericardiotomy (more severe)

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What are the 4 kinds of hepatic cancer?

-fibrolamellar
-hepatocellular carcinoma
-intrahepatic cholangiocarcinoma
-hepatoblastoma

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What are the clinical manifestations of hepatic cancer?

-dull, continuous pain in the RUQ
-jaundice
-weight loss
-stomach pain
-fatigue
-ABD ascites
-chalky stools

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How does Hepatitis B and Hepatitis C contribute to the possible development of hepatic cancer?

the chronic infection from these viruses is causing continuous inflammation and damage to liver cells, which leads to scar tissue (cirrhosis) and eventually cancer

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How does diabetes, specifically type 2 relate to liver cancer?

continuous uncontrolled high blood sugar is going to cause damage to the liver and increase the risk of cancer developing

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how does aflatoxin in mold relate to liver cancer?

compounds in the mold, when ingested can cause serious liver damage. This is common contamination in crops like peanuts, corn and tree nuts

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-long term alcohol use
-viruses
-delirium tremens (DT) - (this is a severe life threatening form of alcohol withdrawal)
These 3 things can cause ________, Which can eventually lead to liver cancer.

cirrhosis

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what gene are we looking for hepatic cancer?

TP53

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LFTs
Bilirubin
AST+ALT+GGT
Alkaline Phosphate
Lactic Dehydrogenase
CBC

These are the labs were looking at for which kind of cancer?

Hepatic/ Liver cancer

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In patients with possible liver cancer their alpha fetoprotein (which is a tumor marker) is generally going to be >______ng/mL, which is proving there’s an issue.

200

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TARE and TACE are both procedures used to treat liver cancer. What are they?

-Trans Arterial Radio-Embolization
tiny radioactive beads are injected into the arteries that supply the liver

-Trans Arterial Chemo-Embolization
chemotherapy and embolic drugs (block blood flow) are given right to the tumor

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What are some other treatment options for liver cancer other than TARE or TACE?

stop drinking + smoking
-percutaneous placement of interstitial radiation
-implantable chemo pump
-laser hyperthermia
-immunotherapy
-inject alcohol to dry out tumor
-surgical removal of lobe
-transplant

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What are 3 potential problems post op, when a patient is receiving a liver transplant?

rejection
infection
bleeding

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True or False?
When a patient is receiving a liver transplant, they can either receive an entire liver donation or just a partial lobe from a live donor.

true

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when a patient is getting a liver transplant its important they are on immunosuppressant therapy to do what?

this will help prevent organ rejection

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What are high risk factors for developing gastric/ stomach cancer?

-smoking
-high sodium/pickled/ smoked diet
-obesity
-prior gastric surgery (this also leads to pernicious anemia and low intrinsic factor B12)

h-pylori infection
-chronic gastritis
-type A blood
-positive EBV

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_____ syndrome is a genetic syndrome that increases the risk of developing colorectal cancer.

Lynch

TP53 gene

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which vitamin will a patient need to take for the rest of their life after a gastrectomy?

vitamin B12

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A patient will remain NPO after surgery until what 2 things are assessed?

peristalsis and bowel sounds

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What are the signs and symptoms of pancreatic cancer?

-upper ABD pain that radiated to the back
-jaundice
-loss of appetite
-weight loss
-depression
-blood clots
-insulin deficiency (DM)

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What are 5 risk factors of developing pancreatic cancer?

-smoking
-industrial chemical toxins
-high fat/ meat diet
-diabetes
-pancreatitis

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Will the patient with pancreatic cancer have different treatment depending on if the cancer is in the head, body or tail of the pancreas?

yes

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also known as a pancreaticoduodenectomy, is a complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. What is the name of this surgery?

Whipple procedure

What are 3 post op complications of the Whipple procedure?

-pancreatitis -extreme pain -blood glucose level issues

What are the signs and symptoms of renal cancer?

-hematuria -night sweats -chronic ABD + back pain -HTN -fever (comes + goes) -swelling - unexplained weight loss -vision issues -pale skin -fatigue

what are the 3 big risk factors of developing renal cancer?

-obesity -smoking -diet

What are 3 potential problems with a kidney transplant or any transplant in general?

-rejection -bleeding (blood clotting cascade interruption) -infection

Antirejection meds are given to patients when getting an organ transplant. What are some of the complications related to the antirejection medications? (6)

-osteoporosis -osteonecrosis -diabetes -excessive hair growth -HTN -high cholesterol

What is the gene mutation for almost all the thoracic area cancers?

TP53

What are the 5 places bladder cancer can metastasize from?

-ovaries -prostate -colon -rectum -uterus

What are some of the signs and symptoms of bladder cancer? (5)

-ABD pain -lower back pain -urine specimen labs- hematuria, proteinuria, pyuria -UTI -urgency

A cystectomy is the removal of the _______.

bladder

An ileal conduit is a urinary diversion surgery that uses the _______ (the last part of the small intestine) to attach the ureters to, so that urine can flow into the conduit instead of the bladder.

ileum

When an ileal conduit is made, what is is called where the urine flows out of the body?

the stoma, which will then drain into a collection bag

An ______ _______ is a urinary diversion surgery that makes a new place inside the body to collect urine instead of the bladder. This surgery uses a part of the large and small intestine. What is each part used for?

Indiana pouch; large - is made into the pouch that will collect urine small - used to make a valve that will prevent urine leakage

When an Indiana pouch is made, how is the urine drained out of the body?

this patient will have a stoma, and a catheter will have to be regularly inserted to drain the urine

What are 3 complications related to not getting the Indiana pouch drained regularly?

-absorption of metabolic waste -urine reflux into the ureters -UTI

If a patient had a ureterosigmoidostomy surgery, what did they have completed?

this is where the ureters are diverted to the bowels

(Bacilli Calmette-Guerin) BCG chemotherapy is a live strain of mycobacterium bovis that is inserted into the bladder. Once this is in the bladder what must you have or help the patient do to make this treatment THE MOST effective?

they need to be rotated on ALL sides so that this chemotherapy covers the entire bladder

if a patient has a neurogenic bladder, which is when nerve damage causes incontinence, retention, or frequency, what kind of catheter would be inserted?

suprapubic

When a patient is taking Ifosfamide chemotherapy for the bladder, what medication is given to prevent hemorrhagic cystitis from the bladder?

Mesnex (Mesna)

Which diabetes medication has a history of causing bladder cancer?

Pioglitazone (Actos)

Bricker's procedure AKA ______ ______.

Ileal conduit

What are 3 major complications related to an ileal conduit or Indiana Pouch?

-hydronephrosis -pyelonephritis -vesicovaginal fistula

How can having an ileal conduit or Indiana pouch lead to hydronephrosis?

this can occur due to narrowing at the connection between the ureter and the ileum, causing obstructed urine flow

How can having an ileal conduit or Indiana pouch cause pyelonephritis?

these patients are at a higher risk of developing UTI's due to a foreign body (the conduit) and the need for regular catheterization

What can cause a vesicovaginal fistula after an ileal conduit or Indiana pouch surgery?

this can occur due to surgical complications or infection

It is important to empty the urostomy bag when it is how full?

2/3

which chemotherapy agents are alkylating and used for bladder cancer by getting inserted into the bladder, and rotating the patient in the bed in ALL directions?

-Methotrexate -Vincristine -Doxorubicin -Cisplatin

Colon cancer is cancer of the large intestine, rectal cancer is cancer of the last few inches of the colon, what is it called when the entire colon or BOTH parts have cancer?

colorectal cancer

How is any kind of colon cancer diagnosed?

colonoscopy

True or False? polyps in the colon can be benign but eventually can become cancerous with NO s+s?

true

What are some signs and symptoms related to colon cancer?

-change in bowel habits or stool lasting longer than 4 weeks -rectal bleeding/ blood in stool -persistent ABD discomfort (IE. pressure, cramps, gas, pain) -feeling of bowel not emptying completely -weakness + fatigue -unexplained weight loss

What are the risk factors of developing colon cancer?

-smoking -family hx of lynch syndrome, crohn's or colitis -alcoholism -high fat/ protein diet -females w/ HX of GYN cancers -hx of IBS -obesity -genetics (specifically men, Jewish and African American's) -diabetes

hereditary nonpolyposis colorectal cancer (HNPCC) AKA ______ _______.

Lynch Syndrome

Lynch Syndrome is a _____ ______ that increases your risk of developing cancer, specifically colorectal cancer.

genetic condition

Lynch Syndrome is due to the genes that are responsible for repairing DNA mistakes being mutated - this is what leads to cancer developing

What is the surgery called that only removes a part of the colon or large intestine?

hemicolectomy

Post op after a colostomy it is important to assess for ______ and _______.

infection and dehiscence

What is the difference between a colostomy and a K pouch?

a colostomy is an outer waste collection and a K pouch allows for internal waste collection through a hole in the abdomen

What are 5 risk factors of uterine cancer?

-obesity + HTN -taking estrogen w/o progesterone -radiation -Tamoxifen (tx for breast cancer) -cervical cancer from HPV

a hysterectomy is the removal of the ________.

uterus

an oophorectomy is the removal of one or both _______.

ovaries

a cervicectomy is the removal of the ________.

cervix

a lymphadenectomy is the removal of 1 or more ________.

lymph nodes

a salpingectomy is the removal of one or both of the _________ _______.

fallopian tubes

S+S of ovarian cancer **BEAT**

B-bloating E-eating less (malnutrition, feeling fuller) A-ABD distension, pelvic pain, pleural effusion, bowel obstruction, hypermenorrhea, foul smelling discharge T- trouble w/ bladder (frequency)

How can we teach women to help prevent/ slash early detection of cervical cancer?

PAP smears **Papanicolaou test**

What are the risk factors of cervical cancer?

-HPV or HIV virus -obesity -unsafe sex -long term oral contraception -smoking/ 2nd hand -poor nutrition -family hx -chronic cervical infections

What other types of cancer have been linked to the HPV virus besides cervical?

-anus -penis -vagina -vulva -oropharyngeal

what are 6 risk factors of ovarian cancer?

-genes (BRCA1, BRCA2, TP53) -older age -early menarche -late menopause -obesity -hx of HNPCC colorectal cancer (lynch syndrome)

What tumor marker is seen in the blood with ovarian cancer?

antigen marker CA125

When is the optimal time for a male to perform a self testicular exam?

after a warm shower because it expands the tissue

What are some warning signs of testicular cancer?

-swelling/ lumps on 1 or both testes -scrotum feeling heavy -dull pain/ pressure in lower belly/ groin -lack of energy/ general feeling of illness -SOB, cough, chest pain -headache + confusion

How does testicular cancer spread?

through the wall of the testicles into the blood supply, through the tubes that transport sperm and lymph nodes

What are some S+S of prostate cancer?

-frequency or difficulty urinating -ED -bloody discharge -rectal discomfort -backache + pelvic pain -spontaneous fractures (bone pain)

a prostatectomy is the removal of the ________.

prostate

what are some of the complications post prostatectomy?

-hemorrhage -clots -catheter obstruction -sexual dysfunction/ impotence

When can sexual activity resume post prostatectomy?

6-8 weeks

What can cause a prostate specific antigen (PSA) to have a false positive?

-BPH -after sex -younger men, due to hormones

if a patient is having a prostatectomy via a TURP and nerve damage is caused, what complication can occur?

PERMINENT erectile dysfunction