Week 11 Flashcards
Cancer
- uncontrolled growth and spread of abnormal cells
- which if not adequetly treated results in death
Malignant cells - characteristics (6)
- mutated DNA alters instructions for function
- parasitic to host/no beneficial function
- uncontrolled reproduction
- invade surrounding tissuses and metastasize
- imortal
- cell birth > cell death
What causes childhood cancers (4)
- unknown (most cases)
- not anything anyone did or failed to do
- related to peak growth
- possibly related to environmental agents (electromagnetic fields, chemicals, pesticides, viruses)
Children at increased risk for cancer (4)
- genetic predisposition (Down syndrome, li-fraumeni syndrome, retinoblastoma gene)
- immunodeficiency (congenital/aquired/treatment-related)
- history of cancer
- prior cancer treatment
Classification of childhood cancers (2)
- hematological malignancies
- solid tumours
Hematological cancers - types
- leukemia (blood/marrow)
- lymphoma (lymph)
Solid tumours (6)
- CNS
- neuroblastoma (SNS)
- Rhabdomyosarcoma (muscle)
- Wilms tumor (kidney)
- Ewig’s sarcoma
- Osteosarcoma (bone)
Cancers and growth - less than 5 years
- leukemia
- CNS tumors
- teratomas
Cancers and growth - children 1-14
- leukemia
- brain tumours
- lymphomas
Cancers and growth - children over 14
- lymphomas
- epithelial carcinomas
- bone tumours
Tissue classification - embryo
- ectoderm
- mesoderm
- endoderm
Tissue classification and pediatric cancer
- most childhood cancers arise from mesoderm or ectoderm (tissues deep within body)
Childhood cancer
- rare
- leukemia most common, followed by brain tumours and lymphomas
Oncology based assessment - G/D (8)
- assess child weight and height (assess weight loss)
- nutritional intake/change in appetite
- developmental assessment = slow progresor/ regression
- school performance (include children with cancer in past)
Oncology based assessment - pain
- pain (abnormal if no acute injury or condition = limping, headache, etc.)
Oncology based assessment- skin (3)
- skin (bruising, petechiae, or signs of bleeding,
- pallor or signs of anemia,
- abnormal lesions)
Oncology based assessment - EENT (3)
- EENT and sensory assessment (symmetry, movements, - - recent change to hearing and vision (diplopia)),
- lymph nodes
Oncology based assessemnt - chest, heart respiratory
- shape of chest, RR, ease of respirations
- heart and lung auscultation
- endurance and activity levels
Oncology based assessment - abdomen (2)
- abdoninal massess,
- N/V anorexia, weight loss
Oncology based assessment - urinary and GI (4)
- frequency of U/O and bowel elimination
- intake and evidence of vomiting or food intolerance
- blood or other discolouration in urine/stool
- be alert for UTI
Oncology based assessment - MSK
- observe expected developmental tasks
- asymetry of bone and muscle
- limping, other abnormalities
- muscle weakness, tingling, etc.
Oncology based assessment - family history
- ask fam hist of cancer
Diagnosis of cancer (9)
- biposy
- bone marrow aspiration
- computed tomography (CT)
- lumbar puncture
- MRI
- PET
- radiograph (x-ray)
- nuclear medicine
- ultrasound
Bone marrow aspiration (purpose, normal value, diagnostic value)
- examines bone marrow
- normal = less than 5% blast cells
- abnormal = greater than 25% blast cells in acute lymphoblastic leukemia
Lumbar puncture (purpose, normal value, diagnostic value)
- examines cerebrospinal fluic
- normal (cell count, polymorpheonuclear leukocytes 0, monocyles 0-5, RBC 0-5
- abnormal = presence of malignant cells
Complete blood count and differential (purpose, normal value, diagnostic value)
- examine celluular component of blood
- normal
- WBC less than 10,000
- platelets 150,000-400,000
- hemoglobin 120-160
- abnormal
- WBC less than 10,000
- platelets 20,000-100,000
- hemoglobin 70-100
Cancer lab tests (5)
- Complete blood count (CBC)
- red blood cell incices
- serum chemistry panel
- tumour markers in blood or urine
- urinalysis
Assessing cancer - TNM
T - local spread of primary tumour (size and are adjacent organs involved)
N - lymph node metastases
M - distant hematogenous metasteses (liver, lungs, bones)
Brain tumours - prevelance
- 20% of cancer in children under 15
