Week 9 Flashcards
When does cancer begin?
When a cell starts diving uncontrollably > the type of cancer is determined by the organ in which the cancer starts.
What is the initial tumour?
The primary or first tumour discovered. When cells from this tumour break off, they can lodge elsewhere and grow into what are known as secondary cancers.
What are the stages of cancer?
0: carcinoma in situ (early)
1: localised and curable
2: early, locally advanced
3: late, locally advanced, may involve lymph nodes
4: metastasised; inoperable or metastatic cancer
Around one third of cancers are due to 5 leading behavioural and dietary risks. What are they?
High BMI
Low fruit/veg intake
Lack of physical activity
Tobacco use
Alcohol use
What is the leading cause of cancer related death?
Lung cancer followed by colorectal cancer
What is the leading cancer diagnosis?
Breast cancer, followed by prostate
More people are dying from cancer in Australia since 1994. True or false?
False. Fewer people are dying from cancer in Australia, since 1994.
By 2035, 24m people are expected to be diagnosed with cancer - up from 14m today. Why?
People are living longer
Population growth
Cost of treatment is spiralling out of control.
What are the four main treatments for cancer?
Surgery
Radiation
Chemotherapy
Hormonal treatments
What influences which treatment is used for cancer?
Site of the cancer
Stage; localised or metastasised
Lymph node involvement
Other prognostic factors such as oestrogen receptivity of breast cancer cells
What are some of the side effects of radiation treatment?
Skin changes > blistering, peeling, dryness, itching, Swelling
Fatigue
Mouth problems
Urinary/bladder problems
Diarrhoea
Difficulty swallowing
What are some of the side effects of chemotherapy?
Nausea
Vomiting
Loss of appetite
Loss of hair
Mouth sores/sore gums/sore throat
Diarrhoea/constipation
Low blood cell counts > increased chance of infection > bleeding and bruising after minor trauma > anaemia > shortness of breath
Infertility/female early menopause
What are some of the side effects of hormonal therapy?
Women: Breast cancer
hot flushes/sweats
changes to periods
feeling sick
joint pain
mood changes
fatigue
Men: Prostate cancer
hot flushes
osteoporosis
fatigue
weight gain
decreased muscle mass
increased chance of diabetes/heart attack/stroke
memory loss
What is MDT cancer care?
Gold standard
Multi-disciplinary approach - medical and allied healthcare professionals come together to determine best treatment plan, while taking into consideration the personal preferences of the patient.
What are the stages of the Cancer Care Continuum?
Risk Assessment
Primary Prevention
Detection
Diagnosis
Cancer/Precursor Treatment
Recurrence/Surveillance
End of Life Care
Risk Status
What are some of the reasons that people avoid diagnosis?
Fear of diagnostic procedure e.g. endoscopy/ mammogram/ biopsy
Embarrassment about seeking care
Feeling too young to have cancer
Symptoms not serious enough
Fear of pain from diagnostic procedure
Fear of screening outcome
What are some of the challenges associated with decision making arounD cancer diagnosis?
Anxiety around making the “right” decision
Understanding the available options
Acknowledging patient preferences and values
Acknowledging the role of others e.g. medical care team, spouse, other family members, friends
The gold standard is shared decision making between all
What are decision aids?
Objective and balanced information about options available
Deeper processing of information
Actively process pros and cons
Values-preference activities (self-assist)
Complement counselling from a healthcare provider
Facilitation of shared decision making
Paper/computer based information such as websites
What is the BRECONDA program?
A 3yr study into decision making associated with breast cancer. Outcomes:
More satisfied with information received
Better informed
More easily able to discuss concerns with surgeons/doctors
Less conflicted about the decisions taken
Less regretful about decisions taken
What did an evaluation into different types of group interventions for breast cancer reveal?
3 interventions
- Education only
- Peer discussion only
- Both
Education enhanced self-esteem and body image, sort term reduction of feelings of confusion, increased discussion with social network members
Peer discussion generated no positive effects > some negative effects.
What are some of the side-effects of treatment?
Residual side effects
Fear of recurrence
Lymph-oedema (chronic)
Infertility
Disfigurement
Speech impairment
Need to re-enter previous life or ‘new normal’
Effect on caregivers/family
What are three main findings from the Rolland Family Systems Illness Model?
- Classify illnesses according to their psychosocial demand (onset, course, outcomes of illness)
- Consider illnesses longitudinally, rather than as a snapshot (crisis, chronic, terminal)
- Evaluate the strengths and weaknesses in family functioning in relation to the disease
What does the FOCUS acronym mean?
F: family involvement
O: optimistic attitude
C: coping effectiveness
U: uncertainty reduction
S: symptom management
What are some of the considerations in terminal phases of care?
Accepting cancer
Existential concerns
Palliative care
Keeping well
Planning for end-of-life
Reprioritising
What is demoralisation in the context of end of life care?
Results from existential conflict
Symptoms of hopelessness caused by a loss of purpose/meaning in life
Associated with hastened desire for death
Clinically significant (13-18%)
Inadequately treated depression + anxiety
Reduced social functioning
What are some of the caregiver concerns associated with end of life care?
Physical and emotional exhaustion
Financial burdens of care
Increased psychological distress
Decreased QOL/sense of coherence
Multiple demands
