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Neoplasm
| Question | Answer |
|---|---|
| $ on cancer tx | in 2004, $72.1 billion, just under 5% of US spending for all medical tx |
| Uninsured in 2007 | 54 million, 19% of US pop., very related to ethnicity |
| Top 3 cancer deaths in men | Lung/bronchus-31%, Prostate-10%, Colon/rectum-8% |
| Top 3 cancer deaths in women | Lung/bronchus-26%, Breast-17%, Colon/rectum-9% |
| Cancer's rank in cause of death | #2- 22.8% of all deaths in 2005; heart disease #1-26.6% |
| Top 3 cancer cases in men | Prostate-25%, Lung/bronchus-15%, Colon/rectum-10%; lung cancer is more fatal, therefore fewer cases, but more deaths |
| Top 3 cancer cases in women | Breast-26%, Lung/bronchus-14%, Colon/rectum-10% |
| Lifetime probability of developing cancer | Men- 1 in 2; Women- 1 in 3 |
| Risk factors for all cancers | Things that cause mutation & constant irritation |
| Causes of cancer: lifestyle, alcohol | higher risk for esophagus, gastric, liver cancer, anything it irritates; when combined c smoking, even more harmful |
| Causes of cancer: lifestyle, inactivity | increased % of fat, increased risk for certain cancers (breast); also tied to heart disease; people c less education are more inactive overall |
| Causes of cancer: lifestyle, nutrition | high fat diet is strongly linked to colon cancer; when you metabolize fat, it resembles carcinogens low fiber- fiber increases peristalsis, and moves material more quickly through GI tract high fructose corn syrup is much of our food: corn is higher cal |
| Causes of cancer: environmental, viral infections | Hep B, HIV-capise sarcoma-HIV in young men in CA first alerted us to HIV, Herpes |
| Causes of cancer: environmental, sun exposure | rays are stronger today than yesterday, as we age we burn easier; the lighter your skin, the more intermittent your exposure, increasing risk for melanoma |
| Causes of cancer: environmental, chemical exposure | DES-Di ethyl sterbesteral (sp?), used to be given to prg moms as anti-emetic: female babies had higher risk for reproductive ca's (DES daughters); Hormones; Cytoxan-chemo drug used c MS, lupus; can cause mutations in kids c cancer later in life; Asbest |
| Causes of cancer: other | Radiation; Genetic predisposition: breast, lung (not kind from smoking), leukemia |
| Initiating/Promoting factor theory | Initiators-events that transform cell into a mutant cell & Promotor-promote growth of that cell into a tumor; Both need to be in place |
| Failure of Immune Response theory | immune system isn't doing correct surveillance and doesn't catch the mutated cells |
| Characteristics of normal cells | 1. Cell cycle-have a particular time period in which they divide 2. Differentiation-all start out the same, and then they specialize 3. Contact inhibition-normal cells grow until they bump into something; cancer cells continue to divide & grow-no restri |
| 4 modes of metastasis | 1. primary invasion-eat into adjacent organ 2. lymph- cells drop into lymph & spread 3. blood stream- chunks fall into b.stream and spread 4. Seeding-c abd ca's, chunks fall off and land on a surface & grow |
| General characteristics of benign | slow, localized, encapsulated, differentiated, no recurrence, not harmful |
| General characteristics of malignant | rapid, metastasizes, non-encapsulated, poorly differentiated, recurrence, harmful |
| Early detection: breast | mammogram yearly after 40; monthly BSE starting at puberty, for men too |
| Early detection: prostate | PSA- Prostate Specific Antigen blood test annually after 50; <4 is normal; > or = 11 indicative of cancer |
| Early detection: uterus | annual PAP after 18; cytology exam of dead cells |
| Early detection: colo-rectal | stool for occult blood yearly after 40; flex sigmoidoscopy q 4 years after 50; most colo-rectal cancers visible in bottom several inches of colon; the sig. is the best test to detect c-r ca's |
| Early detection: ca related check-up | every 3 years 20-39; every year after 40; dentist looks for thrush (sx of HIV), pick up 40% of cases |
| Early warning signs: think CAUTION "C" | Change in bowel/bladder habits; r/t prostate-urgency & inability to start indicated enlargement |
| Early warning signs: "A" | A sore that does not heal- especially in mouth |
| Early warning signs: "U" | Unusual bleeding or discharge; cervical-bleeding, breast-nipple discharge (hard to detect in women who are nursing) |
| Early warning signs: "T" | Thickening or lump in breast or testes |
| Early warning signs: "I" | Indigestion or difficulty swallowing; esophageal-very lethal b/c hard to detect, very insidious |
| Early warning signs: "O" | Obvious change in mole or wart (ABCDE) asymmetry, border irregularity, color change, diameter >6mm, elevated/enlarged |
| Early warning signs: "N" | Nagging cough (lung sx) or hoarseness (laryngeal sx); people who abuse voice (singers) or smokers at increased risk |
| Tests: CXR | chest x-ray; non great for specifics; lung ca, nodes |
| Tests: sigmoidoscopy, bronchoscopy | c brush for biopsy, need to numb throat, may become anxious, listen for stridor |
| Tests: CT, MRI | brain |
| Tests: Radioisotope scans | x-ray test c radioactive iodine; thyroid screening; some ppl allergic-have crash card available c/ epinephrine, antihistamines, & O2 |
| Tests: Bone marrow exam | leukemia, marrow is very sensitive, painful |
| Dx lab: CBC | general test |
| Dx lab: liver function tests | helps determine if primary or metastasized from other areas |
| Dx lab: PSA | Prostate Specific Antigen |
| Dx lab: CEA | Carcino-embryonic Antigen- tumor marker; normally only produced as embryo; the higher the number, the greater the cancer that's detected |
| Dx lab: AFP | Alpha Fetal Protein- made in all fetuses, tumor marker in nonfetuses; higher it is, the more cancer |
| Surgical diagnostic procedures | 1. exploratory surgery 2. biopsy- to determine if benign or malignant; this is the only definite means; needle, incisional, excisional, endoscopic- CT guided biopsy |
| Classification of Cancer: 1st | 1st prefix is organ of primary site ("osteo"- sarcoma) |
| Classification of Cancer: 2nd | -Carcinoma-origin is epithelial tissue (breast, uterus, GI, skin) -Sarcoma-origin is connective tissue (bone, cartilage, muscle, fat) |
| Classification of Cancer: 3rd | leukemia, lymphoma, myeloma-arise from hemapoietic tissue (blood type); suffix "oma" means tumor |
| Grading of Cancer | Indicator of appearance of cells and degree of differentiation: I-most normal, II, III, IV, V-completely anaplastic, undifferentiated |
| Cancer Staging: T | Tumor size: 0=no evidence; 4=large; how big and how far it's spread |
| Cancer Staging: N | local nodes: 0=no nodes involved; 4=nodes on both sides of diaphragm |
| Cancer Staging: M | metastases: 0=no evidence; 4=involvement of organs all over body |
| Systemic responses to cancer | 1. pressure/pain-from tumor size 2. altered taste-'metallic', aversion to sweets 3. metabolic changes (edema)-lack of bl. proteins, can hide wt loss 4. paraneoplastic syndromes (hypercalcemia)-occurs c cancer; CNS depression 5. pathological fractures |
| Cancer tx: surgery | 1. staging 2. resection-taking out tumor 3. palliation-sx control, not a cure, but provides quality of life 4. prophylaxis-preventative 5. vascular access-for chemo or drawing blood |
| Vascular access: Hickman catheter | immediately diluted, increased risk for infection/sepsis; need sterile care |
| Vascular access: Port-a-cath | pillow under skin; less risk for infection, but need to poke everytime |
| Vascular access: PICC line | peripherally inserted central catheter: all the way to the heart |
Created by:
rlvander
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