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Med-Surg II (ch. 24)
Cancer Interventions
| Question | Answer |
|---|---|
| Spreading of cancer cells to other tissues and organs | Metastasizing |
| 2 problems caused when cancer invades bone marrow | anemia and thrombocytopenia |
| Extreme body wasting and malnutrition | Cachexia |
| Common diet prescribed to cancer patients | high protein and carb diet |
| Motor and sensory deficits caused by bone metastases | Pain, fractures, spinal cord compression, and hypercalcemia |
| Major cause of cancer death r/t brain metastasis and primary tumors | Destruction of health brain tissue |
| Result of tumors pressing on blood and lymph vessels in chest, blocking blood flow through chest and lungs | Pulmonary edema and dyspnea |
| Result of tumors thickening alveolar membrane and changing pulmonary blood vessels | Gas exchange reduction |
| Result of lung cancer or spread of cancer to lungs | hypoxia and poor tissue oxygenation |
| The oldest form of cancer treatment and the first method to cure cancer | Surgery |
| The removal of "at-risk" tissue to prevent cancer development | Prophylactic surgery |
| The removal of all or part of a suspected lesion for examination and testing | Diagnostic surgery |
| Provides proof of presence of cancer | Biopsy (diagnostic surgery) |
| Focused on removal of all cancer tissue | Curative surgery |
| Removing part of tumor and leaving a known amount of gross tumor | Cancer control/cytoreduction surgery |
| Decreases the number of cancer cells and increases changes that other therapies can be successful | "debulking" or cytoreduction surgery |
| Focused on improving quality of life during survival time and is not focused on cure | Palliative surgery |
| A "rediagnosis" after treatment; prupose is to assess disease status in pts who have been treated and have no symptoms of remaining tumor | Second-look surgery |
| Increases function, enhances appearance, or both in current or surviving cancer pts | Reconstructive or rehabilitative surgery |
| "local" cancer treatment | radiation therapy |
| 2 types of radiation used for cancer treatment | ionizing and isotopic radiation |
| a different form of a specific element that has a slightly different atomic weight and umber of neutrons | Isotopes |
| Example of ionizing radiation | Radium |
| Example of isotopic radiation | Cobalt |
| Radiation that is generated by machines | X-rays |
| Used most commonly for radiation therapy because of their ability to deeply penetrate tissues; high energy photons | Gamma rays |
| Have much less ability to penetrate tissues and must be placed within or very close to cancer cells to be effective as cancer therapy | Beta particles |
| High energy particles that are not used as part of radiation therapy for cancer | Alpha particles |
| The amount of radiation delivered to a tissue | Exposure |
| Amount of radiation absorbed by the tissue | Radiation dose |
| Intensity of the radiation decreases with the distance from the radiation source | Inverse Square law |
| Radiation absorbed dose | Rad |
| Distant radiation treatment; external to pt | Teletherapy |
| Short or close radiation treatment; comes into direct, continuous contact with the tumor tissues for a specific period of time | Brachytherapy |
| An iodine base with a half-life of 8.05 days | Radionuclide iodine 131 |
| Implants delivering radiation continuously while patients are hospitalized for several days | Low-dose rates (LDR) |
| Implant radiation in which pt comes into department several times a week, and a stronger radiation device is placed for only an hour or so each time | High-dose rate (HDR) |
| Dry mouth | xerostomia |
| 3 factors that determine absorbed radiation dose | 1) intensity of exposure, 2) duration of exposure, 3) closeness of radiation source to cell |
| ____ or radiation is always less than the ______ | dose; exposure |
| The 2 types of radiation delivery methods | Teletherapy and Brachytherapy |
| Ductless glands | Endocrine glands |
| Class of drugs that inhibit production of specific hormones in normal hormone-producing organs | hormone inhibitors |
| Hormone inhibitor that prevents production of estrogen in adrenal gland and reduces blood levels of estrogen | Anastrozole (Armidex) |
| Breast development in men | Gynecomastia |
| The selective destruction of cancer cells through chemical reaction triggered by different types of laser light | Photodynamic therapy (PDT) |
| Agents used to sensitize cells to photodynamic therapy light; enter all cells, but leave normal cells more rapidly | verteporfin and porfimer sodium |
| 2 classes of drugs that increases photosensitivity | antibiotics and antihypertensive drugs |
| Complications of cancer that require immediate intervention | Oncologic emergencies |
| A condition in which organisms enter the bloodstream | Sepsis or Septicemia |
| A life-threatening result of sepsis and a common cause of death in patients with cancer | Septic Shock |
| A problem with the blood-clotting process triggered by many severe illnesses | Disseminated Intravascular Coagulation (DIC) |
| 3 classes of drugs given when sepsis is present with DIC | IV antibiotic therapy, anticoagulants, and cryoprecipitating clotting factors |
| Drugs often used in pts with cancer that can cause SIADH | morphine sulfate and cyclophophamide |
| The antibiotic drug most often used to treat SIADH in cancer pts | demeclocycline |
| Includes preventing fluid overload from SIADH from becoming worse, leading to pulmonary edema and heart failure | patient safety |
| Occur either when a tumor directly enters the spinal cord or when the vertebrae collapse from tumor degradation of the bone | Spinal cord compression (SCC) |
| Palliative treatment course of SCC | high-dose corticosteroids, high-dose radiation, chemotherapy, and or surgery |
| Occurs most often in patients with bone metastasis; worsened by decreased mobility and dehydration | Hypercalcemia |
| Occurs when superior vena cava is compressed or obstructed by tumor growth or by formation of clots in vessel | Superior vena cava syndrome (SVC) |
| Shows stricture or an occlusion blocking blood flow | venogram |
| Edema of the face and tightness oft eh shirt or blouse collar that occurs with SVC syndrome | Stokes' sign |
| A syndrome in which large numbers of tumor cells are destroyed rapidly | Tumor Lysis syndrome (TLS) |
| Modify the pt's biologic response to tumor cells | Biological response modifiers (BRMs) |
| Small protein hormones made by WBCs that generally make the immune system work better; type of BRM | Cytokines |
| Cytokines made by macrophages, neutrophils, eosinophils, and monocytes | monokines |
| Cytokines produced by lymphocytes, especially T-lymphocytes | lymphokines |
| Stimulate faster recovery of bone marrow function after treatment-induced suppression | Colony-stimulating factors |
| The selective destruction of cancer cells through the chemical rx triggered by different types of laser light | Photodynamic Therapy (PDT) |
| 2 agents most commonly used for PDT | verteporfin and porfimer sodium |
| Length of time the pt undergoing PDT is sensitive to light | 12 weeks after photosensitizing drug is injected |
| Length of time skin and eyes will remain sensitive in pt's undergoing PDT | 30 days |
| Length of time a pt undergoing PDT must remain homebound | 1-3 months |
| 2 drug categories that have photosensitizing properties | antibiotics and antihypertensives |
| 2 common types of BRMs used as cancer therapy | ILs and INFs |
| Group of 27 known substances the body makes to help regulate inflammation and immune protection; helps different immune system cells recognize and destroy non-self cells | Interleukins (ILs) |
| Cell-produced proteins that can protect non-infected cells from viral infection and replication | Interferons (INFs) |
| A BRM that reduces the level of TAF | thalidomide (Thalomid) |
| BRMs used for supportive therapy during cancer treatment; induce more rapid recovery of bone marrow after suppression by chemotherapy | colony-stimulating factors |
| The insertion, alteration, or removal of genes within an individual's cells and biological tissue to treat disease | Gene Therapy |
| A gene product of the major histocompatibility complex that have been shown to make the immune system cells better able to recognize cancer cells as foreign and take steps to eliminate or destroy them | Human leukocytes antigen (HLA) |
| Therapy that combines aspects of gene therapy and immunotherapy; often antibodies that work to disrupt cancer cell division in one of several ways | Targeted Therapies |
| 2 types of target therapies that "target" and block growth factor receptors | EGFRs and VEGFRs |
| Target therapy that binds excessive amounts of a certain type of EGFR produced by breast cancer cells in response to the activation of the HER2/neu gene | trastuzumab (Herceptin) |
| Monoclonal antibody target therapy that effects some types of lymphoma | rituximab (Rituxan) |
| Targeted therapy that binds to energy site of the enzyme tyrosine kinase and prevents its activation | imatinib mesylate (Gleevec) |
| Closely resemble normal metabolites and are "counterfeit" metabolites that fool cancer cells into using this in cellular rxs; presence impairs cell division | Antimetabolites |
| Damage cell's DNA and interrupt DNA or RN synthesis | Antitumor antibiotics |
| Interfere with information of microtubules so cells cannot complete mitosis during cell division; cancer cell either does not divide at all or divides only once, resulting in 2 daughter cells that cannot continue to divide | Antimitotic agents |
| Cross-link DNA, making the 2 DNA strands bind tightly together, preventing proper DNA and RNA synthesis and inhibiting cell division | Alkalating agents |
| Disrupt an enzyme needed for DNA synthesis and cell divison; nicks & straightens DNA helix, allowing DNA to be copied, and then reattaches DNA together. Prevent proper DNA maintenance, causing DNA breakage and cell death | Topoisomerase Inhibitors |
| Giving more than one specific anticancer drug in a timed manner | Combination Chemotherapy |
| The time when bone marrow activity and WBC counts are at their lowest levels after chemotherapy | Nadir |
| The treatment of cancer with chemical agents | Chemotherapy |
| Chemotherapy used along with surgery or radiation | Adjuvant therapy |
| Cell-damaging effects | Cytotoxic |
| A new approach to chemotherapy in which the pt's genetic profile is checked to determine the likelihood of experiencing dangerous side effects | Pharmacogenomics |
| Giving higher doses of chemotherapy more often; used for aggressive cancer treatment | Dose-dense chemotherapy |
| The movement of the IV needle so the drug leaks into the surrounding tissues | Extravasation or Infiltration |
| Chemicals that damage tissue on direct contact | Vesicants |
| Drugs that protect normal tissue | Cytoprotectants |
| Decreased number of RBCs and Hg | Anemia |
| Decreased numbers of WBCs leading to immunosuppression | Neutropenia |
| Decreased numbers of platelets | Thrombocytopenia |
| Hair loss | Alopecia |
| Open sores on mucous membranes | Mycositis |
| A group of distressing side effects caused by chemotherapy agents | Symptom distress |
| Vomiting inducing | Emetogenic |
| Mucositis of the mouth | Stomatitis |
| Chemotherapy induced general biochemistry changes that could reduce cognitive function temporarily | Chemobrain |
| The loss of sensory or motor function of peripheral nerves | Peripheral Neuropathy (PN) |
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118501829
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