Cancer Unit from Ms. A's Powerpoint
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| Cancer | A group of diseases characterized by uncontrolled growth and the spread of abnormal cells.
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| Cancer cells are______? | Clones
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| Cancer cells come from one _______________? | particular cell
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| Oncogenes | rapidly multiplying cancer genes, that are mutated forms of genes and cause normal cells to go out of control.
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| Tumor Supressor Genes | normal genes that slow down Cancer and repair DNA mistakes.
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| Carcinogenesis | the process by which normal cells are transformed into cancer cells.
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| Carcinogenesis is a ____________ ________ type of cell growth. | non-regulated
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| What are the 3 stages of cancer progression? | initation, promotion, and progression
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| Iniation stage of cancer progression: | DNA damage and development of a permanent gene mutation have occured.
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| Promotion stage of cancer progression: | subsequent exposure to one or more promoting agents after a cell has undergone initation.
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| Progression stage of cancer progression: | involves neutrogenic and non neutrogenic effects.
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| cell mechanism and growth of benign cancer cells: | localized, slow and steady growth, encapsulated and smooth, rarely occurs after removal.
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| malignant cancer cell mechanism and growth | spreads like fire, variable rapid growth, rarely enclosed in a capsule, may re-occur after removal
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| do not give an im or sub q injection to people with _____________-. | neutropenia
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| leukopenia | reduction in total wbc
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| stomatitis | inflammation of the oral mucosa.
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| thrush | white patches in the throat and mouth.
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| thrombocytopenia | a decrease in the number of circulating platelets due to depression of the bone marrow.
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| the life span of platelets is: | 10 days
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| benign cancer | does not infiltrate surrounding tissue and is rarely fatal.
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| malignant cancer | usually involves more than one site and is fatal without treatment.
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| 7 warning signs of cancer: C-A-N-C-E-R | change in bowel or bladder, a sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast, indigestion/ difficulty swallowing, obivous change in wart or mole, nagging cough or hoarseness.
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| warning signs of ovarian cancer | fatigue, heart burn, abdominal bloating, constipation, weight loss
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| tumor | swelling or enlargement
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| metastasis | direct spread of tumor cells by circulation (blood or lymph), transplantation, or viruses.
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| carcinoma | a malignant tumor that begins in the skin or tissues.
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| sarcoma | a malignant tumor of the connective tissues like bone or muscles.
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| what types of cancer have the largest number of malignant tumors? | lung, colon or rectal, breast and prostate.
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| what types of cancer have the largest number of malignant tumors? | lung, colon or rectal, breast and prostate.
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| Common Causes Of Lung Cancer Include: | cigarette smoking, asbestos, and air pollution
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| s/s of lung cancer include | cough, hemoptysis, dyspnea, fever and chills. ascultation may reveal wheezing. weight loss, fatigue, and reduced stamina. pain is unlikely unless the tumor is presing on a nerve.
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| hemaptysis | coughing up blood.
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| adenoma | a benign tumor or pollyp with malignant potential.
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| colorectal cancer facts | -slow growing adenocarcinoma.-the average time for adenoma to become carcinoma is 10-20 years.-the exact cause is unknown.
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| signs and symptoms of colon cancer | most people with colon cancer are asymptomatic
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| breast cancer facts | -usually adenocarcinoma.-arises from epithelium and developing in lactiferious ducts.-occurs ofst often in upper outer quadrants of breasts.-can take 7-8 years to detect.-metastasis by the blood or lymph systems.
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| signs and symptoms of breast cancer include: | -changes in skin color-feelings of tenderness, puckering or dimpling of the tissue-do a breast self exam
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| epithelium | the layer of cells forming the epidemis of the skin and the surface layer of the mucous and serous membranes.
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| insidious | of gradual subtle or indistinct onset. a slowly developing disease.
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| PSA | prostate specific antigen.
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| prostate cancer is insidious. treatment includes: | radical prostatectomy, hormonal deprivation therapy
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| diagnostic studies related to prostate cancer include: | biopsy, endoscopy, tomography, CT scan, ultrasound, MRI, radio isotope scans, lab studies, PSA (GOLD STANDARD TUMOR MARKER), and CA-125.
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| What is the gold standard tumor marker for prostate cancer? | PSA
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| Tomography | a radiographic study that selects a level in the body and blurs out structures above and below that plane, leaving a clear image of selected anatomy.
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| sigmoidoscopy | use of a sigmoidoscope to inspect the sigmoid colon
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| ways to detect cancer | breast self exam, testicular self exam, pap smear, stools for occult blood, sigmoidoscopy, colonoscopy, mammography
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| mammography | radiographic imaging of the breast to screen for and detect breast cancer.
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| biotherapy | -the manipulation of the interaction between the immune system and malignant cells.-bone marrow transplant-used to treat lukemia-aspiration of the bone marrow from the hip bone.
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| radiation therapy- types and side effects | -destroys good and bad cells.-side effects include: fatigue, skin irritation (burns) or injury-types of radiation include: external radiation, and internal radiation such as brachytherapy implant for prostate cancer.
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| chemotherapy is cytotoxic and: | a chemical that binds to and specifically kills microbes or tumor cells.
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| cytotoxic | toxic to cells
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| how does chemotherapy work? | by interferring with the cells ability to multiply or reproduce.
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| hematopoietic | a substance that assists in or stimulates the production of blood cells.
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| whidch types of cells are most affected by chemo? | cells that reproduce rapidly are the most affected. meaning hematopoietic, gi system cells, and hair folicles.
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| chemobrain | problems with memory, attention span and concentration that may never go away as a resulting side effect of chemo.
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| side effects of chemo include: | -red urine with Doxorubicin Hcl (24-48 hours)-blue urine with Mitoxantrone (immediate 48 hours)-anorexia, stomatitis, diarrhea, constipation, weitht loss, alopecia, fatigue, anemia, leukopenia, thrombocytopenia, chemobrain, tumor lysis, peripheral neu
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| TLS | Tumor lysis syndrome. A sudden, rapid breakdown of cells in response to therapy.
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| some oncologic emergencies include: | TLS, hypercalcemia, SIADH, pericardial effusion, spinal cord compression, and superior vena cava syndrome.
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| pericardial effusion | fluid in ther pericardical cavity, between the visceral and the parietal pericardium.
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| If cancer returns how do the goals change? | The plan is for pallative care rather than curative care at this point.
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| Alternative Therapy For Cancer: | distraction, massage, biofeedback, guided imagery, reiki, acupuncture, prayer.
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| Cancer Prevention: | Primary Prevention of cancer consists of changes on lifestyles to eliminate or reduce exposure to carcinogens.
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| Tolerance: | Getting used to the dose, use this word instead of addiction.
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| Schedule For Cancer Pain Meds Should be | around the clock.
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| Routes For Cancer Pain Meds Include: | oral, topical, sub-q, IM, SL, IV, and rectal
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| Titration | starting low and going slow.
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| Pain Meds For Cancer: | Morphine, Roxanol MS, Oxycodone, Hydromorphone, NaopraxinFentynalAmitriptylineDexamethasone-Decadron-Steroid/ anti-inflammitoryGabapentin-neurontin-used for peripheral neuropathy, and seizures
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| Side Effects Of Opioids | constipation, n&v, sedation, mental status changes, respiratory depression, overdose.
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| Pain Management Options: | Non-opioid and alt for mild pain:( ibuprophrin + heat)Opioid & Non-Opioid & Alt for Mild to Moderate pain: percocet or tylenol #3 with musicOpioid & alternate for moderate to severe pain: morphine and hydormorphone and massage.
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| Pain Management ABCDE | ask/assess, believe patient, choose pain control options with patient, deliver meds in a timely fashion, empower patient to control management of disease and pain.
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| Cancer Pain | Is usually a late symptom of cancer and indicaites tumor obstruction, nerve pressure, invasion of bone, phantom sensation, peripheral neuropathy, and neuralgia.
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| antiemetic | preventing or relieving nausea or vomiting
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| compazine | used for nausea and vomiting, may cause orthostatic hypotension and occular changes.
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| kytril | for nausea and vomiting. given q day in a 5 min infusion (IV).
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| zofran | given for nausea and vomiting, give 30 min via IV before chemo
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| lomotil | antidiarrheal. side effects include dizziness, dry mouth, urinary rentention, and rash.
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| diphenhydramine/ Benadryl | may be used as a antimetic, or sleep aid. Dont use it in the elderly
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| reglan | antiemetic: helps GI motility. don't use if the patient is constipaited becasue it can get worse.
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| lorazepam | antianxiety agent, decreases nausea
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| Cancer pain | 5th vital signindicaites tumor obstruction, nerve pressure, invasion of bone, and phantom sensation
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| superior vena cava syndrome (SVCS) | Is gross edema through out the neck and upper body. It occurs when venous flow through the SVC is obstructed impaing venous circulation or drainage from the head and arms.
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| What is the most common cause of SVCS? | Lung Cancer because of the proximity of the heart to the lungs.
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| S/S of SVCS | dyspnea, non productive cough, hoarsness, dysphagia, facial swelling, edema of head, neck, arms or hands possibly accompanied by discoloration of the upper extremeties. Increased ICP with assoc. visual disturbances, and altered LOC.
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| Treatment Of SVCS | radiation, chemo and steriods
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| Tumor Lysis Syndrome | A rapid breakdown as a consequence of chemotherapy that can be life threatening
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| s/s of tumor lysis syndrome | irregular heart beat, kidney failure, SOB, hyperkalemia, High Uric Acid, hypocalcemia, diarrhea, lethargy, muscle cramps, nausea and vomiting, and weakness.
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| Treatment of TLS | admin IV fluids to increase urine volume and restore electrolyte balance.Admin Na+ Bicarb to IV fluids to alkalize urineAllopurinol to inhibit uric acidif no response to tx, pt may need hemodialysis
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| What happens in Tumor Lysis Syndrome (TLS) | The kidneys can't keep up with the large number of toxins that need to be excreted in the body and cell death occurs.
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| How does Allopurinol help in the treatment of TLS? | it inhibits uric acid production and helps to alkalize urine.
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| In the treatment of TLS you want to maintain a urinary output of at least ___________ ML per hour. | 100
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| Hypercalcemia related to Cancer | is the most common oncologic emergency.Too much calcium is released from the bones and increases the serum calcium level.
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| s/s of hypercalcemia | s/s include: n&v, constipation, increased urine output, excessive thirst, weakness, lethargy, or fatigue, kidney stones, bone pain, confusion, altered LOC, dehydration.
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| tx of hypercalcemia, | decrease serum calcium level, admin NACL, diauresis with furosemide, and admin bisphospate to inhibit bone resorbption.
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| Spinal Cord Compression | is an oncologic emergency that occurs when a growing tumor presses on the spinal cord. It is the most common in the thoracic area of the spinal cord.
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| Hallmark sign of spinal cord compression; | New onset of back pain that worsens with movement, laying down or coughing and follows a nerve.
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| s/s of spinal cord compression (scc) | local inflammation, edema, venous stasis, motor weakness, and loss of bowel or bladder function.
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| treatment of spinal cord compression (scc) | iv dexamethasone and radiation therapy
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