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M6 13-005

Exam 17: Cancer of the Body System

The areas that are most susceptible to developing malignant lesions are where? The lips, oral cavity, tongue, pharynx.
Salivary gland tumors in the parotid gland are usually benign
Subm-axillary gland tumors are mor prone to be Malignant and rapid growing. Usually are painful and impair facial function.
Cancer Cell Characterizatrion Changes in the structure or appearance of anaplatic cells that form a colony of abnormal and dysfunctional calls that invade surrounding tissue.
Epithelioma Cancer associated with the lip.
60% of patients diagnosed with this disorder, cancer has already spread to the neck. Epithelioma
Carcinoma of the oral cavity is more prevalent in whom? Heavy drinkers, smokers and those with prolonged exposure to wind and sun.
Leukoplakia White, firmly attached patch on the mouth and tongue mucosa.
Clinical manifestation of carcinoma of the oral cavity (Lesions) The lips and buccal mucosa develop Lekoplakia.
Carcinoma of the Oral Cavity: Signs and symptoms Lesion, lump, leukoplakia in mouth or on lip longer than 2 weeks. Pain, soreness, bleeding from lesion. Numbness, dysphagia, and loss of feeling.
Early stages of malignant lesions of the mouth is characteristically what? Asymptomatic.
An important diagnostic test for examination of soft tissue is an Indirect laryngoscopy
To rule out the presence of cancer of the mandibular structure, what is performed? Radiographic evaluation is performed of the head and neck.
The most accurate method for a definitive diagnosis is what? An excisional Biopsy
Cytological examination includes The scraping of the lesion as a means of screening intraoral lesions.
Early detection of cancer of the oral cavity results in good prognosis
Stage I Malignant Tumor Treatment Surgery or radiation
Stage II & III Tumor Treatment Surgery AND Radiation
Stage IV Tumor Treatment Treatment is usually palliative.
Small tumors in the mouth can result in surgical removal of what? Tongue to removal of the entire larynx or the portion above the true vocal cords.
For patients with advanced disease, treatment is usually what? Palliative
What is used to relieve pain and decrease the size of the tumor? Radiation or chemotherapy
Carcinoma of the esophagus (Malignant epithelial neoplasm) Usually a tumor with the presence of squamous cell carcinoma or adenocarcinoma that invades the esophagus.
Esophageal cancer occurs more commonly in men
90% of esophageal cancer is squamous cell carcinomas often associated with alcohol abuse & cigarette smoking
other noted causes of esophageal cancer are Chronic irritation, environmental carcinogens, mucosal damage, and nutritional deficiencies.
Esophageal cancer is more prevalent in what age groups in men? 55-70 years old.
Carcinoma of the bronchus, stomach or breast may metastasize to where? The esophagus.
Clinical manifestations of esophageal cancer difficulty swallowing (dysphagia), sensation of food sticking to throat, leading to weight loss.
Diagnostic tests for esophageal cancer Barium swallow with fluoroscopy and endoscopy.
Whats used for the final diagnosis for a high degree of accuracy of esophageal cancer? A biopsy and cytological procedure.
whats considered a palliative treatment for advanced cancer of the esophagus? Chemotherapy
Esophageal dilation is performed to enlarge the area obstructed by the tumor
What is inserted at the site of the tumor to widen the area narrowed by tumor growth? Prosthesis (stent placement)
What therapy is used to destroy some of the tumor? Endoscopic laser therapy.
When located here, the esophagus after resection can be reattached to the stomach. The lower third of the esophagus.
A tumor located here, the esophagus is resected and the esophagus is replaced with a section of jejunum or colon. The upper two thirds of the esophagus.
Types of Surgery for Esophageal cancer Esophagogastrectomy. Esophagogastrostomy. Gastrostomy. Esophagoenterostomy.
Immediate notify physician if what symptoms worsen with treatment? Continuous weight loss, difficulty swallowing soft foods, and any other new problems.
What appears to be contributing factors of stomach cancer? Heredity and chronic inflammation.
What type of cancer is more prevalent in persons between 50 and 70 years old? Gastric Cancer
What groups (racial) have a higher incidence of stomach cancer? Japanese, African-Americans and Latinos.
Why is achlorhydria linked to stomach cancer? Achlorhydria is the absence of free hydrochloric acid in the stomach which may promote bacterial growth.
Clinical manifestations of stomach cancer may include feeling of fullness, anorexia, weight loss and anemia.
Stomach cancer often spreads to where? Lymph nodes, metastasizes to the spleen, liver, pancreas or colon.
What is a late symptom of stomach cancer? pain
Subjective data of a patient with stomach cancer may include... Complaints of vague epigastric discomfort or indigestion. Postprandial (after meal) fullness. Anorexia and weakness.
Objective data of a patient with stomach cancer may include... Weight loss. Bleeding in stools. Hematemesis. Vomiting after taking any intake of food or fluids. Anemia.
Diagnostic tests for stomach cancer Radiographic studies (barium swallow). Endoscopic/gastroscopic examination with biopsy. Stool occult blood tests. Lab studies to include carcinoembryonic antigens (CEA) levels, CBC, and serem B12 levels.
what is the only curative approach/therapeutic management of stomach cancer is what? A subtotal or total gastrectomy.
Problems that can occur during wound healing (post-stomach cancer surgery) may be... Disrupted by dehiscence (partial or complete separation of wound edges). Evisceration (viscera protrude through the disrupted wound).
patients with this, have a higher percentage of (eventhough rare)cancer of the liver. Pre-existing cirrhosis.
Some cases of cancer of the liver are associated with Chronic Hepatitis B or C.
Who has a higher incidence of liver cancer? Men
With cancer of the liver, why is metastatic lung cancer more common? The liver has a high rate of blood flow and extensive capillary network; therefore, cancer cells from other parts of the body are often transported to the liver (often metastasize to the lung).
Malignant cells causes what happen (physically) to the liver? The liver becomes enlarged and misshaped.
Why is cancer of the liver hard to diagnose? Its chard to differentiate from cirrhosis.
S&S of Cancer of the liver Hepatomegaly, ascites, portal hypertension. Weight loss, peripheral edema. Dull abdominal pain in the epigastric or right upper quadrant. Jaundice. Anorexia, nausea, vomiting. Extreme weakness. Frequent pulmonary emboli. Positive AFP.
Treatment for cancer of the liver is... Palliative
What is sometime performed when tumor is localized? Lobectomy
Only what percentage of patients have surgically resectable disease 30-40%
Medical management for cancer of the liver is similar to treatment for cirrhosis
Cancer progresses rapidly and death may occur in 4 to 7 months due to what? hepatic encephalopathy or massive GI bleeding.
Cancer of the gallbladder often occur more often in women
Cancer of the gallbladder is symptomatically similar to cholecystitis
Diagnosis of cancer of the gallbladder is difficult to detect early.
Treatment of cancer of the gallbladder... surgery might be tried, but because the liver is often invaded as well, prognosis is usually poor.
Pancreatic cancer is the __ leading cause of cancer death in mean, and __ in women. 4th and 6th.
Why is there a high death rate attribution with pancreatic cancer? The difficulty in diagnosing the cancer at a curable stage.
Pancreatic cancer is of found in and linked to what? Cigarette smokers, chemical carcinogens, pts with DM, high meat and fat diet, and coffee consumption.
Pancreatic cancer may be or may metastasize from what? Lung, stomach, duodenum or common bile duct.
After diagnosis, many patients live only 4-8 months.
Assessment in pancreatic cancer includes: Vague symptoms. Pain present in 85% of cases. Anorexia, nausea, flatulence, change in stools. Fatigue. Pain in the epigastrium or referred to the back; usually worse at night. Weight loss. Jaundice, pruritis. Recent onset of DM.
What procedure is often performed with pancreatic cancer? Whipple procedure.
Whipple procedure involves what? Pancreatoduodenectomy. Resection of the antrum of the stomach, duodenum and varying sections of the pancreatic ducts & the jejunum.
Why is a subtotal pancreatectomy not recommended? due to complications of postoperative pancreatic fistulas.
What produce a better response than single agents in pancreatic cancer? Combinations of drugs (5-FU and BCNU [carmustine)
What is a new chemotherapeutic agent for patients with metastatic adenocarcinoma that has previously been treated with 5-FU. Gemzar
What is believe by some to be the most effective treatment of the almost always fatal pancreatic cancer? Adjuvant therapy (surgical resection, radiation and chemotherapy)
Highest incidence of colon cancer in patients of what age? 60
Predisposing factors of colon cancer include Dz: Ulcerative Colitis & Diverticulosis ↑ risk. Polyps may malignantly change & become carcinomas. Lack of bulk in diet. High fat intake. High bacterial counts in colon.
Clinical manifestations of Colon cancer Early stages may be asymptomatic. S&S vary with location of cancerous growth.
Subjective data with colon cancer Changes in bowel habits, excessive flatus, cramps and rectal bleeding. Later stages of colon cancer, Pt complain of ABD pain, nausea & cachexia (weakness and emaciation associated with general ill health and malnutrition).
Objective data with colon cancer Vomiting, weight loss, ABD distension or ascites. Most common clinical manifestations are chronic blood loss and anemia.
Diagnostic tests for colon cancer. DRE cna identify 15% of colorectal cancers. Proctosigmoidoscopy with biopsy. Colonoscopy. Endorectal Ultrasonography. CT scan of ABD. Upper GI series, radiological ABD series and barium enema visualization or sigmoidoscopy. H&H. CBC.
What is significant of a blood test for carcinoembryonic antigen (CEA)? CEA is a glycoprotein found in malignant and non-malignant growths. Antibodies to this antigen are measured. Because the CEA level can be elevated in benign and malignant diseases, it is not considered a specific test for colorectal cancer.
Medical management of colorectal cancer includes Radiation, chemotherapy and surgery.
With colorectal cancer radiation therapy is often used prior to surgery... why and for how long? To reduce the size of the tumor and decrease the rate of lymphatic involvement. Administered over a 4 to 6 week period.
With colorectal cancer, chemotherapy is given to whom? Pts w/ systemic disease that is incurable by Sx and radiation alone. Pts which undetected metastasis is detected. Palliative therapy to reduce the tumor size or relieve symptoms of the disease.
What does surgery depend on in colorectal cancer? location of the tumor, presence of obstruction or perforation of the bowel, possible metastasis and the patient's health.
If there is no obstruction, a portion of the bowel on either side, what happens? the tumor is removed and an end-to-end anastomosis is done between the divided ends.
When obstruction of the bowel is present, what are the commonly used procedures? one stage resections with anastomosis or a two stage resection bringing the ends of the bowel to the surface of the abdomen for closure later.
Right Hemicolectomy: Resection of ascending colon and hepatic flexure. The ileum is anastomosed to the transverse colon.
Left Hemicolectomy: Resection of splenic flexure, descending colon and sigmoid colon. The transverse colon is anastomosed to the rectum.
Anterior Rectosigmoid Resection: Resection of part of the descending colon, the sigmoid colon, and the upper rectum. The descending colon is anastomosed to the remaining rectum.
In carcinoma of the rectum, every effort is made to preserve what? The sphincter
Complications that can occur with colorectal cancer surgery are what? delayed wound healing, hemorrhage, persistent perineal sinus tracts, infections, urinary tract and sexual dysfunction.
Colon cancer medications: Antacids. Cimetidine (Tagamet). Lomitol. Kaopectate. Immodium. Rantidine (Zantac). Pepcid. Prilosec.
Antacids: Precaution Do not give within 2 hours of other medications.
Cimetidine (Tagament): action Inhibits gastric acid.
Lomitol: Classification Antidiarrheal
Immodium: classification Antidiarrheal
Kaopectate: Classification Antidiarrheal
Ranitidine: action Inhibits gastric acid
Pepcid: Action Inhibits gastric acid
Prilosec: Action TOTALLY inhibits gastric acid
Metamucil (Psyllium): Use chronic atonic or spastic constipation with rectal disorders and anorectal surgery.
Skin tumor etiology an alteration in the genetic structure of the cell (the DNA). This can be associated with exposure to a carcinogen
Risk factors for skin cancer Hereditary. Radiation exposure. Chemicals (Alcohol & tobacco). Irritants. Diet. Hormones. Immune factors.
The most conclusive evidence of cancerous growth is a... Biopsy
Benign tumors: Types Keloid. Angioma. Verruca (wart). Nevus (Mole).
Malignant tumors: Types Basal Cell Carcinoma. Squamous cell carcinoma. Malignant melanoma.
ABCD's of Melanoma A-Asymmetry. B-Border is irregular. C-Color is varied from one area to another. D-Diameter is generally larger than 6mm.
Skin cancer preventions Avoid sun exposure, Wear hats and clothing to cover skin. Use sunscreen.
Tumors of the bone may be primary or secondary, benign or malignant.
Metastasis from ___, ____, _____,____ and ____ may be one cause of bone cancer. Lung, breast, prostate, thyroid and kidney.
Types of bone cancer Osteogenic Sarcoma. Osteochondroma.
Osteogenic Sarcoma are primarily malignant bone tumor seen in Young people.
Osteogenic Sarcoma can metastasize throughout the body via the blood stream.
Osteogenic Sarcoma is a fast growing that affects what? the long bones, particularly the distal femur, proximal tibia, and proximal humerus.
Osteogenic Sarcoma affects more of which sex? Males
Osteogenic Sarcoma is seen primarily between what ages? 10 and 25
Osteogenic Sarcoma metastasize and invade other bones and what else? Lung tissue.
Osteochondroma is what type of tumor? Benign.
Osteochondroma usually affect which bones? humerus, tibia, and femur
With bone cancer, why do spontaneous fracture occur? as the healthy cells are replaced by cancer cells, there is a decrease in the strength of the bone.
With bone cancer, why does anemia occur? due to the invasion of the cancer into the long bone and the disruption of the manufacturing of the red blood cells in the bone marrow.
Subjective data with bone cancer Pain in the affected bone site. Pain especially with weight bearing. Tenderness at the affected side.
Objective data with bone cancer Assessment of the affected part that may reveal edema and discoloration of the skin.
Diagnostic tests for bone cancer Radiographic studies. Bone scan. Bone biopsy. CBC, platelets (bone marrow involvement). Serum protein levels (elevated in multiple myeloma). Serum alkaline phosphatase (elevation may indicate osteogenic sarcoma).
Types of surgery for bone cancer. Wide excision or resection. Bone curettage. Leg or arm amputation.
Treatment for bone cancer is aimed at Removing the malignant lesion
Alopecia the loss of hair from aging, drugs, or disease processes.
Hypertrichosis (Hirsutism) the excessive growth of hair. It can be hereditary or the result of hormone dysfunction and medications.
Hypotrichosis the absence of hair or a decrease in hair growth. Causes include skin disease, endocrine disorders and malnutrition.
Paronychia disorder where the nails get soft or brittle.
Created by: jtzuetrong



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