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M6 13-005
Exam 17: Cancer of the Body System
| Term | Definition |
|---|---|
| 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. |
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jtzuetrong
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