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Oncology
Week 10
| Term | Definition |
|---|---|
| Patho of cancer | Exposure to carcinogens (gene mutation), mutated cells with uncontrolled proliferation. Lack contact inhibition, resist apoptosis causing dysplasia (abnormal cell growth) |
| Metastasis | Tumors grow locally, then spread and indave through direct cell to cell transfer, lymphatic spread, bloodstream spread. Primary tumor: where cancer originates. Secondary: same cancer type spreads to other area |
| Solid tumor malignancies | arise from specific body organs, carcinoma, squamous cell carcinoma, sarcoma, melanoma, gliomas, meningiomas |
| Constitutional cancer symptoms | systemic and nonspecific; fatigue, unexplained weight loss, fever of unknown origin, night sweats |
| Labs for cancer dx | CBC, LFTs, tumor marker assays, cytogenic studies, genetic tests, imaging (CT, PET, MRI, US, xray, angiography). |
| Cancer treatment modalities | Primary is tumor removal through surgery, chemotherapy, radiation or a combo. May be given first before surgery for large tumors |
| Cancer surgical complications | Bleeding, infection, pain, deconditioning, weight loss/malnutrition, altered skin integrity, variable organ function |
| Radiation | External (solid tumors, destroys DNA, divided doses 5xweek. Pt not radioactive) .Radiopharm/systemic (radioactive substances through IV, pt radioactive for 3-4 days), Ablation (laser like beams). Internal/brachy (infused seeds, radioactive pt) |
| Radiation complications | Early: inflammation, irritation, altered mucosal integrity. Progressive: injury to internal structures, fatigue. Late: fibrosis (lysis of abd adhesions), strictures (dilation) |
| Radiation precautions | don PPE, handle radioactive waste carefully, maintain distance from pt (3-6 ft), keep contact as low as reasonably achievable, avoid spills/contamination |
| Chemotherapy patho | destroys all rapidly dividing cells, can cause systemic side effects to hair, skin, GI lining, bone marrow. |
| Side effects of chemo | alopecia, neutropenia, thrombocytopenia, anemia, peripheral neuropathy, cognitive impairment, bowel alteration, malnutrition, xerostomia |
| Bowel obstruction emergency | ab pain/distention, N/V, constipation, intermittent diarrhea. Treat with surgery, NPO, parenteral nutrition; detailed GI assessment/monitor progression |
| Leukostasis | excessive immature WBCs causing blurred vision, CVA, dyspnea, poor perfusion and oliguria. Treat with emergent chemo, leukapheresis. Monitor WBC, assess thrombosis s/s and bleeding |
| Malignant pericardial effusion | chest pain, SOB. Treat with pericardiocentesis. Assess VS/HF s/s, give fluids and prepare pt for treatment. |
| Pleural effusion | dyspnea, diminished breath sounds, hypoxemia. Treat thoracentesis with assessment of hypoxemia and progression. |
| Spinal cord compression | pain, neuro deficits. Treat with corticosteroids, radiation and surgery. Frequent neuro checks, assess pain and incontinence |
| Superior vena cava syndrome | Have dyspnea, upper body edema, neuro symptoms. Treat with chemo/radiation, corticosteroids, stent placement. Assess for decreased CO. |
| Tumor lysis syndrome | present with electrolyte imbalance s/s. treat by correcting electrolytes and assess for hypocalcemia, renal dysfunction and EKG changes. Killing cells causes increase in potassium (monitor heart and give calcium gluconate) |
| Lung cancer | non-small cell is most common, small cell is more aggressive. Risk factors include asbestos, coal/soot/tar, pollution, tobacco and wood dust. Diagnose with chest imaging, biopsy, bronchoscopy, sputum cytology. Treat with surgery, chemo, radiation |
| Lung cancer symptoms | early are asymptomatic. New persistent cough, recurrent infections, SOB, dyspnea, hemoptysis, chest discomfort, weight loss, paraneoplastic syndromes. |
| Colorectal cancer | diagnosed through colonoscopy (polyp greater than 1 cm, 3+). Dysplasia is precancerous and most common is adenocarcinoma. Common but highly preventable and curable with early detection. |
| Colorectal cancer risk factors | obese, sedentary, smoking, diet (high fat, red meat, low fruit/veggies), alcohol / beer (rectal), med conditions (IBS, UC, crohns) |
| Colorectal cancer symptoms | early is no symptoms, unexplained weight loss, fatigue, change in bowel habits, blood in stool, abdominal distention/discomfort, anemia |
| Treatment for colorectal cancer | chemo, radiation, surgery, colectomy (removal of part/all of colon), hemicolectomy (half or less of colon), abdominoperineal resection (affected colon/rectum removed. anus is closed, ileostomy is permanent) |
| Gastric cancer | Caused by chronic inflammation and H pylori. Risk factors are diet, gastric conditions, infections, lifestyle, and genetic. Early symptoms are vague with late diagnosis and poor prognosis. |
| Gastric cancer symptoms | indigestion, anorexia, weight loss, epigastric pain, vomiting, palpable abd mass, cachexia, occult bleeding, secondary anemia, massive hematemesis, melana |
| Gastric cancer diagnosis | imaging, endoscopy (EGD/CT/EUS), labs (CBC, liver, CEA tumor marker, stool guaiac). Manage with chemo, radiation, antiemetics, opioids/vitamins |
| Dumping syndrome | LIFE THREATENING. Early (30 min after eating due to rapid emptying of contents into small intestine causing vertigo, increased HR, pallor, diaphoresis). Late (1-3 hrs after eating, causing hypoglycemia, syncope) |
| Thyroid cancer patho | most common endocrine cancer that is slow growing/low death rate with four types. Risk factors: childhood exposure to radiation (neck), female, family hx and genetics. |
| Thyroid cancer symptoms / diagnosis | painless/palpable nodule, hoarseness, dysphagia, fullness in neck, swollen lymph nodes. Dx through fine-needle aspiration biopsy, CT/MRI/TSH levels, radioiodine imaging |
| Treatment for thyroid cancer | Primary is surgery, radioiodine therapy, radiation, chemo |
| Brain cancer patho | Can be highly aggressive, primary rarely metastasize with secondary from other areas. Glioblastomas are from glial cells (most common, aggressive and life expectancy 8 months). |
| Brain cancer risk factors / diagnosis | sometimes unknown, age over 85, genetics, excessive alcohol, tobacco, radon, xrays, EBV; Dx with biopsy, lumbar puncture, CT/MRI, PET, xray |
| Brain cancer symptoms | Altered LOC, headache, vision, balance, behavior, seizures, increased ICP, coordination, bowel/bladder issues, weakness, numbness/tingling. |
| Treatment brain cancer | craniotomy (skull removed and bone flap replaced), craniectomy (bone flap not replaced). Chemo (must cross BBB) and radiation |
| Brain cancer complications | increased ICP, intracranial bleeding postop, cerebral edema, seizures, thrombosis |
| Liver cancer (hepatocellular carcinoma) | Poor prognosis due to late dx. Risk factors: longterm liver inflammation, chronic infection, heavy acl use, obesity, diabetes. Present with enlarged liver, RUW pain with extension to back/shoulder, fatigue, SOB, weight loss, jaundice, ascites, weakness |
| Liver cancer diagnosis and treatment | routine screening, labs (LFTs, bilirubin), CT, US, biopsy. Treat with surgery, palliative care, partial hepatectomy, liver transplant, chemo/radiation, radiofrequency ablation |
| Pancreatic cancer | Late dx, poor prognosis. No screening test. Risk factors: smoking, obesity, gas exposure, diabetes, chronic pancreatitis, genetics. present with jaundice, itching, dark urine, pain, pale/greasy stools, weight loss |
| Pancreatic cancer diagnosis and treatment | Labs (LFTs, tumor markers), biopsy, CT/US/ERCP, MRCP. Treat with surgery, combines chemo, radiation |
| Whipple procedure patho | head of the pancreas, distal stomach, spleen, common bile duct, gallbladder, portions of the duodenum, proximal jejunum and lymph nodes resected. |
| Whipple procedure priorities | maintain NGT to min. pressure on surgical site, maintain low wall suction, don't reposition/irrigate/check for placement. Notify dr if removed, maintain NPO and measure NGT output. Prevent ascites, hyperglycemia, infection. Skin care (pruritus)/nutrition |
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