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Oncology Cabrera

Characterized by abnormal, unrelated cell proliferation; Invade normal tissue and compete with normal cells for oxygen, nutrients, and space; Neoplasms or tumors Cancer
Abnormal cells that reproduce without the regulatory mechanisms that control growth cancer
Abnormal tissue or tumors neoplasms
suffix that indicates a tumor "-oma"
cancer of originating from epithelial cells carcinomas
cancers that originate in organs that fight infection lymphomas
cancers that originate in organs that form blood leukemias
cancers that originate in connective tissue (bone and muscle) sarcomas
tumors that are relatively harmless unless location impairs function of vital organs; do not spread to other parts of the body; may cause problems if it puts pressure on or obstructs organs benign tumors
Benign tumors grow __________________. They remain localized and ____________________. slow and steadily; encapsulated
When palpated, benign tumors are: smooth, easily defined and moveable
Benign tumors have less profuse blood _________. Cells resemble _________ tissue. When removed, benign tumors rarely _________ and are rarely fatal. supply; original; reoccur
Malignant tumors are ____________ and capable of spreading. They grow __________ and unpredictably. invasive; rapidly
Malignant tumors are rarely encapsulated. When palpated, they have ________ borders and are immovable. irregular
Malignant tumors have a blood supply that is ___________ than normal. The cells of a malignant tumor are not _____________ to original tissue. greater; similar
Malignant tumors destroy surrounding tissue by depriving it of ________________________. Recurrence is _____________ when removed. They are _______ when not treated. oxygen, nutrients and space; common; fatal
Malignant tumors may have abnormal proteins (tumor markers) on the cell surface that identifies the cell as ______________. malignant
Cancer is the leading cause of death in the US. The most prevalent cancer is ___________. lung cancer
Chemical agents account for ______% of all cancers. 75%
Environmental factors that can cause cancer: diet, viruses, bacteria, defective genes, medical interventions
Major factor in cancer prevention and development: immune system
4 main tumor classifications: carcinoma, lymphoma, leukemia, sarcoma
pg. 213, Table 18-2
when malignant cells migrate from the original site metastasis
Most common sites of metastasis are: liver, brain, bone and lungs
Cancer may metastasize to adjacent tissue via the: lymphatic system or by diffusion in the body cavity
commonly removed from the site of the original tumor to be evaluated for cancerous cells lymph nodes
area where malignant cells first form primary site
where the cancer has metastasized or spread to (once the cancer has metastasized; cancer treatment is more difficult and less likely to be curative) secondary site
process of malignant transformation and the 3 stages carcinogenesis; initiation, promotion, and progression
involves carcinogens that alter genetic structure of DNA within cells initiation
repeated exposure to carcinogens transforms genetic information to form mutant cells promotion
malignant cells invade adjacent tissue and metastasize progression
Tumors are classified by: their anatomic site, stage, and cell appearance and differentiation (ow cells differ from the parent cell or tissue of origin)
cancers that arise from fibrous connective tissue fibroma
cancers that arise from fat tissue lipoma
cancers that arise from smooth muscle tissues leiomyomas
cancers that are usually benign: fibroma, lipoma, leiomyoma
cancers that are usually malignant: carcinoma, sarcoma, melanoma, leukemia and lymphomas
Cancer that arises from epithelial cells (skin, glands, linings of digestive, urinary and respiratory tracts) carcinoma
Cancer that arises from connective tissue (bone, muscle and other connective tissue) sarcoma
cancer that arises from pigment cells of the skin melanoma
cancer that arises from blood forming tissues, lymphoid tissue, plasma cells and bone marrow leukemias and lymphomas
stage of cancer where malignant cells are confined to the tissue of origin Stage I
stage of cancer where cancer has spread to local area (usually the lymph nodes) Stage II
stage of cancer where the tumor is larger or spread to surrounding tissues or both Stage III
stage of cancer where cancer has metastasized to distant body parts Stage IV
Poorly-differentiated less like parent tissue
well-differentiated looks more like parent cell
Seven warning signs of cancer: change in bowel habits or bladder function; sores that do not heal; unusual bleeding or discharge; thickening or lump in breast or other body parts; indigestion or difficulty swallowing; a recent change in a wart or ole; nagging cough or hoarseness
Cancer is the ___________ leading cause of death. second
One-half of all men and __________ of all women will develop cancer during their lives. one-third
risk factors of cancer: heredity; familial
factors and agents that contribute to the development of cancers: carcinogens
Chemical agents account for ______% of all cancers. 75%
Exposure to _____________ are some carcinogens. tobacco, asbestos, coal dust
environmental factors that can lead to cancer: sunlight, radiation, pollution
Diets high in _____, salt smoked meats, alcohol, and __________ can increase the risk of cancer. fat, nitrates
Diets high in fiber, carotene, and Vitamins __________ can reduce the risk of cancer. A, C, E
Cells can change due to invasion of virus DNA and contribute to _________ cancer. causing
Kaposi's sarcoma is usually cause from: AIDS virus
Helicobacter pylori usually turns into: GI cancers
medically prescribed interventions that can cause cancer immunosuppressive drugs and hormone replacements
Prevention and early detection are key to cancer __________. survival
Ways to prevent cancer: avoid carcinogens; identify high risk people (to be screened sooner); healthy diet; intact immune system
Ways to screen for cancer: self exams; regular doctor exams; know warning signs; early detection
tests for carcinomas of the testicals, pancreas and liver alph-fetoprotein
levels are inreased with breast, pancreas, liver, kidney and colon cancer; may be elevated for no reason carcinoembryonic antigen (CEA)
tests for prostate cancer, slightly elevated in benign prostate hyperplasia prostate-specific antigen (PSA)
test for metastatic breast cancer CA 15-3
test for gastrointestinal and pancreatic cancer CA 19-9
test for ovarian cancer CA 125
x-ray that gives 3-dimensional view of tissue used to determine tumor density, size and location; used in detectng many types of cancer CT
x-ray where tissues are observed for changes using radioactive isotope nuclear imaging
x-ray study where magetic fields are used to differentiate diseasesd tissue from healthy tissue; used to study blood flow; visualizes tumors hidden by bone MRI
x-ray test that shows cross-sectional view of tissue that looks at increased concentration of isotopes in malignant cells; differentiates between benign and malignant cells PET
monoclonal antibodies labeled with isotopes are injected intravenously and accumulate at the tumor site which makes tumor able to be visualized radioimmunoconjugates
uses high frequency sound waves; determines if tumor is solid or fluid filled ultrasound
x-rays used to look at differences in the densities of body tissues; used for bone and gastric cancers fluoroscopy
most accurate diagnosis of cancerous cells; tissue samples are excised from the body and are examined microscopically biopsy
types of biopsies needle biopsy, surgical excision, tissue samples of removed mass
immediate examination of the cells once tumor is removed; specimen is quickly frozen into thin sheets and observed frozen section
flexible tubes with special fiber cameras to look at specific body areas endoscopy
endoscopic procedure that looks at the stomach gastroscopy
endoscopic procedure that looks at the lungs bronchoscopy
endoscopic procedure that looks at the colon colonoscopy
microscopic examination of cells; used to diagnose malignancies in cells; can be obtained by needle aspiration, scraping, brushig or sputum cytology
when the tumor is confined and has not invaded surrounding tissues, surgery is the primary treatment; curative treatment surgery
when entire tumor cannot be removed, as much as possible is removed debulking
the tumor and a small amount of surrounding healthy tissues are removed local excision
removes tumor, lymph nodes and any involved adjacent structures and adjacent structures and surrounding tissue that poses a risk for metastasis wide or radical excision
surgery done with a local recurrence of cancer; more extensive than previous surgery salvage surgery
surgery done when client is at high risk for developing cancer; usually done for breast or reproductive cancers prophylactic surgery
surgery done to relieve uncomfortable symptoms or prolong life; not a cure palliative surgery
high-energy ionizing radiation used to destroy cancer cells by disrupting cell function and division and alteration of DNA molecules; cell death occurs immediately or after; no more reproduction can occur radiation therapy
Goal of radiation therapy: to destroy malignant cells without permanently damaging healthy tissue
____________ cells are more sensitive to radiation. Malignant
causes cell death; usually have daily treatments over several weeks; will be marked with marker or tattoo (do not wash); do not apply any lotions to area external radiation
internal radiation where radioactive source is implanted or placed on the _________ implanted inside the patient's body; poses a ___________ to others tumor; threat
internal radiation that is inserted in the body in a sealed container directy into the tumor body; can be held in place with an applicator sealed source
Precautions when using internal radiation therapy: private room (preferably lead-lined); sign on door; no children or pregnant women; limit time in room; use lead aprons, monitoring devices; 30 minutes total per shift; monitor for accidental dislodged sources
Precautions for unsealed sources (could be liquid, oral, Iodine 131) wear gloves; body fluids require special considerations because radiation is excreted through urine, saliva, sweat and feces); flush more than once; use separate eating utensils; wash clothes separately;drink plenty of fluids to flush system
side effects of radiation bone marrow suppression/myelosuppression; anemia; leukopenia; thrombocytopenia; alopecia; anorexia, altered taste, mouth sores (stomatitis); dry mouth; erythema to area; harm to fetus, sterility, impotence
low blood count anemia
low WBC count (normal is 5,000 - 10,000) leukopenia
low platelet count; prone to bleeding; normal is 150,000 - 450,000 thrombocytopenia
hair loss alopecia
anorexia, altered taste, mouth sores stomatitis
Chemotherapy has the _________ side effect as radiation. same
uses antineoplastic agents to treat cancer cells; can be used to cure cancer, prevention of metastasis, slow growth of tumor, destroy tumor cells or relieve symptoms chemotherapy
Chemotherapy must be given by ______ certified with ________________. RN; chemo training
Chemo can be used to: cure cancer, prevent metastasis, slow tumor growth, destroy tumor cells, relieve symptoms
Chemo agents can be _____________ or ____________. cell cycle specific or cell cycle non-specific drugs
Chemotherapy can be given: orally, IV, IM, intraperitoneally, intraarterially, intrapleurally, topically, intrathecally (in head), or directly into cavity
Chemo is ___________. cytotoxic (toxic to cells)
chemotherapy drugs that interfere with the process of cell division alkylating drugs and mitotic inhibitors
chemotherapy drugs that interfere with DNA and RNA antineoplastic antibiotics and antimetabolites
chemotherapy drugs that are used in treating cancers that use hormones as growth factors hormones
Chemo drugs may be used alone or: in combinations
Chemotherapy cannot distinguish between: healthy and cancerous cells
Side effects of chemotherapy: N/V, alopecia, dry skin, myelosupression (supress what the bone makes - blood cells); side effects are same for chemo and radiation
Chemotherapy may also have toxic effects on: lungs, heart, nerve tissue, kidneys and bladder
Vesicants cause tissue necrosis (extravasation)of surrounding _________________. tissues and structures
Treatment of extravasation and nursing guidelines for patients receiving chemo on pg. 224
peripheral blood stem cell transplant; collected by apheresis bone marrow transplantaton
process of separating blood into components for later reinfusion apheresis
3 types of apheresis autologous (self); allogeneic (compatible donor); syngeneic (identical twin)
When apheresis has been done, watch vigorously for: s/s of infection (many people die from this) because of lack of white blood cells (usually done for leukemia patients)
uses biologic response modifiers to stimulate the body's natural immune system to restrict and destroy cancer cells; manipulates the natural immune response by restoring, stimulating or augmenting the natural defenses immunotherapy
Teach chemotherapy patients: keep all appts; go to ER if fever of 100.4 or more; watch for bleeding; use electric razor; eat small, frequent meals; eat slowly; suck on hard candy; teach about wigs; take lid off tray before entering room; increase fluids to flush out chemo
Drugs that help with clotting: platelets, Vitamin K
antigen injected into client in hopes to stimulate an immune response to destroy malignant cells nonspecific immunotherapy
tumor cells are injected into mice to form antibodies; antibodies are removed from the spleen and cultured with more cancer cells to form more antibodies which are injected into a client to destroy tumor cells (after purification) monoclonal antibody immunotherapy
immunotherapy - substances that immune system cells produce to enhance the immune system interferons; interleukins; ematopoietic growth factors (colony stimulating factors); tumor necrosis factor
colony stimulating factors that are good at treating s/e of radiaion - can stimulate RBC growth or WBC growth without blood transfusions hmatopoietic growth factors
type of immunotherapy - uses tems > 41.5C (106.7F) to destroy tumor cells; alters cell membrane permeability so that uptake of chemo and immunoterapeutic agents are increased; uses radio waves, ultrasound, microwaves, hot water baths hyperthermia
Clients may experience local burns, tissue damage, electrolyte imbalances and neuropathies when being treated with: hyperthermia
photoactive drug injected into client (porfimer/Photofrin); stored in high concentrations in malignant cells; laser light activates drugand destroys tumor; pt must stay protected from sunlight and bright indoor light for 30 days or sunburn can occur photodynamic therapy
replaces altered genes with correct genes, inhibiting defective genes, and introducing substances that destroy genes or cancer cells gene therapy
process that rids the body of cells that are not longer needed or defective in some way apoptosis
Researchers think that tumor cells have an ______________ molecule that prevents their destrction from natural ways; are trying to find meds that block those molecules so cancer cells can die anti-cell-death
number one cause of cancer cell death lung cancer
Lung cancer has an increased number of diagnosis because of: more accurate diagnosing; aging population; cigarette smoking; increased air pollution; exposure to industrial pollution
four major cells types involved with lung cancer: epidermold or squamous cell; lart cell or undifferentiated; adenocarcinoma; small cell or oat cell
slow growing; arise from the bronchi and bronchioles leading to obstruction; metastasize to the thorax and small bowel; 25%-35% of all lung tumors epidermold or squamous cell
arise in the peripheral bronchi; no well-defined growth patters; usually diagnosed as a bulky tumor mass; metastasize early to the CNS; 5% - 20% of all lung tumors large cell or undifferentiated
arise from the mucus glands; patchy growth throughout lung fields; lead to malignant pleural effusion; 25%-35% of lung tumors adenocarsinoma
most malignant form of lung cancer; arises from the bronchi; hypersecretes antiduiretic hormone; metastasizes to the mediastinum, liver, bone, bone marrow, CNS, adrenal glands, pancreas and other endocrine organs small cell or oat cell (worst type)
symptoms do not appear until the disease is well established; long term suvival rate is low; s/s - nagging cough, bloody sputum, weight loss, SOBOE (shortness of breath on exertion) small cell or oat cell
any malignant blood disorder in which the leukocytes (WBCs), usually in an immature form, proliferate unregulated; often accompanied by a decrease in erythrocytes (RBCs) and platelets leukemia
Four types of leukemia acute lymphocytic leukemia; chronic lymphocytic leukemia; acute meylogenous leukemia; chronic myelogenous leukemia
onset is usually younger that 5, rarely over 15; increased lymphocytes, decrease RBCs and platelets acute lymphocytic leukemia (ALL)
onset is older than 40; most common type in adults; increased lymphocytes, normal or low RBCs and platelets chronic lymphocytic leukemia (CLL)
decrease in myeloid formed cells (monocytes, granulocytes, RBCs and platelets); occurs in all age ranges acute myelogenous leukemia (AML)
same as AML but greater number of normal cells; onset is older than 20, increasing incidence with age; genetic link chronic myelogenous leukemia (CML)
s/s of leukemia fatigue from anemia; infections; bruising; spleen and lymph enlargement; bleeding in the nose, mouth and GI tract
treatment for leukemia chemotherapy; bone marrow transplant; stem cell transplant
malignancy involving the plasma cells of B-lymphocyte cells in the bone marrow; prognosis is poor with estimated survival rate of 1-5 years multiple myeloma
pathophysiology of multiple myeloma abnormal plasma cells release osteoclast acivating factor; esteoclast breaks down bone cells; increases blood calcium; greatly increases risk of fractures; releases proteins that damage kidneys and reduce production of antibodies
treatment for multiple myeloma steroids (can slow bone growth) and chemotherapy; bone marrow transplants; stem cell transplants; treatment does not cure, but prolongs life
cancer that affects the lymphatic system lymphoma
two types of lymphomas: Hodgkin's and Non-Hodgkins
lymphoma - age of onset is 15-40 and then older than 55; has Reed-Sternberg cells; orderly growth; more curable Hodgkins
lymphoma - thirty subtypes; peaks after 50; no Reed-Sternberg cells; B and T cell origins; metastasis is common; less curable Non-Hodgkins
lymphomas are treated with: radiation; chemotherapy; immunotherapy with monoclonal antibodies (tumor fighting antibodies); bone marrow transplant
named for cell type and area of the brain; account for a small percentage of cancer deaths; about 50% are malignant; benign tumors can be fatal because of increased ICP and damage to surrounding tissues brain tumors
s/s of brain tumors are related to: the area of the brain that is invaded by the tumor
most common type of brain tumor glioma
most aggressive brain tumor glioblastoma
treatment of brain cancer surgical removal if possible; limited radiation; some chemotherapy
approximately 75% develop in the sigmoid colon and rectum; genetics; lifestyle and environmental factors contribute; many develop from benign adenomas cancer of the GI tract
rarely begins in the liver; chemotherapy is the main treatmen, but is usually considered palliative treatment cancer of the liver
fatal - usually less than a year; quickly spreads to duodenum, stomach, spleen and left adrenal gland cancer of the pancreas
for cancer in the head of the pancreas, s/s include: pain, jaundice, weight loss, N/V and diarrhea
for cancer in the tail of the pancreas, s/s include: GI bleed or back pain
treatment for pancreatic cancer - if cancer is in the head of the panreas, surgery may be an option; radiation and chmotherapy may prolong life
accounts for 3% of cancer; may reach considerable size before etection; s/s include anemia, weakness and weight loss; late s/s are gross hematuria (peeing blood) and flank pain cancer of the kidney
treatment for cancer of the kidney removal of the kidney (nephrectomy); not responsive to chemotherapy or radiation, however radiation may be used as a palliative measure
occurs most often in men, 50 to 70 years old; risk factors include cigarette smoking and exposure to rubber and cable chemicals; s/s include painless intermittent hematuria, bladder irritability and infections cancer of the bladder
treatment of cancer of the bladder partial or total cystectomy; may require urostomy; chemotherapy
abnormal osteoblast or myeloblast (marrow cells) that exhibit rapid and uncontrolled growth; usually located around the knee in the distal femur or proximal fibula; s/s/ include pathological break, limp, or abnormal gait bone cancer
treatment for bone cancer amputation, chemotherapy, radiation
endometrial cells that migrate out of the uterus and attach to toher organsi in the pelvic cavity; builds and bleeds like the tissue within the uterus, causing pain and local inflammation; considered benign unterine growth endometriosis
complications of endometriosis obstruction of organs in plevic area (bladder, bowels, urethra)
treatment of endometrisis drugs that decrease endometrionic growth; laparoscopy; hysterectomy
after a hysterectomy, monitor for: bleeding - main post-op complication
most prevalent form of cancer in women; in early stages, survival rate is greater than 90%; 80% of breast lumps are benign breast cancer
types of breast cancer: ductual carcinoma; lobular carcinoma; medullary carcinoma; mucinous carcinoma; tubular ductal carcinoma; inflammatory breast cancer
Breast cancer may be in any part of the breast, but 48% are locted in the _________________ and 17% are located in the ________________. upper outer quadrant; nipple area
When palpating, breast cancer can feel like: a painless mass, firm, irregular shaped, fixed to underlying structures
__________ women have the highest incidence of breast cancer, but ___________ women are most likely to die from breast cancer. white; black
late s/s of breast cancer: dimpling of skin, nipple discharge, retraction of nipple, edema, differences in nipple size, lymph nodes may be enlarged
routine screening for breast cancer: physical exam every 3 years until 40, then yearly; base-line mammogram at 40; monthly self exams (after each period - if post menopausal, same day each month)
treatment for breast cancer: lumpectomy; simple mastectomy (all breast tissue - no lymph nodes); radical mastectomy (all breast, axillary lymph nodes, pectoralis major - pg 852); removal of lymph nodes pg 852-853
after breast cancer surgery: cancer is staged and determined whether or not it is estrogen receptor positive; radiation therapy; chemotherapy; reconstructive surgery may be done, using the pectoral muscle or abdomen muscles
If breast cancer is estrogen receptor positive, madication is given to suppress estrogen Tamoxifin
after breast cancer surgery: no needle sticks to affected side; no blood pressures to affected side; elevation of affected arm; no lifting with affected arm
metastasizes widely to the abdomen through the peritoneal fluid; incidence is low, mortality is high; vague or no symptoms until the cancer is well advanced; most s/s are attributed to the GI tract ovarian cancer
treatment for ovarian cancer if confine to ovaries, surgical removal, chemotherapy and radiation
rare cancer; can be caused byHPV or genital herpies; s/s are pruritis and burning, white patches (vulvar) and vaginal bleeding (vaginal) vulvar cancer and vanginal cancer
treatment of vulvar cancer and vanginal cancer surgical removal; chemotherapy; radiation
most common in men older than 50; thrid most common cause of cancer deaths in men; grows slowly; high survival rate if detected early; cause is unknow but r/t diets high in fat prostate cancer
s/s of prostate cancer decreased urinary flow and difficulty starting stream (early sign); back pain; hematuria (blood in urine); hemospermia; erectile dysfunction
diagnosis of prostate cancer: rectal exam; elevated PSA (prostate-specific antingen);biopsy; IVP (Intravenous Polygram to watch urinary flow) to detect urinary tract dysfunction
treatment of prostate cancer: prostatectomy (TURP - Transurethral Resection of Prostate); bilateral orhiectomy; hormone therapy; radiation
rare cancer; occurs more often in uncircumcised men; treatment includes tumor excision, chemo, and radiation; advanced requres amputation of the penis, testes and scrotum cancer of the penis
rapidly metastasizing malignancy; occurs between 18 and 40; involve sperm forming germ cells cancer of the testes
s/s of cancer of the testes gradual or sudden swelling of the scrotum; hard, non-tender lump felt on palpation; aching in testes; abdominal pain (late sign)
treatment of cancer of the testes orchiectomy and ligation of the affected testicle (sperm can be frozen for later use); chemotherapy; radiation;
most common type of cancer in the US; increased exposure to UV radiation increases risk cancer of the skin (although most people die from lung cancer)
3 types of skin cancer: basal cell carcinoma; squamous cell carcinoma; malignant melanoma
most common skin cancer; small, shiny gray or yellow plaque; slow growing, rarely metastasizes; commonly recurs basal cell carcinoma
skin cancer that occurs in sun exposed areas such as ear, nose, hands, scalp; scaly, elevated lesion with irregular borders; shallow ulcerations form if untreated; can metastasize through the blood and lymph squamous cell carcinoma
skin cancer that arises from pre-existing moles anywhere on the body; raised brown or black lesions; poor prognosis because of distant metastases malignant melanoma
s/s of skin cancer
treatment for skin cancer: surgical excision, cryosurgery or radiation therapy for basal cell adn squamous cell; radical excision of tumor and adjacent tissues and chemotherapy for melanoma; skin grafting may be necessary
nursing managment of the client with skin cancer: pain and comfort - pain can be from obstruction or nerve compression by a tumor; fatigue (from chemo)
S/S of infecton caused by treatment of cancer fever; elevated WBC count; pain, redness; drainage
Other symptoms client being treated for cancer may have: bleeding (use electric razor); immobility; alterations in body image; changes in psychological and mental status; grieving; emotional support to client and family; side effects of chemotherapy and radiation
Client and family teaching with cancer: medicatins, treatment and procedures (teach pts what to expect from treatment and procedures); adverse effects associated with treatment; resources for support; follow-up needed after discharge from the hospital
When treating pt with cancer, you must allow time for clients to express their feelings or discuss home care.
Teach pt to go watch for s/s of infection - go to ER if fever is over: 100.4
Created by: akgalyean