Chapter 25 Medical Surgical
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| What are the most common sites for cancer in men? | prostate 27%
Lung and bronchus 14%
colon and rectum 8%
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| What are the most common sites for cancer in women? | breast 29%
Lung and bronchus 13%
colon and rectum 8%
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| What is a benign tumor | mass of cells relatively harmless, do not spread to other parts of the body only become a problem when they apply pressure or obstruct body organs, surgical removal is often recommended
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| What is a malignant tumor | mass of cells that are abnormal in appearance; unable to perform function of origin; not recognized by other cells; may have tumor markers; inadequate space and nutrients, can migrate from one tissue to or organ to another
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| What is regional invasion | movement of cancer cells into adjoining tissue
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| Define metastasis | process by which cancer spreads
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| define metastatic growths | tumors found away from original site of malignant cells: most common sites are liver, brain, bone and lungs
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| What are the steps to malignant transformation | Initiation; promotion; progression; metastasis
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| describe initiation | DNA is exposed to carcinogen, irreversible changes in DNA (cell appears abmormal but still functions normally)
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| describe promotion | sufficient exposure to an agent (promotor) to encourage / enhance cell growth (latent period before increased growth forms tumors)
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| describe progression | accelerated growth rate, enhanced invasiveness, altered appearance and biochemical activity (tumor development, cells mutate)
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| describe metastasis | transformed cell relocate by direct extension, invasion, establishment of remote sites
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| How are tumors classified | by anatomic site, stage and cell appearance & differentiation
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| Name benign tumors by anatomic site | Fibroma - fibrous connective tissue
Lipoma - fat tissue
leiomyomas - smooth muscle tissue
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| name malignant tumors by anatomic site | carcinoma - skin, glands, lining of digestive, urinary & respiratory tracts.
Sarcoma - bone, muscle, other connective tissue.
Melanoma - pigment cells in skin.
Leukemia & lymphoma - blood forming tissues; lymphoid tissue; plasma cells, & bone marrow
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| stage 1 | malignant cells are confined to tissue of origin, no invasion of other tissues
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| stage 2 | limited spread of cancer occurs in local area, usually to nearby lymph nodes
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| stage 3 | tumor is larger, has spread from site of origin to nearby tissues, regional lymph nodes are likely to be involved
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| state 4 | cancer has metastasized to distant parts of body, term advanced is also used to describe this stage
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| TNM Staging system | specifies the status of the primary tumor, regional lymph notes, and distant metastases
t = tumor
n = regional lymph nodes
m = distant mestastases
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| T stages in the TNM staging system | TO - no sign of tumor after treatment
tis 0 malignancy in epithelial tissue but not basement membrane
T1-minimal size and extension
T 2 & 3 - progressively increasing in size and extension
T4-larg size and extension
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| N stages in the TNM staging system | NO - no regional lymph notes involved
N1 - minimal reginal lymph node involvement
N2 - increased involvement of regional lymph nodes
N3 - extensive involvement of regional lymph nodes
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| M stages in the TNM staging system | MO - no distant metastasis
M1 - distant metastasis present
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| Warning signs of cancer C.A.U.T.I.O.N | Changes in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficult swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
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| What are radioprotectors | Medications that can help to protect the salivery glands as well as mucus producing tissues
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| Medical term for dry mouth | Xerostoma
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| What is osteradionecrosis | Destruction of bone caused by radiation
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| Side effects of radiation therapy | Bone marrow suppression; alopecia summer: anorexia; dry mouth; nausea and vomiting in semi: diarrhea and inflammation of the skin, aesophagus, longs, in bladder
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| Inflammation of the esophagus is? | Esophagitis
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| Inflammation of the lungs is? | Pneumonitis
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| Inflammation of the bladder is? | Cystitis
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| Sources of a radiation used for therapy include | Radioactive forms of iodine, phosphorus,radium, iridium, radon,and cesium
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| Adjuvant therapy is? | used then patient has had surgery or radiotherapy and is free of signs of disease but has a high likelihood of recurrence, chemo is administered to eradicate remaining undetected cells
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| what is a tumor marker? | abnormal proteins on cell surface
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| what is an example of prophylactically measures | having part of colon removed to prevent cancer when familial polyposis has been determined
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| Neoadjuvant therapy is ? | used chemo is used to reduce the extent of tumor before surgery or radiotherapy
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| intraoperative radiation therapy (IORT) | a technique in which the tumor/tumor bed is radiated directly during surgery (this is during external radiation)
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| forms of internal radiation: | sealed-source radiation
unsealed-source radiation
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| Effects of bone marrow suppression | Anemia; low WBCs, low platelets
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| What is chemotherapy | use of chemical agents in the treatment of disease
antineoplastics / anticancer drugs
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| What is biotherapy | agents that work by affecting biologic process: hematopoietic growth factors, BRM, monoclonal antibodies (MAb)
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| what are hematopoietic growth factors | colony-stimulating factors (CSF), used to stimulate the bone marrow to produce RBCs & WBCs
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| what are BRMs | boost the body's existing defenses, act directly on malignant cells, stimulate immune system to act against them
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| what is Monoclonal antibodies (MAb) | use antibodies made in large number in a lab rather than by a person's own immune system, recognize very specific targets/antigens present on certain kinds of cancer cells
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| what is allogenic transplant | receive cells from sibling/relative
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| what is a matched unrelated donor (MUD) transplant | donated from unrelated donor
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| what is complementary therapy | non traditional therapy & conventional therapy used together
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| Alternative therapy | uses non traditional therapy in place of traditional treatment
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| examples of antiemetics: | palonosetron;
dolasetron;
ondansetron;
granisetron
*greatly improved management of N/V with chemo....fewer side effects
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| what is mucositis | inflammation of the mucosa may extend from mouth and effect entire intestinal tract . . . painful, can interfere with adequate food intake
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| what is stomatitis |
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| important facts regarding thrombocytopenia |
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| actions to be taken for Change in bowel or bladder habits | ultrasonography and endoscopy
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| action to be taken for a sore that does not heal | biopsy and oral and skin examination
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| action to be taken for unusual bleeding or discharge in stool | rectal exam and colonoscopy
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| action to be taken for unusual bleeding in between periods | gynaec exam for cervix and biopsy
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| action to be taken for thickening or lump in the breast, testicles, elsewhere | ultrasonography and FNAC if abnormal
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| action taken for indigestion or difficulty swallowing | endoscopy
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| action taken for obvious change in the size of mole, or mouth sore | biopsy
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| actions taken for nagging cough or hoarseness | ENT examination and X-ray chest
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