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79 Cards in this Set
- Front
- Back
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What does METASTASIS mean?
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SPREADING of a disease to another part of the body
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Which skin cancer gives the POOREST prognosis?
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MALIGNANT melanoma
Diagnosis: excisional biopsy and full depth punch biopsy, CBC with differential reveals anemia, elevated ESR, abnormal platelet count, abnormal LFT's |
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What is the SLOW growing destructive SKIN cancer?
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Basal cell carcinoma
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What does MELANOMA mean?
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Any of several malignant neoplasms (usually of the SKIN) consisting of melanocytes, SKIN CANCER, TUMOR in SKIN
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What is the CONTRIBUTING factor to BASAL CELL CARCINOMA?
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- UV light
- Fair skin - Prolonged sun exposure - Extensive sunburns - Radiation - Burns - Immunosuppression - X ray therapy for acne |
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Where is the most COMMON place to have BASAL CELL CARCINOMA?
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- NOSE
- Small, smooth, pinkish, translucent papules usually occurring on the face |
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What does a blue/black mole indicate?
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SKIN CANCER - malignant melanoma
S&S - red, white, BLUE color over a BROWN or BLACK background and an irregular notched margin |
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What is the PRIMARY prevention to REDUCE your chances of SKIN CANCER?
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SUNSCREEN, cover up, hats, limit exposure, drugs that make you photosensitive, stay out of the sun
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Why would a patient be ANEMIC if they had BONE cancer?
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LACK of blood cells in the bone marrow - SECONDARY anemias
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What types of skin cancer arise with PROLONGED exposure to the sun?
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Basal cell carcinoma, Squamous cell carcinoma, Malignant melanoma
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What is Kaposi's sarcoma?
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Painless, cancerous purplish or brown lesions ALL over body and internal organs - AFFECTS Squamous cells and AIDS patients
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What is LYMPHADENOATHY?
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Chronic, ABNORMAL enlargement of the lymph nodes associated with MALIGNANT melanoma metastasis
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What is OSTEOGENIC sarcoma?
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MALIGNANT bone tumor
S&S: bone pain that is greater at night, usually associated with movement, dull and localized; swollen, tender mass; pathological fractures, SECONDARY anemia (not making RBC's to carry oxygen), hypercalcemia |
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Why are we CAUTIOUS with older adult patients with bone cancer?
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Avoid fractures
- Cancer involving the bone in older adults is most commonly the result of metastatic spread from another tumor |
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Why would we SCAN the lungs for malignant bone tumors?
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To make sure it hasn't metastasized
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What are NON-SURGICAL treatments for bone cancer?
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Radiation, chemotherapy, biotherapy
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Patient has cancer and it has metastasized to lymphatic tissue - what is this called?
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LYMPHOMA
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What is a PATHOLOGICAL fracture?
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Related to DISEASE (cancer, osteoporosis, osteomyelitis)
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Does EARLY oral cancer hurt?
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NO, can be asymptomatic
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How do you confirm oral cancer?
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BIOSPY
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What are contributing factors to oral cancer?
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Tobacco use, alcohol use, chronic irritation from rough teeth, fillings or dentures, infection with HPV
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What is your PRIORITY after you remove an oral tumor?
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AIRWAY
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What is LEUKOPLAKIA?
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Lump or ulcer, TONGUE CANCER
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What is GERD?
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Gastroesophagel reflux disease - acid to the esophagus
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Is GERD a predispose factor to carcinoma of the esophagus?
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YES
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Which group of people is carcinoma of the esophagus most common in?
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Japan, China, the Middle East, parts of South Africa - develops in men > 60
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Which type of blood is there a 10% increase risk for GASTRIC CANCER?
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Type A blood
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Is GASTRIC cancer usually mis-diagnosed for a peptic ulcer?
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YES
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What are the S&S of Gastric cancer? (stomach cancer)
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Early signs include chronic dyspepsia, and epigastric cancer
Later signs include weight loss, anorexia, dysphagia, feeling of fullness after eating (postprandial), anemia, fatigue, coffee ground emesis, melena Diagnosis: HgB, HCT |
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Why would you have a LOW HgB and HCT with GASTRIC cancer?
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- Portal bleeding AND pressure
Normal hemoglobin lab levels: Female (12-16), Male (14-18) Normal HCT lab levels: 37-57% |
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How can one DECREASE their risk of getting colorectal cancer?
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Eat a HIGH fiber, LOW FAT diet; oatmeal, apples, chicken, pork, eggs, turkey, lean red meat
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What is CEA?
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Carcinogenic embryonic antigen (detects for colorectal cancer)
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What lab tests would you take to detect for Colorectal cancer, if it has metastasized?
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LFT (increased levels)
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Is there a greater possibility that a patient's liver cancer was metastasized from ANOTHER site?
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YES - the liver is one of the most common sites of metastasis from other primary cancers, metastatic liver carcinoma is MORE common than primary
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What is a WHIPPLE procedure?
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Removed the head of the pancreas, but cure rate is low
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What is a POLYP?
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A SMALL vascular growth on the surface of a mucous membrane (abnormal growth)
Can be found in the INTESTINES, STOMACH, BLADDER and COLON |
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What are the possible S&S of COLORECTAL cancer?
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CHANGES in bowel habits such as bleeding, pain, anemia, anorexia, symptoms of local obstruction, symptoms of direct extension to adjacent organs (bladder, prostate, ureters, vagina, sacrum), fatigue
RIGHT colon obstruction: tarry stools, anemia, abdominal cramping, weakness, fatigue, dyspnea on exertion, vomiting LEFT colon obstruction: rectal bleeding, abdominal cramping, rectal pressure, constipation, diarrhea, ribbon stools and pain |
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Are patients with polyps at RICK for colorectal cancer?
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YES, they are ABNORMAL tissue growth
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What is PRIMARY cancer vs. SECONDARY cancer?
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Primary: when it STARTS
Secondary: METASTASIS |
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Why would you have a surgical resection for early signs of cancer?
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So it does NOT grow back - REMOVE the cancer
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Where is the most COMMON site of pancreatic cancer?
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HEAD of the pancreas
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AFTER a post-Whipple procedure, what are the precautions to PREVENT complications?
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PAIN MANAGEMENT, medicate with opioids, provide post-op care, MONITOR NG and SURGICAL drainage, incentive spirometer, provide IV fluid and blood, MONITOR GLUCOSE, monitor DVT, administer anticoagulants, monitor for peritonitis, fever, increased WBC (infection), abdominal pain, ALTERED bowel sounds
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What is the NUMBER one risk factor for PANCREATIC cancer?
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CIGARETTE SMOKE (twice the risk)
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WHY would a patient have altered nutrition diagnosis with pancreatic cancer?
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Patient will be SICK, weak, high or low blood sugar, anorexic - should have TPN, small frequent meals via NG or GT feeding
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Why should you assist with grieving with METASTATIC pancreatic cancer?
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Because patient will most likely die
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What are the MODIFIABLE risk factors for bladder cancer?
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TOBACCO and smoking
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What are the USUAL early signs and symptoms of BLADDER cancer?
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Painless hematuria (blood in the urine)
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What is BPH?
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Benign prostate hypertophy - enlarging of the prostate
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Which lab results would show possible BPH?
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PSA (first), DRE (second)
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Why is surgery (prostatectomy) the most COMMON intervention for prostate cancer?
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Patient can live WITHOUT a prostate, this is the CURE for cancer as long as there is NO metastasis
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What is LEUKEMIA?
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Cancer of the WBC's
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What is the PRIORITY care with leukemia?
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PROTECT from infection
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What is ALL?
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Acute lymphocytic leukemia: MALIGNANT disease caused by abnormal growth and development of early lymphocytes; originates in the blast cells of the bone marrow
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What are the S&S of ALL?
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Jaundice, generalized edema
Acute leukemias: BONE pain, joint swelling, enlarged liver and spleen, weight loss, fever, poor wound healing, signs of ANEMIA, sign of bleeding and fatigue, pallor Chronic leukemias: sternal rib (bone) pain, enlarged liver and spleen, weight loss, fever, signs of anemia, sign of bleeding, prolonged infection, nodular enlargement |
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BEFORE bone marrow transplant, why would you ERADICATE the WBC's?
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Start with CLEAN WBC's ad get rid of the bad - TOTAL body irradiation before transplant infusion
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Is SMOKING and important environmental factor for leukemia?
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YES - smoking and 2nd hand smoke
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What is MULTIPLE MYELOMA?
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A neoplasm of bone marrow plasma cells that infiltrates bones to produce osteolytic lesions throughout the skeleton
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What is CLL?
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Chronic lymphocytic leukemia: gradual accumulation of mature long-lived lymphocytes, most often affects adults over age 60
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What are the NUMBER one symptoms of MULTIPLE MYELOMA?
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SEVERE, CONSTANT back pain and rib (bone) pain
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What is the diagnostic in urine for multiple myeloma?
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Urine studies reveal BENICE JONES PROTEIN and HYPERCALCEMIA
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What is the number one prevention for bone cancer?
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RISK for FRACTURES (handle gently) - lack of calcium and phosphorous
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What LYMPH nodes would be affected in HODGKIN'S DISEASE?
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Cervical region (neck)
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Who is at a HIGHER risk for Hodgkin's disease?
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Most common in YOUNG adults, and more common in MALES
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What hormone treatment would you use for PROSTATE cancer?
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Suppress with ESTROGEN (Lupron or Zoladex)
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What type of drug is tamoxifen (Nolvadex)?
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Anti-estrogen: used for breast cancer
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Why would you see a gynecologist when on tamoxifen (Nolvadex)?
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Because it also affects the ovaries and uterus
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Why would you administer antiemetics prior to chemotherapy?
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To prevent nausea and vomiting (zofran, compazine, benedryl, phenergan, marinol, reglan)
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What are ANTINEOPLASTIC medications used for?
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Anti-cancer
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Why is it important to teach patients to notify their PCP if they have S&S of infection?
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They are immunosuppressed - S&S for fever, chills, sore throat, malaise
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Which cells are at least risk for destruction due to cancer medication?
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Nerve cells (brain and spinal cord) - least traumatized
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What should you instruct your patients to do when taking cytotoxin?
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Take with a FULL glass of water, 8-10 glasses, 3 L, to flush out toxins
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What is the normal WBC count?
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5,000-10,000
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What is the NORMAL platelet count?
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150,000-450,000
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Normal hemoglobin lab levels?
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Female: 12-16
Male: 14-18 |
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What is METHOTREXATE?
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Antimetabolites: immunosuppressant - inhibits dihydrofolate reductase; inhibits lymphocyte proliferation (folate antagonist)
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Why should you take vital signs prior to giving oral methotrexate (cytotoxin)?
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Know baseline vitals because it can DESTROY any part of the body (cells)
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Why are hormone treatments used for cancer?
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Because they are tumor sensitive
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What s BRM?
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Biological response modifiers (immunodulators, immunistimulants)
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What does BRM do?
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Amp up the immune system - stimulates the bone marrow, stimulate a faster recovery of bone marrow function after treatment induced suppression
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