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29 Cards in this Set
- Front
- Back
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treatment options are based on:
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tumor type and whether or not the tumor has spread
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essential information during history and physical
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how long mas has been present, whether its growing rapidly, is it waxing and waning, has the pet had previous tumors, if yes, what kind, is pet showing any signs of illness
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What should be done during physical?
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evaluate mass for ulceration or discharge; FNA on lymph nodes; rectal exam on pets that strain while urinating or defecating; oral exam if drooling, halitosis;
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What two questions must be asked to determine appropriate therapy?
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What is it?
How far has it spread? |
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How to determine what it is
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FNA, or biopsy
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FNA (fine needle aspirate)
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easy to perform, minimally invasive, often diagnostic for tumor type, determines whether or not lesion is malignant
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trephination technique
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redirect needle through several planes of mass w/o concurrent aspiration; recommended because it is less likely to rupture tumor cells and has less blood contamination of samples
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aspiration technique
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syringe is attached to a needle and samples can be aspirated while directing needle through several planes of mass
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gold standard for diagnosis of tumor type
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biopsy
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how is tumor grade obtained during biopsy
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looking at cell morphology and local invasion into lymphatics, blood vessels, and surrounding stroma within biopsy sample
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How to get accurate tumor grade?
Why is tumor grade important? |
based on mitotic index, percent tumor necrosis, degree of cellular differentiation, and infiltration into surrounding tissue
it is often linked to overall prognosis |
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incisional or core biopsy
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a small sample of tumor is taken using a sclpel, punch biopsy instrument, pinch biopsy forceps, Tru-Cut, Jamhidi bone core
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downfall to incisional biopsy
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inability to get accurate grade
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excisional biopsy
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procedure in which entire tumor is removed and submitted for evaluation
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When performing a biopsy why is it important to remove biopsy tract?
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it insures tumor cells seeded along tract are removed
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How to ensure adequate sample will be removed?
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use palpation, radiographs, impression smears
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Why are staging tests performed?
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to determine systemic extent of disease and help determine treament plan
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Staging tests include:
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MDB, CBC, serum chemistry panel, urinalysis, xrays, CT, MRI, ultrasound, FNA, bone marrow aspirate,
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this treatment option offers a potential cure for localized disease and is used as part of combination therapy for many tumor types
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surgery
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recurring themes of surgey oncology
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1. The first surgery has the best chance to cure.
2. Surgical margins are very important. |
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this therapy option offers a potential cure for localized tumors, may be combined with surgery or with chemo to treat local or distant disease; works by sterilizing cells and keeps them from being able to undergo successful mitosis
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radiation therapy
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radiation therapy works best on what type of tumors
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localized round cell tumors (lymphom, mast cell tumors)
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acute side effects of RT
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moist desquamation and mucositis: will resolve with minimal nursing care, not considered dose limiting
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chronic side effects of RT
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arise from damage to tissue slowly renewing population (bone, retina, CNS): clinical syndromes include formation of bony sequestra, retinal lesions,cataracts, dose limiting
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treatment option that is indicated for patients that have systemic or metatastic disease: damages (and in some cases kills) cells that are growing and dividing rapidly
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chemotherapy
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three main populations of rapidly dividing cells that maybe affected by chemotherapy
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tumor cells, intestinal epithelial cells, bone marrow
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The 4E model
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engagement, empathy, education, enlistment
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client communication includes:
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breaking the news and responding to client emotion, offering options, providing support, empowering client through appropriate engagement and enlistment into the management of pets disease
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be sure client understands the following points before starting therapy
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goals of therapy
what to expect their role in the decision making |
