Oncology and Hematology - Cancer 2023 with verified questions and answers

Cancer When normal cells mature into abnormal cells and metastasize though out the body Common cancer in men and women Men- prostate women- breast Tumor (Neoplasm) Mass of abnormal cells that serve no purpose: Benign or malignant Benign (non cancerous) Tumors characteristics (3) crowds tissues and obstructs organ functions slow growth and localized Easily removed and doesn't reoccur Malignant (cancerous) Tumor characteristics (3) Grows rapidly and metastasizes difficult to remove and reoccurs Carcinogens cancer causing agents that damage cells oncogenes in the cells DNA Oncogenes function in DNA? What happens when they are damaged? controls cells growth, replication and replacement when damaged they are repressed Different types of CARCINOGENS (7) Viruses, drugs, hormones, chemicals, tobacco, foods that are charred, radiation Carcinogen viruses and the cancer they cause 3 Hep B (liver Cancer) HPV (cervical, Penile cancer) HIV (kaposi Sarcoma) Carcinogen drugs (2) Heroin and Chemo drugs Carcinogen Hormone and the cancers it causes Estrogen (uterine and breast cancer) What type of women are more at risk for cancer ? Younger women that have started their menstrual cycle @ a younger age or ended it late or took estrogen What type of foods are considered carcinogens? Any food that is pre prepared or preserved (additives) What additives in pickling are know as carcinogens? Nitrosamines (chemical) UNCONTROLLABLE risk factors for Cancer (4) Inherited, Age, gender, poverty, CONTROLLABLE risk factors for Cancer (3) Stress Food choices/obesity Lifestyle occupational What age group has a increase risk for cancer? 55 and up Why is age changes proves that AGE is a uncontrollable risk factor for cancer? (3) With age................ Immune responses lower cells age and damage over time usually more long term exposure to carcinogens Why is gender a uncontrollable factor in females and males? increases risk of breast and thyroid cancer in woman Increases risk of bladder and prostate cancer in men Why is stress a risk factor for cancer? Stress keeps certain hormone levels high (cortisol and epinephrine) leading to impaired immunity What are 6 warning signs of cancer (6) Persistent cough and hoarse voice bleeding or d/c recent weight loss recent change in skin color/texture, wart, moles functional change (trouble swollowing, indigestion) palpable lump or thickening in breast or other tissue Manifestations of cancer 4 Pain Anorexia- cachexia Bone marrow suppression disrupted organ function anorexia cachexia cancer cells divert nutrients from normal cells to feed themselves and multiple and grow. Tumors secrete Diagnostic testing 8 Cancer screening prevention tumor markers CBC ultrasound (noninvasive) Radiological tests Direct visualization exploratory surgery cytologic examination What radiological tests are done? 5 CT scan/xray MRI Nuclear scan Angiogram What are tumor markers proteins found in the blood that indicate malignancy Ultrasounds are used for what type of cancer indication? 2 Breast and prostate Why wouldnt you do a MRI? pt has a pacemaker or prosthesis Nuclear scan oral or injected radioisotoped Angiogram Helps show blood flow via dye, can show where tumor disrupts the normal flow direct visualization use of scope to view and biopsy lesions Exploratory Surgery View, biopsy with frozen plasma to determin how much to remove Cytologic examination 2 Tissue samples (PAP testing) Aspiration of fluid/ needle How are tumors named? type of tissue orgin purpose of tumor grading evaluated cell differentiation and est the rate of growth 1 is the least malignant and well differentiated 4 most most aggressive and least differentiated well differentiated means tumor is similar to normal cells least differentiated means tumor is odd and specialized Tumor staging size of of tumor uses TNM classification and numbers T- tumor size N- lymph node involve M-metastasis the higher the numbers the larger the tumor and its involvement Cancer tx (7) surgery radiation (external and internal) chemotherapy biotherapy bone marrow transplant stem cell transplant other: spiritual approach, herbal therapies 3 types of surgeries Debulking palliative Reconstructive Debulking tumors (surgery) reduce the bulk to the tumor so that other tx such as radiation/chemo are more effective Palliative Surgery If tumor is nonresectable or metastasized, surgery to remove pressure on organs may occur, via debulking, for comfort Reconstructive surgery may happen after debulking or palliative surgery (ex breast reconstruction after surgery) All surgeries will be a mix with chemo, radiation, or bio therapies T or F T External Radiation Machine is external, delivers radiation at a distance toward tumor site, no danger to others from pt after tx What is a common problem with external radiation? can cause damage to the surrounding tissues and skin (burning or sloughing or skin Other external radiation damage 5 Bone marrow depression Fistulas/Necrosis GI distress: N/V Ulceration of mucus membranes increases susceptibility to infection Internal Radiation Brachytherapy- radioactive seeds or capsules inserted directly into tumor sites - not common Common cancer linked to ingestion of a radioactive pill thyroid cancer internal radiation precautions 4 keep distance from pt (6ft) private room and bath wear monitoring device to keep track of exposure no pregnant people near pt Rules for rare radiation implants 3 wear lead gloves do not touch anything radioactive if implant falls out use forcepts to retrieve it and put implant in lead containor Chemotherapy drugs that interrupt cell metabolism and replication (not selective and effects normal cells too) Work in specific phases of cell cycle combo drugs Chemo adverse effects Pancytopenia (WBC, RBC and PLT LOW) N/V Alopecia (loss of hair) Teratogenic effect on fetus (if pregnant) Hyperuricemia chemo brain Sterility in males (not reversible) Stomatisis Is alopecia reversible? Yes When do you give antiemetics (Zophran, Ondanstron) to a chemo pt Shortly before chemo Stomatitis foods to avoid Imflammation of the mouth (sores) avoid spicy and acidic Meds to decrese uric acid 2 Allopurinol (Zyloprim) PO and hydrate IV for 48hrs before chemo Drugs to increase blood cells (colony stimulating factors) Neupogen (filgrastin) -increases neutrophils Epogen (epoietin) increases production of RBC Biotherapy and the meds Use of meds that boost immune system Interferon - we naturally make by immune system Interleukin- Stimulates T cells (destroy invading abnormal cells) Cachecexia Wasted appearance Benign Non cancerous Carcinogenisis Process when normal cells turn into cancerous ones Tumor Mass of abnormal cells that serve no purpose Hemolysis Destruction of RBC Hemostasis Blood clotting Plasma RBC WBC and PLTS Satiety Sensation of fullness lymphaDENTITS Inflammed lymph nodes Lymph ANGITIS Inflammed lymph vessels Brawny edema Edematous tissue hard and tough and turns brown Primary lymphodema Unknow cause, developes during puberty or childhood