Flashcards in Day 4- Cancer Deck (40)
~85% of all cancers
~origin is epithelial tissue, or embryonic ectoderm (skin, large intestine, breast, stomach, breast, lungs)
~Can be fast-growing, as epithelial tissue grows rapidly and replaces itself regularly
~Spreads by invading local tissues and metastasis, usually by lymphatics
~tumors of connective tissues, or embryonic mesoderm (bone, cartilage, muscle, fibrous tissue, fat, synovium)
~Look for persistent swelling or lump in soft tissue, pain, warmth
~Frequently seen in younger folks (
What are two different types of bone tumors?
**than 1%, but primarily affects children and young adults
~also called osteogenic sarcoma
~most common between ages 10-25 y.o., usually around knee in femur or tib/fib
~Appears to be related to growth spurt
~Pain in lesion area, or pathological fracture
~5-year survival is ~70%
*could have a hormonal component
~3rd most common, typically pelvis, femur, tibia, ulna, metatarsus, ages 5-16 y.o.
~Pain, swelling, fever, fatigue
~5-year survival is ~70%
What do you do if you have a pt with bone pain that persists?
get an xray or bone scan to see if there is cancer in the bones
~most malignant cartilage tumor, #2 behind osteosarcoma
~Slow-growing, but increased risk for thrombus formation and mets to lung
~non-cancerous, benign tumor
~Pain, swelling, warmth, tenderness
***If aspirin/NSAID significantly relieves pain – more than expected – may signal this type of tumor, which is prostaglandin sensitive; this is a RED FLAG TO KEEP IN MIND!
Where is intramedullary cancer?
Within the spinal cord
Where is extramedullary cancer?
Within the dura mater
Where is extradural cancer?
Outside the dura mater
Where is intracranial
within the cranium
~80% are intracranial
~Of that, 60% are primary, 40% are mets
Neoplasms of the Nerve Tissue
~Benign tumors are dangerous – are space-occupying lesions
**Examples - meningiomas, schwannomas, neuromas
~Primary CNS tumors rarely metastasize beyond the CNS – no lymphatic path, hematologic spread unlikely
~Most common primary malignant tumor is astrocytoma
What are the grading for astrocytomas?
~Graded I – IV
~grade IV glioma, such as glioblastoma multiforme (also known as astrocytoma) has very poor prognosis
~Low grade tumors more common in children
~I and II can usually be treated by removing the tumor
What ate the major types of blood borne cancers?
~Hodgkin’s and non-Hodgkin’s Disease
lymphomas and leukemias
~Arise from bone marrow
~% of blast cells present determines whether cancer is leukemia (“liquid”) or lymphoma (“solid”)
metastasis is hematogenous
~plasma cells in bone marrow
5-year survival ~ 47%
~Bone marrow transplants improving survival
Where are the 2 places that cancer will most likely spread to?
Why does mets usually go to the lungs?
Most common mets, as venous drainage passes through superior and inferior venae cavae, - lung is the first organ to filter malignant cells
Where does lung cancer often metastasis to?
20-25% of patients develop ____ mets
20-25% of patients develop brain mets (lung, colon, kidney, melanoma, breast)
Are brain tumors always symptomatic?
Brain tumors may be asymptomatic, or vary widely, depending on location and size
S/S of cauda equine syndrome
~saddle and/or perianal hypesthesia or anesthesia
~B/B changes or dysfunction
~lower extremity weakness
~decrease rectal tone
~decrease perineal reflexes
~diminished or absent LE reflexes
~Rare disorder, probably due to altered immune system – tumor elsewhere, possibly not diagnosed
~Seen in patients with constitutional, cardiovascular, integumentary, rheumatic, neurologic, hematology, GI, or renal/urologic problems
~Patients with unexplained medical problems should be referred to physician
Is primary bone cancer common?
~Primary bone cancer is uncommon
~bone mets are very common, especially to vascular bone (vertebrae, pelvis, ribs, skull, proximal femur)
Describe bone pain
~episodic “stabbing” pain
~worse at night- wakes person up
**Pathologic fractures, back pain, hypercalcemia from osteolytic lesions (muscle pain, spasms, arrhythmias, nausea, vomiting, dehydration, thirst)
Liver- where were the mets likely come from?
~Liver filters blood from GI tract
~collects mets from stomach, colorectum, pancreas
~may refer to R shoulder
~Bilateral carpal tunnel syndrome – really an ammonia abnormality due to liver dysfunction
side effects of cancer
~Bone marrow suppression – infection control needed! (Leukopenia, Anemia)
~Radiation skin reactions, nausea, vomiting (no topicals without physician permission)
~Radiation osteonecrosis, irreversible