Lecture 7: Cancer Detection, Treatment, and Prevention Flashcards Preview

SBL (Skin, Blood, Lymph) Exam 1 and 2 > Lecture 7: Cancer Detection, Treatment, and Prevention > Flashcards

Flashcards in Lecture 7: Cancer Detection, Treatment, and Prevention Deck (56)
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1

What are 3 problems that masses can cause?

- invasion of adjacent structures, obstruction of passageways (GI/airways), and compression (spinal cord)

2

What does a mass tell you about malignancy?

NOTHING

- though invasion of the skin (for example) is a BIG concern for potential malignancy

3

How would a lung carcinoma cause airway obstruction?

by growing endobronchially

- could cause downstream tissue to collapse and/or airway stridor

4

What is Superior Vena Cava Syndrome and what are 3 common findings of it? What is a sign to detect potential Superior Vena Cava Syndrome?

- obstruction of the superior vena cava causes:

venous distension of neck and chest wall, with facial edema and plethora (pinkness of face), and upper arm edema

- Pemberton's Sign: above findings become exaggerated when arms are raised above the pts head

5

What is a hematological issue regarding tumors?

HEMORRHAGE

- even benign tumors can be fatal if they hemorrhage

- should consider tumors if we see hematuria, hematochezia (stool), hematemsis (vomit), or hemotpysis (cough)

6

What kind of cancer should we consider in older female patients who seem to be "menstruating again"?

UTERINE CANCER

7

What is the most common renal tumor in adults?

Renal Cell Carcinoma

- extremely vascular and bleeds A LOT

8

What can abrupt and chronic tumor hemorrhaging lead to?

Abrupt - rapid enlargement of a tumor or compartment, leading to increased PAIN

Chronic - can lead to iron-deficiency anemia, meaning we should get a colonoscopy ordered to check for tumors (especially in order individuals)

9

Ovarian Carcinomas and tissue irritation

ovarian carcinomas can irritate the peritoneum around the mass, causing inflammation

- inflammed tissue causes fluid leakage into the peritoneal cavity that can lead to MALIGNANT ASCITES

**can also see malignant pleural effusions**

10

What is an adnexal mass?

- lump of tissue near the uterus, ovaries, fallopian tubes, or the connecting tissues

11

What is a common tumor marker for ovarian cancer?

CA-125

12

What is the step-wise process for dealing with pts suspected of having cancer?

1. vague symptomatology
2. phyiscal examination
3. laboratory testing
4. radiographic evaluation
5. surgery --> DEFINITIVE DIAGNOSIS and treatment

13

What are the 3 components of cancer staging?

1. T (tumor size/invasion) - ranked 1-4
2. N (degree of lymph node involvement) - ranked 0-2
3. M (distant metastases) - ranked 0-2

14

What are the 4 types of metastatic spread and which one is the most common?

1. lymphatic - MOST COMMON
- typical spread of CARCINOMAS
2. hematogenous
- typical spread of SARCOMAS (or adv. carcinomas)
3. transcoelomic
- punches through membrane, seeding cavity nearby
4. canalicular - travels through pre-existing lumen/duct
- ex: bile duct/sub-arachnoid space

15

What are the 4 most likely sites for hematogenous metastasis to spread?

Lung, Liver, Brain, Bone

16

What is a consideration for checking lymph nodes in a suspected case of breast cancer vs lung carcinoma?

Breast - check the axillary and supraclavicular LNs close to the breast

Lung - no easy access for physical examination of hilar and mediastinal LNs --> USE RADIOGRAPHIC EVALS

17

What are Sentinel Node Biopsies? What are two common cancers this practice is used in?

- used to determine staging of potential cancer

- radioactive dye administered that is taken up by the tumor; can be tracked by probe to see if sentinel nodes are involved

- EX: breast carcinoma and melanoma

18

What organ is a myometrial leiomyosarcoma likely to metastasize to?

LUNGS

- LIVER is also very common

19

What is an example of a carcinoma that does not require lymph node staging?

Renal Cell Carcinoma

- it is hematogenously spread (think lungs, liver, brain, bone)

20

Why is fatigue/weight loss a symptom of metastatic cancer?

extreme fatigue caused by the extreme burden of having the tumor

21

What is Sister Mary Joseph nodule and what kind of cancer is it typically a sign of?

- large, round, red umbilical mass caused by metastasis of ovarian carcinomas

22

What is a Virchow Node and what is typically responsible for it?

- a supraclavicular lymphadenopathy (usually LEFT-SIDED) often associated with carcinomas in older adults

- seen in ANY thoracic/abdominal/pelvic carcinomas

23

What are clues to determining if a tumor is Primary vs Metastatic?

Primary - solitary, no other cancer diagnosis, unusual met location, typical pt. demographic

Metastatic - multiple tumors, history of cancer, typical mets location, unusual

24

Why are tumor recurrences typically metastatic in nature?

- the primary tumor site initially got the most treatment, but other sites might not have received enough to eliminate their cancer cells completely

25

What are common serum tumor markers of:

1. ovarian cancer
2. myeloma
3. medullary thyroid carcinoma

1. CA-125

2. B2 microglobulin

3. calcitonin

26

What are clues to determining if a tumor is Primary vs Metastatic?

Primary - solitary, no other cancer diagnosis, unusual met location, typical pt. demographic

Metastatic - multiple tumors, history of cancer, typical mets location, unusual

27

Why are tumor recurrences typically metastatic in nature?

- the primary tumor site initially got the most treatment, but other sites might not have received enough to eliminate their cancer cells completely

28

What are common serum tumor markers of:

1. ovarian cancer
2. myeloma
3. medullary thyroid carcinoma

1. CA-125

2. B2 microglobulin

3. calcitonin

29

What are two common features of patients suffering from late metastasis from breast cancer?

- can occur decades later

- pt. has back pain after "definitive" breast cancer therapy (due to osseous metastasis to the spine)

30

What are 4 common cancers that cause Humoral Hypercalcemia of Malignancy (HHM)?

- inc. in PTHrP (parathyroid hormone-related protein)

- squamous carcinomas (any site), and cancers of breast/gastrointestinal/genitourinary tracts