Pediatric Oncology

What is a group of chronic diseases characterized by uncontrolled growth and spread of abnormal cells, which, if not adequately treated, results in the death of the patient?

cancer

What are the causes of cancer?

unknowns, EBV, HPV, genetic links

What class of cancer is cancer of the blood and cancer of the immune system?

hematologic malignancies

What class of cancer is cancer of the bone, organs, or tissues?

solid tumors (sarcomas)

What lab work is needed to diagnose cancer?

CBC and chemistries

What tests and procedures are needed to diagnose cancer?

biopsy, bone marrow aspirate, LP, bone scan, CT scan

What are common types of hematologic cancer?

leukemia and lymphoma

What are common types of solid tumors?

Wilms tumor, rhabdomyosarcoma, retinoblastoma, osteosarcoma, Ewing’s sarcoma, neuroblastoma, CNS tumors

What is a malignancy of bone marrow or blood-forming tissues, where blasts are immature, and is the most common type of childhood cancer?

leukemias

What are the types of leukemias?

ALL and AML

What is a genetic predisposition for leukemia?

down syndrome

What type of cancer is when cells don’t work properly to protect the body and crowd the healthy cells of the immune system, and may involve any subpopulation of lymphoid cells?

lymphoma

What are the types of lymohomas?

hodgkins (EBV) and non-hodgkins

What lymph nodes are usually affected in lymphoma?

epitrochlear (elbow) and supraclavicular

What type of tumor is characterized by a malignant renal tumor or intrabdominal tumor, which is a non-tender, firm flank mass not crossing midline, in a healthy-appearing child and is associated with other GU abnormalities?

Wilms Tumor

What nursing consideration is needed with a Wilms Tumor?

do not palpate abdomen

What tumor is a malignant tumor of embryonic mesenchyme?

rhabdomyosarcoma

What are the 2 types of rhabdomyosarcoma?

embryonal and alveolar

What type of rhabdomyosarcoma is characterized by appearing in the orbit, head/neck, and GU system, and is most common in younger children?

embryonal

What type of rhabdomyosarcoma is characterized by appearing in the arms and legs, and is most common in adolescents?

alveolar

What cancer is characterized by immature retinoblasts changing to cancer cells due to a mutation of the RB1 gene, which may increase a child’s risk of developing other cancers later in life?

retinoblastoma

What type of bone malignancy is characterized by bone-forming mesenchyme in the metaphysis of long bones and femur?

osteosarcoma

What type of bone malignancy is characterized by a tumor in the marrow space of the shaft of long bones, pelvis, or chest wall with soft tissue involvement?

ewing sarcoma

What tumors arises from the neural crest?

neuroblastoma

What type of tumors are the most common cause of childhood cancer?

cranial tumors

What type of cranial tumor arises from normal cells within the brain and can be benign or malignant?

primary

What type of cranial tumor originates outside the CNS and is always malignant?

secondary

Why have improved imaging and techniques helped with cranial tumors?

increased diagnosis, improved surgical procedures, greater degree of resection, radiation/chem innovation

What are the challenges with cranial tumors?

blood brain barrier, surgical inaccessibility

What treatment is used for cancer?

chemotherapy, surgery, radiation, bone marrow transplant, immunotherapy

What is a procedure that kills rapidly diving cells?

chemotherapy

What type of chemo is when 2 or more agents have greater response than one alone because they act in different phases of the cell cycle?

combination therapy

What is chemo administered through?

central line

What are the general side effect of chemo?

hematopoietic, hypersensitivity, neurologic, cardiopulmonary, reproductive, GU, integumentary, GI

What are precautions when administering chemo?

vesicant, anaphylaxis, education, and specialized training

How do you decide what type of line a child needs for chemo?

length of treatment