Oncology

prognosis of cancer

incidence is steady and the deaths are declining (people with cancer are living longer)

neoplasia

new growth that is uncoordinated, more autonomous, and less regulated

abnormal growth caused by an external stimulus

hyperplasia and hypertrophy

hyperplasia

increase in the number of cells

metaplasia

abnormal replacement of cells with another type of cells

types of abnormal cell growth that are not replaceable

dysplasia, anaplasia, neoplasia

dysplasia

presence of abnormal cells that may become cancerous

anaplasia

severe dysplasia where the cells are more disorganized, undifferentiated and growing

how are cancer cells "immortal"

abnormally long telomeres that do not shorten

characteristics of cell division

different cells will be at different stages within the same tissue

when are cells more susceptible to treatment

right before or during division

symptoms of cancer

tissue structural problems, wasting/weakening, decreased immune response, paraneoplastic syndrome, pain

staging and grading of tumors

T(tumor), N(nodes), M(metastasis)

types of imaging to see cancer

ultrasound, xray, MRI, CT, PET

what is seen in cancer imaging

cell type, structure, properties, characteristics, behavior and metabolism

purpose of imaging for cancer

distinguish cancer from normal tissue to grade, stage, and track it

lab values for cancer

CBC, BMP, organ function

purpose of tissue biopsies

to see if there is still some tumor left where it was removed

modalities for surgical interventions

surgery, radiation, chemo, targeted therapies, bone marrow transplant

purpose of debulking a tumor

puts the tumor in a more vulnerable state (division) so we can intervene better

purpose of surgery

preventative, palliatively, curative, exploratory, support of other approaches (neoadjuvant)

purpose of radiation

curative, shrink the tumor for other approaches, disrupt DNA to prevent mitosis

types of radiation

external beam, internal radiation emitting seeds, IV infusions

acute radiation side effects

fatigue, redness, ulcers, fibrosis, impaired circulation, hair loss

chronic radiation side effects

fertility concerns, secondary cancers, bone necrosis, emotional reactions

benefit of multiple radiation beams

allows for the same energy but has less effect on the healthy tissue

characteristics of photon therapy

x ray or gamma rays that extend a beam of energy past the target

characteristics of proton therapy

protons focused on a point while minimizing release to surrounding tissues, no exit dose beyond target

purpose of chemotherapy

used for blood cancers, prevent mitosis, adjuvant with radiation and surgery

how is a chemotherapy agent selected

account for other comorbidities, drug interactions, concurrent therapy, cost

side effects of chemotherapy

myelosuppression, cardiac toxicity, neuropathy, pulmonary fibrosis, alopecia, cognitive impact

chemotherapy supportive care

anti-emetics, transfusions, RBC/WBC support, analgesics

side effects of hormone and immunotherapy

anorexia, fatigue, dyspnea, fluid retention, pulmonary edema

hematologic complications from cancer treatment

neutropenia, thrombocytopenia, anemia

types of cancer that spread to bones

prostate, breast, lung, renal, thyroid, multiple myeloma

population of bone cancer

more common in kids

common sites of bone cancer

vertebral bodies, pelvis, femur, ribs

types of lesions caused by bone cancer

lytic (holes) and sclerotic (increased density)

PT concerns for bone cancer

decreased WB, minimize twisting, gentle AROM preferred over PROM, long bone pain not changing with activity

predictor of 10-year survival in breast cancer

amount of lymph node involvement near initial tumor site

breast cancer treatments

mastectomy, node dissection, anti-estrogen hormone therapy

effects of anti-estrogen hormone therapy

acceleration of menopause, fluid retention, weakened muscles/ligaments/tendons

complications of breast cancer treatment

lymphedema, vulnerable to infection, vulnerable to trauma