Cancer Prevention, HIV Diagnosis, and Allergies
Primary Cancer Prevention
Definition: Aiming to prevent cancer before it starts.
Key Components:
Healthy lifestyle choices:
Eating a nutritious diet rich in fruits, vegetables, and whole grains.
Avoiding smoking and limiting alcohol consumption.
Limiting exposure to carcinogens:
Reducing contact with chemicals known to cause cancer.
Vaccinations:
Vaccines for viruses associated with cancer, e.g., HPV vaccination.
Secondary Cancer Prevention
Definition: Early detection of cancer to improve outcomes.
Screenings:
Regularly scheduled screenings for early detection of cancer.
Importance of awareness of changing guidelines:
For example, Pap smears used to be conducted yearly for women; now, it's every three years.
Common screenings:
Cervical cancer screenings (Pap smears).
Colon cancer screenings (colonoscopies).
Breast cancer screenings (mammograms).
Prostate cancer screenings (PSA tests).
Note on age:
Cancer risk usually increases with age, leading to more frequent screenings and additional types of screenings.
Tertiary Cancer Prevention
Definition: Prevention of recurrence of cancer or development of a new cancer after treatment.
Focus: For individuals already diagnosed and treated for cancer, ensuring follow-up care and monitoring.
Treatment Options Overview
Treatments categorized into three main types:
Surgery:
Debulking surgery: Removal of a significant portion of the tumor, often combined with chemotherapy or radiation.
Curative surgery: Complete removal of the tumor may lead to a cure without the need for further treatment, depending on the cancer type and stage.
Hormone removal surgery: Common in hormone-sensitive cancers such as breast cancer; may involve removing ovaries to limit estrogen production.
Combination Treatments:
Often, surgery is combined with chemotherapy and/or radiation to enhance effectiveness.
Palliative Care:
Focused on relieving symptoms and improving quality of life, particularly in advanced stages of cancer.
Reconstruction Surgery:
Aesthetic surgeries post-cancer treatment to enhance body image, e.g., breast reconstruction after mastectomy.
Chemotherapy
Administration:
IV Chemotherapy:
Often requires an implantable device like a port-a-cath for easier access and repeated treatments.
Complications and Side Effects:
Bone marrow suppression: Reducing blood cell counts, increasing infection risk.
Anorexia: Loss of appetite.
Alopecia: Hair loss.
Possible effects on reproductive options leading to discussions of sperm/egg banking for future family planning.
Risk of developing secondary cancers, including leukemia due to chemotherapy damage to bone marrow.
Tumor Lysis Syndrome (TLS)
Definition: A condition that occurs when cancer cells lyse (break down) and release their contents into the bloodstream, causing electrolyte imbalances.
Hallmarks:
Hyperkalemia: Elevated potassium levels.
Hyperphosphatemia: Elevated phosphorus levels.
Hypocalcemia: Low calcium levels.
Elevated uric acid: Can lead to gout or kidney stones.
Management:
Hydration to flush out electrolytes and possibly use of diuretics (e.g., furosemide) to help reduce potassium levels.
Radiation Therapy
Types of Radiation:
Internal Radiation (Brachytherapy): Involves placing radioactive sources directly inside or near the tumor, e.g., prostate cancer seeds.
External Radiation: Delivers radiation from outside the body, requiring careful marking of treatment areas.
Safety Precautions:
Patients may need to limit contact with others, especially vulnerable populations (children, pregnant women), for a period after treatment.
Skin Care:
Patients need to manage skin damage from radiation, including wound care and possible impacts on nutrition and swallowing in the irradiated areas.
HIV Overview
Discovery: Identified in 1981 following unusual pneumonia cases.
Transmission: Predominantly through sexual contact and sharing needles; sexual contact accounts for the majority of new diagnoses.
Stages of HIV:
Stage 1: Acute Infection: Initial flu-like symptoms post-exposure.
Stage 2: Chronic Latency: Virus is present but not actively replicating, lasting up to 10 years untreated.
Stage 3: AIDS: Diagnosis made by either a CD4 count below 200 or the presence of AIDS-defining conditions (e.g., certain opportunistic infections or cancers).
Common AIDS-defining Conditions:
Pneumocystis pneumonia (fungal): Often leads to severe infections in immunocompromised individuals.
Kaposi sarcoma: A cancer often presenting as purple lesions, characteristic of AIDS.
HIV Treatment
ART (Antiretroviral Therapy): No cure exists, but treatment allows individuals to live longer, healthier lives by maintaining a low viral load and improving immune function.
Viral Load Monitoring: Ongoing testing to determine treatment efficacy and adjust as necessary.
Pre-Exposure Prophylaxis (PrEP): Daily medication for individuals at high risk for HIV to prevent infection.
Post-Exposure Prophylaxis (PEP): Emergency medication taken after potential HIV exposure, effective only within 72 hours.
Allergies and Hypersensitivity
Types of Hypersensitivities:
Type I (IgE-mediated): Includes most common allergies (like food allergies); has the potential for anaphylaxis, a severe systemic reaction.
Type II: Hemolytic anemia; involves blood cell destruction, typically rare.
Type III: Involves autoimmune diseases.
Type IV (Delayed): Occurs hours to days post-exposure (e.g., poison ivy).
Anaphylaxis: A life-threatening allergic reaction leading to severe hypotension and airway edema.
Management: Immediate administration of epinephrine; follow-up with antihistamines, corticosteroids, and supportive care (oxygen and IV fluids).
Rheumatoid Arthritis (RA)
Definition: A chronic autoimmune disease causing inflammation in the joints, leading to pain, swelling, stiffness, and potential joint damage and deformity.
Characteristics:
Typically affects smaller joints (hands, feet) symmetrically.
Can also affect other organ systems (skin, eyes, lungs, heart).
Often involves periods of flares and remission.
Systemic Lupus Erythematosus (SLE Lupus)
Definition: A chronic autoimmune disease that can affect various parts of the body, including joints, skin, kidneys, blood cells, brain, heart, and lungs.
Hallmarks:
Characterized by inflammation and tissue damage caused by the body's own immune system.
Wide range of symptoms, including fatigue, joint pain, skin rashes (e.g., butterfly rash across the face), and kidney problems.
Highly variable in its presentation and severity among individuals.