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diagnostic tests for cancer
- used to ID source of cancer, determine if metastasized, and stage of cancer
- blood work - CBC, electrolytes, liver function tests, absolute neutrophil count (# of neutrophils actually doing work)
- bone marrow aspiration/biopsy
- lumbar puncture - to look for abnormal cancers in spinal fluid
- tumor biopsy - may also be used to remove or debulk a tumor
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tx of cancer - surgery
- remove/debulk tumor
- determine stage and type
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tx of cancer - chemo
- kills good and bad cells
- timed with cell cycle for max destruction
- different drugs work on different phases of cell growth
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tx of cancer - radiation
- energy destroys DNA and cell
- may be curative or palliative
- used for local and regional control of cancer
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tx of cancer - biotherapy
- use parts of the body already programmed to destroy cells to target cancer cells
- tumor necrosis factor
- HPV vaccine to help fight ovarian cancer
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tx of cancer - bone marrow/stem cell transplant
- kill cancer with chemo or radiation then resupply body with stem cells
- uses own bone marrow, donor marrow, umbilical cord blood
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clinical manifestations of cancer
- pain - direct or indirect
- cachexia
- anemia
- bruising
- neuro symptoms - increased ICP, eye abnormalities
- palpable mass
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metabolic emergency - tumor lysis syndrome
- lysis of tumor cells
- results in release of uric acid, potassium, phosphate, calcium(decreased levels)
- serum sodium levels may decrease
- most common in Burkitt's lymphoma and acute lymphocytic leukemia
- tx - vigorous hydration, monitor I&Os for oliguria, monitor for altered LOC, give allopurinol to breakdown uric acid
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metabolic emergency - septic shock
- risk factor - immunosuppression
- tx - cultures then abx
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metabolic emergency - hypercalcemia
occurs when bone is destroyed and releases calcium
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hematologic emergency - bone marrow suppression
- results in anemia and thrombocytopenia then hemorrhage occurs (GI bleeding, stroke, DIC)
- tx - platelets and packed RBCs
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hematologic emergency - hyperleukocytosis
- high # of leukemic blast cells
- infiltrate and obstruction in small blood vessels
- tx - allopurinol, hydration, bicarbonate infusion
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space occupying lesions
- rapid tumor growth may cause spinal cord compression, increased ICP, brain herniation, seizures, heptamegaly, vena cava syndrome
- tx - decrease size, radiation, chemo, corticosteroids
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clinical manifestations brain tumors
- HA
- N/V
- irritable and dizzy
- trunca ataxia - can't walk straight
- change in vision or hearing
- fatigue
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brain tumor tx
- depends on type
- radiation - not used for kids under 3
- chemo - intrathecally d/t blood brain barrier
- pain meds
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neuroblastoma
- smooth, hard, nontender mass
- occurs anywhere along sympathetic nervous system chain
- abd, thoracic area, adrenal area, cervical area
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clinical manifestations of neuroblastoma
- retroperitoneal mass - altered bowel or bladder function, weight loss, abd distention, enlarged liver
- mediastinal mass - dyspnea, infection
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tx of neuroblastoma
- surgical removal of mass
- then chemo - multiple drugs used
- radiation often used when not responsive to chemo
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