cancer continue

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cancer continue
2014-10-10 17:12:22
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  1. colon rectal test
    • ØDigital
    • Rectal Exam (DRE): start at age 50 years if no identifiable risk factors.
    • Annually to monitor for rectal cancer in men and women.
    • ØFecal Immunochemical Test (FIT):
    • ØFecal Occult Blood Test (FOBT):
    • ØProctosigmoidoscopy: done if DRE, FIT or FOBT are positive.
    • ØColonoscopy: same as above plus will be done if change in bowel pattern.
    • ØDouble contrast barium enema:
    • ØCT colonography(virtual colonoscopy): done every 5-10 years if warranted
  2. Nuclear Med
    • Uses body’s chemistry to show “hot” &
    • “cold” spots. Needs increased fluids after to flush system. Radioactive tracer can be injected, given orally or inhaled.
  3. Positive-emission tomography (PET)
    • Injection or oral intake of a type of
    • radioactive sugar. Shows high metabolic activity. Combination of CT and Nuclear
    • med.
  4. Lymphangiography
    Radioactive dye injected in between toes on each foot. After: inc. fluids, √temp q4hrs x 48hrs, elevate legs, √ bleeding, √CMS
  5. Antigen Skin Test
    • ◦Antigen (dinitrochlorobenzene
    • (DNCB)) applied locally to skin.
    • ◦After 10-14 days check for reaction.
    • ◦If positive reaction (induration & inflammation) person has good immune
    • function.
    • ◦Also used to monitor client receiving immunotherapy to determine response to
    • therapy.
  6. AFP
    increase I pregnant females, tumor marker increased testicular liver ovarian
  7. CEA
    colorectal, breast
  8. PSA
    Inc. in prostatic cancer
  9. Hodgkin’s
    • §Generally presents as regional
    • enlargement of a single group of peripheral lymph nodes
    • §Involves contiguous nodes
    • §Rarely extranodal
    • §Rare type of cancer
  10. Non-Hodgkin’s
    • §Nodal involvement more widely
    • disseminated

    §Involves noncontiguous nodes

    §Extranodal involvement is frequent

    • §5th most
    • common diagnosed cancer in the US
  11. Clinical Manifestations of HD
    • Enlarged painless unicentric (initiates
    • in a single node) lymph node followed by progressive enlargement of other
    • nodes.

    —Pruritis (d/t increased eosinophiles)


    —Fever (B)

    —Low back pain


    • —Unexplained weight loss (›10% of body
    • weight) (B)

    —Nodal pain with ETOH ingestion

    —Drenching night sweats (B)

    • (B) symptoms have prognostic
    • implications. These are found in ~40% of patients and are more common in
    • advanced disease
  12. Clinical Manifestations of NHL
    • Lymphadenopathy most common but can wax
    • and wane

    —33% have (B) symptoms

    • —Depending on where tumors are located can
    • have: hepatosplenomegaly, respiratory distress, renal dysfunction, and gastric
    • complaints.

    • —Typically very little clinical
    • manifestations until disease has advanced to a later stage (III or IV)
  13. BRM’s (Biological Response Modifiers)
    • ◦Interleukins:
    • natural substances produced by lymphocytes and monocytes

    • ◦Interferons:
    • Groups of proteins naturally produced by the body to respond to viral
    • infections.

    • ◦Vaccines:
    • Could be specific or nonspecific
  14. Lymphocytic (ALL)
    •Most common childhood form

    • •Survival rates:85% in children and
    • 40% in adults

    • •At risk for CNS involvement
    • •Treated with combination of Chemo agents and/or BMT

    •Responds better to treatment

    •Anemia common and severe
  15. Myelogenous (AML)
    • •More
    • resistant to treatment

    • •More
    • common in adults over 65 yrs.

    • •Childhood survival rate approx. 50%, less
    • in adults.

    •Treated with chemo and/or BMT.

    •Anemia common and severe
  16. Lymphocytic (CLL)
    • •More
    • common in adults

    • •Clients
    • remain asymptomatic for years

    • •First
    • S/S fatigue and hepatosplenomegaly

    • •Better
    • response if treated early

    • •Anemia
    • common, mild
  17. Myelogenous (CML)
    •Usually asymptomatic

    •First S/S is change in CBC (found by chance)

    •Found to have DNA translocation

    •Lymphadenopathy commonly found

    •Anemia in 50%, mild
  18. non small cell lung cancer
    • Squamous Cell:
    • •20-30% of non-small cell
    • •Central
    • chest
    • Adenocarcinoma:
    • •Outer region of lung
    • •Peripheral masses and nodules
    • •40% of non-small cell
    • Large cell undifferentiated
    • •15% of non-small cell
    • •Most aggressive form of non-small cell
    • •Any part of lung including bronchoalveolar
  19. Small Cell Lung Cancer
    • •Arises
    • in bronchi, spreads to bronchial by infiltration

    • •Has usually metastasized by time of
    • diagnosis

    •Spreads widely through body

    • •Fastest growing & poorest prognosis
    • of all lung cancer