Exam II contemporary cancer

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darbydo88
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46621
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Exam II contemporary cancer
Updated:
2010-11-01 20:46:56
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Contemporary
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cancer
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  1. abnormal and unrestricted growth of cells that can invade and destroy normal body tissues
    neoplasm
  2. usually circumscribed and encapsulated, slow growing, cells resemble tissue where it arises
    benign
  3. infiltrates locally, and has potential to spread (metastasize), cells atypical or dysplastic and may not resemble parent tissue
    malignant (neoplasm or cancer)
  4. how are cancers classified? (2)
    • origin of tissue involved(carcinomas from epithelial tisssu, and sarcomas from connective tissue
    • type of cell (epithelial or connective)`
  5. a succinct, standardized description of a tumor based on origin and spread
    made of 3 components (name them)
    • staging
    • T (tumor size)
    • N (presence or absence of lymph nodes)
    • M (presence or absence of distant metastases)
  6. second leading cause of death in US for those under 85
    Cancer
  7. Factors of survival for cancer
    • Location and size of tumor
    • Type of cancer
    • presence of distant metastasis
    • Tumor sensativity
    • physical condition/age of the patient
  8. Risk factors for cancer
    • Tobacco
    • alcohol
    • sunlight
    • environmental/occupational
    • viruses
    • socioeconomic (lack of medical care)
  9. determining factors for treating cancer
    location and size of tumor
  10. treatment objectives
    • cure
    • control
    • palliation
  11. treatment approaches
    • surgery
    • chemotherapy
    • radioation therapy
    • hematopoietic cell trasmplantation (blood)
    • hormone therapy
    • vaccine therapy
    • biotherapy
    • combination of two or more approaches
  12. most common treatment for solid tumors (malignant and non malignant)
    surgery
  13. indication for surgery
    • location and size of tumor (small and localized)
    • intial therapy prior to chemotherapy or radiation therapy
    • palliation
  14. objectives of chemotherapy
    • destroy cancer cell
    • prevent recurrence,
    • improve quality of life
  15. Indications for chemotherapy
    • eliminate a localized tumor too large for surgical removal
    • treat cancer that has metastasized to other parts of the body
    • prevent cancer recurrence with maintenance therapy
    • use prior to surgery to make a tumor easier to remove completely
    • extend life when no chance of a cure is possible (palliation)
  16. Syde effects of chemotherapy
    • alopecia
    • mylosupression
    • immunosupression
    • nausea, vomiting, diarrhea
    • loss of appetite
    • gastrointestinal mucositis
  17. Oral complications of chemotherapy
    • oral mucositis/stomatitis
    • xerostomia
    • infections (bacterial, fungual, viral)
    • bleeding
    • neurotoxicity
    • altered tooth development (drugs before age 10)
  18. ionizing radiation impact cell's ability to replicate and survive
    readiation therapy
  19. indications for radiation therapy
    • small localized radiosensitive tumors
    • shrink tumore before surgery
    • assist chemotherapy concurrently
    • prevent metastaisi
    • prevent recurrence
    • palliation therapy
  20. systemic side effects of radiation
    • skin reactions (simmilar to bad sunburn)
    • fatigue
    • gastric upset (nausea, vomiting, constipation, diarrhea)`
  21. oral complications of Radiation
    • oral mucositis or stomatitis
    • xerostomia
    • radiation caries
    • taste loss
    • infeciton (bacterial, viral, fungal)
    • trismus
    • osteoradionecrosis
  22. radiation causing the bone to be destroyed
    osteoradionecrosis
  23. used to treat blood disorders such as leukemia. Substitutes blood stem cells or bone marrow from a healthy and compatible source
    hematopoietic cell transplantation
  24. types of transplants
    • autologous (self)
    • unrelated (any matched donor)
    • allogeneic (siblings)
    • haploidentical (parent)
    • syngeneic (identical twin)
  25. how long is immune recovery
    3-12 months
  26. how long is long term recovery
    1-3 years
  27. the donor's T lymphocytes see the host cell antigens as foreign and react against the host tissue
    acute-graft-versus-host disease (acute GVHD)
  28. Symptoms of Acute GVHD
    • present during the first 100 days
    • painful red skin rash starting on the palms of hands and soles of feet and progressing to the upper trunk
    • sever, persistent diarrhea
    • jaundice, elevated liver enzymes, liver tenderness
  29. Infections of Acute GVHD
    • Bacterial
    • viral: herpes simlex, varicella zoster, cytomegalovirus
    • fungal: candida albicans
  30. Organ complications associated with Acute GVHD
    • gastrointestinal
    • hepatic
    • cardiac
    • pulmonary
    • hematologic
    • neurologic
  31. oral complications w acute GVHD
    • oral mucositis: sever (appears 10-14 days psot-transplant)
    • xerostomia
    • viral and fungal infections (herpes simplex virus and candida albicans)
  32. Chronic complications of transplants
    Chronic-graft-versus-host disease (chronic GVHD)
  33. Which organs does Chronic HVGD affect
    All
  34. appears up to...years psttransplant
    2
  35. oral complications of chronic HVGD
    • mucositis
    • oral infection/periodontal infection
    • xerostomia/dental caries
    • poor oral hygiene
  36. dental hygiene care plan
    • assess
    • eliminate disease
    • preventive oral care instruction
  37. Personal factors in Dental care plan
    • encourage patient to bring friend/family to take notes
    • provide written instructions
    • provide positive reinforcement
    • show acceptance
    • practice active listening skills
  38. pretreatment therapy
    intensive personal oral care prior to theray to reduce risk of oral complication
  39. Pre-treatment guidelines for cancer therapy patients
    • conduct a pretratment oral health assessment
    • schedule a DH treatment in consultation with the oncologist
    • perform DH treatment prior to cancer treatment
    • evalutate patient's oral health knowledge and provide oral hygiene regimen based on the cancer therapy being received
    • ANTICIPATORY GUIDANCE
  40. prevent tooth demineralization and dental caries
    • recommend daily application fo flouride gel at home (perscription strength)
    • demonstrate application of a 1.1% neutral pH sodium fluride gel or .4% stannous unflavored gel
  41. what kind of sodum flouride should be used on porcelain crowns or glass or resin ionomer restorations
    nautral pH
  42. how long do you leave the tray on?
    5 min..dont eat for 30 min after
  43. During radiation how often should these be done..biofilm removal? trays? exercising for trismus?
    • 2X daily
    • 1x daily
    • 3x daily open and close 20 times
  44. After radiation therapy how often should you recall the patient?
    every 4-8 weeks for the first 6 months
  45. DH job during chemotherapy
    • consult oncologist
    • postpone clinical services
    • antibiotic premedication
  46. DH job after chemotherapy
    • place patient on a DH maintenance schedule when all side-effects are resolved
    • get patient's release
  47. DH job after hematopoietic cell transplantation
    • monitor patient's oral health (may have oral infections)
    • consult iwth oncologist prior to clinical procedures
    • delay elective procedures
    • follow patient for longterm oral complications
  48. Special care for children
    • extract loose primary teeth
    • remove orthodontic bands/brackets
    • monitor craniofacial/dental structures
    • perform routine daily personal oral care
    • avoid cariogenic foods/drinks

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