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oncologylecture
lymphomas/breast/cervical
| Question | Answer |
|---|---|
| what are risk factors of hodgkin's lymphoma? | mono/EBV,immunodeficiency syndromes, immunosuppressant tx post transplants,tonsillectomy,appendendectomy,delayed exposure to infection |
| what are risk factors of non-hodgkin's lymphoma? | AA,immunodeficiency,organ transplant,autoimmune d/o,EBV,hx of CA w/radiation,malaria,kaposis's sarcoma,h.pylori,exposure to nuclear explosion,pesticides/herbicides,creosote/lead/formaldehyde |
| What are the clinical manifestations of hodgkin's lymphoma? | asymptomatic/lymph node swelling in neck/chest/mediastinum,unicentric(arises from single group of lymph nodes),spreads to adjacent lymph nodes,nodes=painless,rubbery,cough&dyspnea w/mediastinal involvement,SVCS, |
| What are common manifestations of hodgkin's lymphoma? ie. s&s | wt. loss,fever,malaise,night sweats,pruritis,painless lymphadenopathy,*etoh induced pain-different from non-hodgkin's lymphoma |
| What are the clinical manifestations of non-hodgkin's lymphoma? | involves malignant B-cells,multicentric(involves more than 1 group of nodes),GI problems w/abdominal nodes involved(ie.bleeding, bowel obstruction,back/ab pain,jaundice,ascites,spinal cord compression,ureteral obstruction),bone marrow depression |
| What are common manifestations of non-hodgkin's lymphoma? ie. s&s | wt. loss,fever,malaise,night sweats,pruritis,painless lymphadenopathy |
| At what age is non-hodgkin's and hodgkin's lymphoma more prevelant? | Hodgkin's=15-40 yearsNon-hodgkin's=>60years |
| What is lymphoma? | Malignant tumor that arises from the lymphatic system and can be spread to other organs, may be classified as hogkin's or non-hodgkins; 9th most common cancer |
| How are lymphoma's diagnosed? | r/o infection as source of lymph node involvement;labs-anemia,leukocytosis,increased sed.rate,thrombocytopenia,increased alkaline phosphotase;cxr,ct of chest/ab/pelvis;BM biopsy;poss. lymphangiogram;lymph node biopsy (reed sternberg cells=dx of hodgkin's) |
| what is the treatment for hodgkin's lymphoma? | chemo=main tx=MOPP, ABVD;radiation,stem cell transplant(rare),monoclonal antibody therapy (rituximab) |
| What is the treatment for non-hodgkin's lymphoma? | chemo=main tx=CHOP,COP;radiation,stem cell transplant(rare),monoclonal antibody therapy (rituximab) |
| Management of treatment related side effects (Chemo) | BM suppression (neutropenia=worse 7-14 days post chemo;monitor for s&s of infection,anemia (epogen/procrit),platelet transfusion,leukopenia(neupogen);*fatigue*;N/V(zofran);alopecia;stomatitis/mucositis;peripheral neuropathies(safety issues, ie.mobility) |
| Management of treatment related side effects(radiation) | skin care (ie.dry/moist desquamation,nonperfumed lotion/soap/deoderant,avoid sun x1year);post radiation pneumonitis-cough(chest);diarrhea(ab),sterility(pelvis);thyroid dysfunction(mantle field);also avoid pregnancy,secondary malignancies |
| Risks for developing Ovarian Cancer | unknown etiology;risks->40yearsold, usually postmenopausal women,genetics(>risk if primary relative had);personal hx of breast CA or uterine CA;single/nulliparous &infertile;early menarche &late menopause;diabetics;decreased risk w/oral contraceptive use |
| Prevention/screening/detection of ovarian cancer | annual pelvic exams (look for adnexal mass,vague ab complaints in middle age);tumor markers=nonspecific(elevated AFP,CEA,CA-125*breast/ovarian);No specific test=teach early detection/report and s&s/yearly screening |
| Clinical manifestations of ovarian cancer | most not detected until symptoms present=usually advanced stage;early-vague GI symptoms(dyspepsia,indigestion,anorexia&early satiety);late-pressure on rectum/bladder,increased girth,sob,pain,intestinal or urteral obstruction,muscle wasting |
| Diagnosis and staging for ovarian cancer | transvaginal US (if at risk or diagnostic);CBC, chemistries, CA-125,CXR,cystoscopy,proctoscopy,IVP,barium enema,CT/MRI;exploratory laparotomy debulking(staging done,biopsies of pelvic organs/diaphragm/lymph nodes,oophrectomy) |
| treatment for ovarian cancer | surgical removal of ovaries(oophrectomy) or total hysterectomy;radiation;chemo(cisplatin&cyclophosphamide),liposomal therapy(doxorubicin enclosed in phoslipid layer-better penetration of tumor,used after primary tx failed |
| Risk factors for breast cancer | 1in8 women will develop,unknown etiology;risks-sex,>40years,AA,personal hx of breast ca,family hx/genetics,single/nulliparous,early menarche/late menopause,benign breast disease,obesity,radiation exposure,exogenous hormones,etoh;BF=decreased chances |
| Prevention/Screening/Detection of Breast cancer | goal of healthy people 2010=increase access/adherence to guidelines; screening-BSE,clinical breast exam,mammography(yearly starting at 40years);palpable lesion=1cm&usually 8years old; |
| Classifications of breast cancer | non-invasive or carcinoma in situ (remains in mammary ducts);invasive (penetrates tissue of surrounding ducts);inflammatory(skin thickening,swollen breast,redness/heat,p'eau d'orange skin) |
| Clinical manifestations of breast cancer | *hard/irregular/nontender mass,p'eau d'orange skin,skin dimpling,inverted or retracted nipples,ulceration of underlying skin |
| Diagnosis and staging for breast cancer | mammogram,US,biopsy;common sites of metastasis-bone,lung,pleura,liver,adrenals,brain |
| Treatment for breast cancer | surgery-lumpectomy(almost always followed by 6wk of radiation), |
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