Lecture Notes: Oncology and Hematology Overview

Introduction

• Rough overview of oncology-related questions on exams.
• Focus on patient management rather than basic pathophysiology.

Cancer Overview

• Malignant disorders: Abnormal cell proliferation, genetic component, potential for metastasis.
• Benign vs. Malignant: Benign tumors are non-cancerous and do not invade other tissues.
• Stages of Cancer
  • Initiation: DNA damage and permanent mutation.
  • Promotion: Introduction of carcinogens causing reversible or irreversible damage.
  • Progression: Tumor becomes invasive and metastatic.

Metastatic Cancer

• Common sites: Bone, lung, liver, central nervous system.
• Causes
  • Radiation, chemical carcinogens, genetic factors, dietary factors, hormonal agents (e.g., estrogen therapy).
• Examples: Breast cancer, colon cancer, prostate cancer.

Risk Factors for Cancer

• Age, family history, lifestyle choices (e.g., smoking, alcohol consumption), occupational exposure to carcinogens.

Cancer Prevention and Screening

• Primary Prevention: Reducing risk factors, education on lifestyle changes.
• Secondary Prevention: Screening for early detection (e.g., self exams, mammograms, colonoscopies).
• Tertiary Prevention: Post-diagnosis care to keep patients as healthy as possible, education on treatment options.

Diagnosis and Staging

• Methods: Biopsy (incisional, excisional, needle aspiration).
• Staging Systems: TNM (tumor, node, metastasis) and grading systems.
• Goal of Therapy: Cure, control, palliation.

Cancer Treatment

• Surgery: Diagnostic, primary treatment, prophylactic, palliative, reconstructive.
• Radiation Therapy
  • Can cure, control, or palliate cancer.
  • Side effects: Skin integrity issues, myelosuppression, organ toxicity.
• Chemotherapy
  • Side effects: Immunosuppression, nausea, cognitive impairment.
  • Management: Symptom control, patient education.
• Bone Marrow Transplant
  • Types: Autologous, allogeneic, syngeneic.
  • Risks: Graft vs. host disease, pancytopenia.

Nursing Management

• Post-Surgery: Monitor for hemorrhage, infection, patient education on risks.
• Patient Support: Emotional support, therapeutic communication, pain management.
• Handling Medication: Proper administration of antibiotics, chemotherapy, monitoring side effects.

Oncological Emergencies

• Tumor Lysis Syndrome: Breakdown of tumor cells leading to electrolyte imbalances, potential for cardiac arrest.
• Superior Vena Cava Syndrome: Obstruction of SVC causing swelling, respiratory issues, treated with radiation or chemo.
• Spinal Cord Compression: Loss of motor/sensory function, treated with steroids, radiation.
• Hypercalcemia: High calcium levels, managed with hydration, drugs to lower calcium.

Types of Leukemia

• Acute Myeloid Leukemia (AML): Common in adults, involves myeloid stem cells.
• Chronic Myeloid Leukemia (CML): Chronic condition mainly affecting adults.
• Acute Lymphoblastic Leukemia (ALL): Common in children but can affect adults.
• Chronic Lymphocytic Leukemia (CLL): Common chronic leukemia in adults.

Lymphoma

• Hodgkin Lymphoma: Predictable spread, high cure rate, symptoms include painless lymph node enlargement.
• Non-Hodgkin Lymphoma: Unpredictable spread, risk of tumor lysis syndrome.

Miscellaneous Conditions

• Polycythemia Vera: Overproduction of erythrocytes, risk for clots, and bleeding.
• Multiple Myeloma: Malignant disease of B lymphocytes, increased risk with age and previous radiation exposure.

Examinations and Review

• Handle exam questions by focusing on the scenario and symptoms.
• Prioritize based on emergency signs like airway issues and infection.

Conclusion

• Study and understand the management and emergency responses related to these oncological and hematological conditions.