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Cancer grade and stage grading; classifies cellular aspects of a cancer. Staging; classifies clinical aspects of the cancer. 12. Histologic class i - well differentiated ii - moderate differentiation iii - poor differentiation iv - immature & undifferentiated 13. Clinical staging o - ca in situ i (a) - localized growth ii (b) - limited local growth iii (c) - extensive local and regional growth iv (d) - metastasis 14. Tnm classification t - primary tumor n - regional lymph nodes m - distant metastasis tis no mo t4 n3 m1 15. Goal education and early detection c a u t i o n 16. Surgical interventions biopsy cure control - debulking palliative staging reconstructive prophylaxis 17. Radiation destroys cells, causes inflammatory response side effects goals: cure control palliative radiation recall external implants isotopes 18. Chemotherapy cell cycle non-specific alkylating –cytoxan, leukeran, n. Mustard antitumor antibiotics - adriamycin nitrosoureas –carmustine, hydrourea corticosteroids –prednisone, decadron hormones –estrogen, provera, androgen cell cycle specific antimetabolities –methotrexate, 5-fu plant alkaloids (miotic inhibitors) –vinblastine, vincristine cisplatin tamoxifen 19. Synergistic effect the total is greater than the individual parts each agent has: action against cancer different site of action different organ toxicity or time of toxicity 20. Mopp protocol 21. Side effects cluster the common ones: bone marrow suppression alopecia nausea and vomiting adriamycin - cardiac cisplatin – renal 22. Complications pain control bone marrow suppression infection - neutropenia hemorrhage anemia infarction superior vena cava syndrome spinal cord compression tumor lysis syndrome 23. Common problems/complications associated with cancer tumor lysis syndrome (tls); destruction of cells (lysis) release of purine and potassium (k+) into bloodstream purines converted to uric acid (in liver) k+ into bloodstream hyperuricemia hyperkalemia obstruction of kidney tubules arf 24. Paraneoplastic syndromes secretion of insulin secretion of acth hypercalcemia siadh 25. viagra online cheap generic viagra buy generic viagra cheap generic viagra viagra online cheap viagra cheap viagra online buy cheap viagra buy viagra online Siadh - syndrome of inappropriate adh adh release water reabsorption into circulation -renal tubules extravascular fluid plasma osmolality glomerular filtration rate serum sodium levels cerebral edema 26. Leukemia aml - acute myelogenous age of onset (15-39 yrs), usually affects adults prognosis is generally poor, best with bone marrow transplant most common type of leukemia equal incidence in males and females all - acute lymphocytic age of onset (<15 yrs), usually affects children, accounts for approx 10% of adult leukemia's prognosis is poorer for adults than for children fever & bleeding increased incidence in males 27. Leukemia cml - chronic myelogenous age of onset (>50 yrs) involves liver & spleen blastic crisis cll - chronic lymphocytic older patients – over 50 lymph node involvement 28. Lymphoma lymph system ly.




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