Tumors and Cancer - NCLEX-PN

Approximately 60% of patients diagnosed with Lambert-Eaton syndrome have an underlying cancer, most often small cell lung cancer. Lambert-Eaton syndrome is an autoimmune disorder in which the release of neurotransmitter is not permitted due to antibodies against the presynaptic calcium channels. This results in muscle weakness in the limbs. The other conditions listed are not associated with any respiratory cancers.

Helicobacter pylori is present in the stomach of 60% of individuals with gastric cancer. Cancer in these cases may be caused by chronic inflammation at the site of infection, resulting in metaplasia.

Staphylococcus aureus, Salmonella enterica, and Escherichia coli are all common causes of gastroenteritis but are not associated with malignancy.

Smoking, obesity, and high blood pressure are among the most common risk factors for development of renal cell carcinoma. Other risk factors include genetic susceptibility, diuretic use, and male gender. Alcohol consumption has not been associated with increased rates of renal cell cancer.

Renal cell carcinoma can cause hypercalcemia, due to secretion of PTHrP (parathyroid hormone-related protein).

SIADH and Lambert-Eaton myasthenic syndrome are both associated with small-cell lung cancer, while polymyositis is associated with non-Hodgkin lymphoma.

Multiple myeloma is caused by metaplasia of plasma cells. No other white blood cell type is typically metaplastic, though abnormal plasma cell accumulation in bone marrow does interfere with the synthesis of all other blood cell types.

Hepatocellular carcinoma is associated with exposure to aflatoxin, from Aspergillus species, which can be found in many foods. Most commonly contaminated foods are corn, peanuts (and peanut butter), pistachios, brazil nuts, chillies, black pepper, dried fruit, and figs.

Asbestos is linked to mesothelioma, organophosphate exposure is linked to leukemia, and lead exposure has not been directly associated with any increase in malignancy, although current studies are pending further evidence.

Carcinogens cause cancer by making changes to the host's DNA. They can be chemical (ex. pharmaceutical drugs), or viral (ex. Epstein-Barr). Additionally, exposure to radiation has also been known to damage DNA and is another form of a carcinogen.

Hair loss can be alarming if large amounts of hair are seen in linens. Shampooing, brushing, heat tools, and hair dyes can increase fallout. The nurse should welcome healthy discussion about self esteem if appropriate.

Thrombocytopenia occurs when the blood does not have a high enough platelet count. Slow clotting blood, increased bruising, or petechiae can all point to thrombocytopenia.

Anemia is a condition caused the the deficiency of healthy red blood cells in the blood stream. This results in lack of sufficient oxygen delivery to tissues.

All of the above are proven risk factors with the exception of mouthwash use. Poor dental care, prolonged present irritation (such as excessive flossing), tobacco and alcohol use, infection with certain strains of HPV, and an unbalanced diet can increase the risk of oral cancer.

EBV infection is common in Burkitt lymphoma. In malaria-endemic areas, it is thought that the cancer is actually caused by chronic malarial infection increasing a person's susceptibility to chronic EBV infection. The same is assumed about HIV co-infection with EBV in the United States.

None of the other infections listed are associated with Burkitt lymphoma.

90% of medulloblastomas are in pediatric patients. It is the tumor type in 14.5% of primary brain malignancies of childhood and adolescence. Glioblastoma is the most common type of brain tumor in adults and accounts for 52% of all primary brain tumors. Meningiomas are also fairly common in adult populations, accounting for 34% of primary brain tumors. Juvenile pilocytic astrocytoma is a brain tumor of childhood but only accounts for 2% of cases.

Actinic keratosis occasionally develops into squamous cell carcinoma and is generally removed prophylactically. Actinic keratosis is not associated with development of any of the other skin cancer types listed.

Small cell carcinoma (also called oat cell cancer) makes up 15% of lung cancers and almost always presents in patients with a history of cigarette smoking.

Adenocarcinoma is the most common type of lung cancer in patients who have never smoked. Mesothelioma is most commonly caused by asbestos exposure, while bronchial carcinoids are often of unknown etiology.

Paget's disease of the breast will often present as itchy, scaling, cracked, red lesions around the nipple. The other conditions mentioned are all forms of breast cancer, but all of them originate in tissues deeper to the breast and will generally present without a visible rash, though some skin changes such as redness or dimpling may occur.

A fibroma is considered a benign fibrous tissue tumor. The other tumor types are all malignant.

The most common soft tissue tumor in children is rhabdomyosarcoma. This generally presents on the face, neck, or extremities, with nearly one-third of cases presenting with orbital involvement. 90% of all cases of rhabdomyosarcoma are seen in children, most often seen in children under 10 years of age. Leiomyosarcoma, epithelioid sarcoma, and desmoid tumors are all relatively rare soft tissue tumors of childhood.

The incidence of cancer-linked genes can increase an individual's risk of developing cancer. However, their absence does not guarantee that the individual will not develop cancers of any kind.

A papanicolaou test (pap smear) may be preformed routinely on adult women as a screening for cervical cancer. A rapid antigen detection test (rapid strep test), urine analysis, cervical cerclage, or vaginal ultrasound would not be part of routine screening.