Selected Cancer Problems
| Subjective Data | Objective Data | Risk Factors | Annual Incidence | Specific Treatment | |
|---|---|---|---|---|---|
| ENDOCRINE | |||||
| Thyroid cancer | Painless nodule; dysphagia; difficulty breathing | Enlarged thyroid , thyroid nodule; thyroid lymph nodes; hoarseness; hypofunctional nodule seen on isotopic imaging scanning; needle biopsy for cytology studies | Radiation exposure on childhood | 18,100 new cases; 1200 estimated deaths | Surgery: total thyroidectomy, possible radical neck dissection Radiation: external, or radio active iodine Chemotherapy: chlorambucil, doxorubicin, vincristine (Leukeran, adriamycin, Oncovin, respectively) |
| BLOOD AND LYMPH TISSUES | |||||
| Hodgkin’s Disease | Fatigue; generalized pruritis; anorexia | Painless enlargement of lymph nodes, especially in cervical area; fever; night sweats; hepatosplenomegaly; anemia; peak age of incidence, 15 - 35; diagnostic test - biopsy shows of presence Reed - sternberg cells; x-rays, scans, laparotomy | For young adults 15 - 35 years old, not clearly defined, some relationship to socioeconomic status, men - women ratio is 1.5:1; increased frequency among caucasians | 7500 new cases; 1300 estimated deaths |
Staging and Treatment:
Stage I - involement of a single node or a single node region; excision of lesion, and total nodal radiation. Stage II - involvement of two or more lymph node regions on same side of diaphragm; excision of lesion and radiation. Stage III - involvement of lymph node regions of both sides of the diaphragm, which may include the spleen; combination of radiation and chemotherapy. Stage IV - involvement of one or more extra lymphatic organs or tissues, with or without lymphatic involvement; treated with chemotherapy alone, radiation therapy alone, or both Presence or absence of symptoms of night sweats, significant fever, and weight loss; treated with chemotherapy, MOPP protocol - Mustargen (mechlorethamine HCI, alkylating agent) Oncovin (vincristine, plant alkaloid), procarbazine (antineoplastic); prednisone (corticosteroid). |
| Non-Hodgkin’s Lymphoma | Night sweats | Nontender lymphadenopathy, enlarged liver and spleen, weight loss, fever | Age 50 - 60 years old | 53,600 new cases; 23,800 estimated deaths | Stage I - rarely observed, but remission possible with radiation therapy Stage II - radiation therapy Stage III and IV - combination chemotherapy, with or without radiation therapy |
| Multiple myeloma | Weakness, history of frequent infections, especially pneumonias; severe bone pain on motion; neurological symptoms, paralysis | Fractures of long bones; deformity of; strenun, ribs, vertebrae, pelvis; hepatosplenomegaly; anemia and bleeding tendencies Elevated uric acid | Exposure to ionizing radiation; middle aged or older women | 13,200 new cases; 11,400 estimated deaths |
Surgery: relieve spinal cord compression; orthopedic procedures to relieve or support bone problems Radiation: for some lesions Chemotherapy: alkylating agents; antitumor antibiotics; plant alkaloids; hormones - melphalan and prednisone |