Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > 1.9 Surgical oncology (basic concepts, importance of TNM staging, neoadjuvant and adjuvant oncological treatment, concept of onco-team, importance) > Flashcards

1.9 Surgical oncology (basic concepts, importance of TNM staging, neoadjuvant and adjuvant oncological treatment, concept of onco-team, importance) Flashcards

1
Q

What is the risk factor assessment in surgical oncology?

A
  • cancer risk assessment involves the estimation of a patient’s susceptibility for cancer
  • it involves genetic counselling, detailed history and environmental risk factors and a thorough family history
  • genetic testing for hereditary syndromes may be done
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Screening and diagnosis in surgical oncology

A
  • cancers that are screened for should be asymptomatic for a longer period of time, probable to produce morbidity, mortality and treatable
  • diagnosis by biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the direct clinical manifestations of cancer?

A

seven danger signals of cancer
1. change in bowel or bladder habits
2. a sore that does not heal
3. unusual bleeding or discharge
4. thickening or lump in breast/elsewhere
5. indigestion or difficulty in swallowing
6. obvious change in wart or mole
7. nagging cough or hoarseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the indirect/systemic clinical manifestations of cancer?

A
  1. secondary to metastasis: cachexia
  2. secondary to none: metastatic
    a. ectopic production of known hormones
    b. secretion of unidentified, hormone-like substances
    c. toxic substances secreted from the tumor
    d. autoimmune host is sensitized to an antigen from the tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Paraneoplastic syndrome and hormone production of tumors

A
  • paraneoplastic syndromes refer to consequences of cancer in the body
  • one effect is altered hormone production by the tumor

examples:
- small cell carcinoma of the lung: ACTH
- carcinoid tumors: lipotrophin
- pancreatic islet cell tumors: vasopressin
- malignant epithelial thymomas: calcitonin, PTH, gastrin, insulin, glucagon
- lung epidermoid tumors: GH, glucagon
- breast cancers: hcG, HPL, calcitonin, PTH, ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are clinical history signs of cancer?

A
  1. weight loss
  2. loss of appetite
  3. bleeding or a discharge from any body orifice or nipple
  4. sore that is slow to heal
  5. persistent cough or wheeze
  6. change in voice
  7. difficulty swallowing
  8. change in bowel habitat
  9. growing lump in the skin, breast, abdomen or muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the cancer signs found during physical examination?

A
  • palpable masses (moveable, non-moveable)
  • lymph node enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Laboratory evaluation of cancer

A
  1. blood examination:
    - complete blood count
    - electrolyte panel
    - liver enzymes
    - tumor markers
  2. imaging:
    - ultrasound, X-ray, contrast CT, MRI, PET
  3. sampling techniques:
    - ERCP: endoscopic retrograde cholangiopancreatography
    - endoscopy: bronchoscopy, esophagoscopy, gastroscopy, colonoscopy
  4. biopsy:
    - FNAB: removing cells from a mass using a thin needle
    - core needle biopsy: removal of tissue from a suspicious mass – used for prostate, breast and liver masses mainly; they are stained and examined by a pathologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is staging and its significance?

A
  • it is the histological examination of cancerous tissue in surgical oncology
  • determing the features of the primary tumor and the presence/absence of invasion and metastasis
  • it should be done before surgery to check for any metastases, the depth of the tumor etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the stages of cancer?

A
  • stage I: conacer is confined to primary site
  • stage II: more locally advanced disease
  • stage III: metastasis to regional lymph node
  • stage IV: metastasis to distant sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is TNM staging?

A

primary tumor (T)
- TX: primary tumor cannot be evaluated
- T0: no evidence of primary tumor
- Tis: tumor in situ
- T1, T2, T3, T4: size and extent of primary tumor

Regional lymph nodes (N)
- NX: regional lymph nodes cannot be evaluated
- N0: no regional lymph node involvement
- N1, N2, N3: number and location of involved lymph nodes

Distant metastasis (M)
- MX: distant metastasis cannot be evaluated
- M0: no distant metastasis
- M1: distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the significance of TNM staging?

A
  • planning of therapy
  • information about prognosis
  • evaluation of results
  • comparing different therapeutic modalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the diagnostic interventions in surgical oncology?

A

sentinel node biopsy
- sentinel node is the first lymph node that a cancer spreads to
- biopsy may be used to obtain information of the primary tumor
- removal of the sentinel lymph node may be therapeutically in the case of melanoma, breast cancer and skin carcinoma

laparoscopy
- evaluation of ie. gastric, pancreatic cancer

mediastinoscopy, bronchoscopy
- evaluation of lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the palliative interventions in surgical oncology?

A

in cases that the tumor cannot be resected completely

  • life threatening complications can be solved (ileus, bleeding)
  • resection, debulking (removal of as much tumor as possible)
  • bypass, stoma, endoprosthesis, stabilization of bones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the vital indications for surgery in oncology?

A
  • obstructions
  • perforations
  • hemmorrhage
  • certain fractures
  • vertebral compressions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the surgical therapy for metastasis of cancers?

A
  • to the bones from breast, prostate, kidney, or thyroid: treatment of pathological fractures
  • to the brain from lung, breast, pancreas: radiotherapy, resection
  • to the lung from colorectal, carcinoid, bone, CT, kidney: atypical resection, lobectomy, sementectomy
  • to the liver from colorectal, carcinoid, breast: resection, radiofrequency ablation, PEIT (percutaneous ethanol injection therapy), cryotherapy, hepatic artery embolization
17
Q

What is “en bloc” resection?

A
  • complete removal of the tumor itself and any organs/tissues involved
  • this helps in obtaining tumor free margins and reducing the risk of local recurrence
  • more radical “en bloc” is required with more aggressive cancers and all contiguous lymph nodes may be removed
18
Q

Principle of surgical techniques in surgical oncology

A
  1. tumor contamination/avoiding propagation
    - no touch technique: do not touch or press the tumor directly or cells can spread easily (first ligate the veins)
    - isolation: avoid propagation
    - exchange of surgical instruments
  2. excision in normal tissue
  3. en block resection
19
Q

What are the non-surgical therpaies of cancer?

A
  1. chemotherapy
    - primary chemotherapy: chemotherapy alone without any radiotherapy or surgery (ie. hematological malignancies)
    - chemotherapy as an adjuvant to surgery/radiotherapy: used in patients with high risk of relapse
    - chemotherapy prior to surgery (neoadjuvant): less radical operation due to shrinkage of tumor beforehand (ie. breast cancer)
  2. hormone therapy
    - breast and prostate cancers depend on sex hormones
    - prosate: LHRH analogues and anti-androgen drugs
    - breast: anti-estrogen, progestins, LHRH analogues and aromatase inhibitors
  3. radiation therapy
    - primary treatment in radiosensitive tumors (ie. seminoma, Hodgkin’s lymphoma) or in with chemotherapy (ie. laryngeal cancer, BCC)
    - methods: teletherapy/external beam radiotherapy; brachytherapy; systemic radioisotope therapy
  4. immunotherapy
  5. gene therapy
    - aims to alter the genetic programs of cancer cells
    - mutation compensation, molecular chemotherapy, immunopentiation, antiagiogenic therapy, viral-mediated oncolysis, non-viral gene delivery
20
Q

How to determine the treatment results in surgical oncology?

A
  • overall survival
  • disease free survival time
  • effects of treatment:
    - complete remission
    - partial remission
    - stable disease
    - progression
21
Q

What are the prognostic factors of cancer?

A
  • patient related factors
  • tumore related factors
  • genetic factors
  • MACIS score (papillary cancer of the thyroid)
  • Nottinham score
22
Q

What are the follow-up routines in surgical oncology?

A
  • follow-up visits for life in 1-3 month intervals, and eventually 6 month intervals
  • aim is early detection of recurrent disease or progression
  • treatment of theapy induced complications
  • early diagnosis of secondary tumor

Surgery (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions