Basic Oncology Flashcards
Define: cancer that begins in the skin or in tissues that line or cover internal organs
Carcinoma
Define: cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissues
Sarcoma
Define: cancer that starts in the blood-forming tissue
Leukemia
A tumor that remain in their primary location, do not invade tissues, do not metastasize, grow slowly, have distinct borders
Benign
A tumor that grow uncontrollably, grow quickly, able to spread locally and to distant sites (metastasize), have irregular borders
Define: An abnormal mass of tissue as a result of abnormal cellular proliferation and irregular apoptosis.
Tumor/ Neoplasm
3 types of spread for cancer
Seeding (direct)
Lymphogenous (carcinomas)
Hematogenous (Sarcomas)
What is a Proto-oncogenes
NORMAL cellular genes that regulate cellular growth and differentiation
Define: mutated proto-oncogenes that stimulate unregulated, abnormal cellular division
-Promote tumor progression
Oncogenes
Modifiable vs Non-Modifiable Rsk factors for cancer
Non-Modifiable risk factors
-Age
(Single greatest non-modifiable risk factor for cancer)
-Genetics
Modifiable risk factors
- Tobacco
- Alcohol consumption
- Nutrition
- Physical activity/obesity
- Exposures - carcinogens
- Radiation & chemicals
- Infectious pathogens
Alcohol consumption can lead to what types of cancer
Increased association with head/neck, esophagus and liver cancers, possible association w/ breast cancer
What is the role of cancer screening
Primary ! prevention of Cancer
What is the USPSTF recommendation screening for breast cancer
Mammography every 2 years between 50-74
Also recommends against the teaching of SBE and states insufficient evidence to assess the benefits and harm of CBE
What is the AMERCIAN CANCER SOCIETY recommendation for breast cancer screening
Yearly mammography beginning at age 45; can switch to every 2 years age >55 (up to 74)
Women ages 40 to 44 should have the choice to start annual breast cancer screening
-Recommends against clinical breast examination (CBE) and self breast examination (SBE) - lack of evidence to suggest a clear benefit
Should women conduct self breast exams?
USFPTF and American Cancer society say NO
What is the USPSTF recommendation for screening of colorectal cancer
Recommend screening at 45 and the q 10 years
What is the recommended screening for colorectal cancer in a pt with FamHx of 1st degree relative (FDR) with colorectal cancer
Begin at age 40 or 10 years before FDR diagnosis, which ever is earliest
Repeat every 5 years
(Note differnce of 5 vs q10 years for normal pts)
What is the recommendation for prostate cancer screening
The decision to undergo periodic prostate-specific antigen (PSA) screening should be an individual one
Age =/> 70 years
Recommends against PSA-based screening
What is the screening recommendation for cervical cancer for age 21-29 years
Every 3 years with cervical cytology alone
What is the recommendation for cervical screening in age 30-65
Every 3 years with cervical cytology alone
Or
Every 5 years with high-risk human papillomavirus (hrHPV) testing alone
Or
Every 5 years with hrHPV testing in
combination with cytology (cotesting)
When should women NOT be screened for Cervical Cancer
Age > 65 years
-Adequate prior screening and who are not at risk – recommends against screening
Age < 21 years
Recommends against screening
Women who have had a hysterectomy
What is the recommended screening for Lung Cancer
Age 50-80 years
-Annual screening with low-dose computed tomography (LDCT) in patients who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years
Are tumor markers used for screening
NOT USUALLY
Exception is PSA
Serum Tumor marker: AFP
Alpha fetoprotein (AFP):
Hepatocellular cancer
Testicular cancer
Serum Tumor Marker: CA-125
Ovarian Cancer
Serum Tumor Marker: CEA
Carcinoembryonic antigen (CEA): Colon cancer, pancreatic cancer, and some breast cancers
Serum Tumor Marker CA19-9
Pancreatic Cancer
Serum Tumor Marker for testicular cancer
AFP and HCG
What is cancer GRADING
On a scale from I-IV
And notes level of differentiation And mitosis
Undifferentiated (IV) is worse
What is cancer STAGING
Describes the severity of cancer based on the size and/or extent of the primary tumor and whether or not the cancer has spread in the body
Estimates prognosis &, guides treatment options
Staged: 0 - IV
What is the most widely used cancer staging system for solid tumors
TNM system
T –size and/or extent of primary TUMOR
N – absence/presence of spread to NEARBY LYMPH nodes
M – absence/presence of distant METZ
What is the Preferred Treatment for cancer
Surgical Removal
What is the difference of Adjuvant and NeoAdjuvant Chemotherapy
Adjuvant chemo - given after a primary treatment (surgery)
Neoadjuvant chemo - given before a primary treatment (surgery)
What is a paraneoplastic syndrome
Develops when malignant tumors release hormones and/or proteins that affects a certain body system(s)
Or
when antibodies released by the immune system designed to destroy tumor cells also damage normal (non-cancerous) cells
A pt that presents with a Hypercalcemia or an unknown cause of Hyponatremia
Think
Paraneoplastic presentation of Cancer
Cushing syndrome
SIADH
HyperCa2+
ANd Lambert-Eaton Syndrome
Think
Small Cell Lung Cancer
Any pt with hypercalcemia
Think
SCC of the lung
Breast Carcinoma
Renal Carcinoma
Adult T-Cell Leukemia/Lymphoma
JUST THINK CANCER!
