Cancer Flashcards
what solid tumors are considered cancerous?
malignant histological (microscopic) and clinical (behavioral) qualities are properly called cancers. Other tumors are called benign.
define neoplasm and what is a malignant neoplasm?
neoplasm means new growth , malignant neoplasm is synonym for cancer.
define a low-grade cancer
they have well-differentiated cell populations and grow slowly, they differ little from normal cells.
define anaplastic (undifferentiated) tumors
a bizarre cell pattern, that sometimes make it impossible to identify their tissue of origin.
what is the tumors growth fraction?
as colony enlarges some cells become reproductively inactive those that continue to replace represent the growth fraction.
the higher the growth fraction, will the tumor rapidly or slowly increase?
rapidly
what is a mitotic rate and how can it affect cancer?
a higher mitotic rate can have direct bearing on the prognosis of some cancers (sarcoma)
what id doubling time?
the time requried for a cancer to double in size. slow growing malignancies ca require a decade to produce symptoms. There is why there can be long latent period before certain cancers metastasize or recur.
what kind of tissues can be considered resistant to infiltration and can serve as barrier to tumor expansions?
arterial walls and cartilage.
what is a stroma?
a supportive matrix of a malignant neoplasm. it contains connective tissues and blood vessels.
how can one distinguish between malignant neoplasm from their benign counter part
their tendency to metastasize. when tumor deposits appear in lymphodes and internal organs distant from primary tumor, this is done using lymphatic and blood vessels.
describe how a tumor would metastisize by seeding body cavities
This is a common mode of dissemination for ovarian cancers, that can rupture and scatter tumor deposits throughout the peritoneal cavity.
how do carcinomas spead?
by both lympathic and venous embolization. slower growing carcinomas usually invade lympho nodes prior to turning up in the lungs and liver.
how do sarcomas spread?
through the bloodstream. it is unusual to discover lymph node involvement in many forms of sarcome.
what is an encapsulated tumor?
benign tumors. they grow slowly by expansion rather than infiltration. Although the vast majority pose little risk.
name 5 ways in which benign tumors can result in morbidity?
- hemorrhage
- obstruction
- hormone elaboration
- damage to vital structures
- malignant transformation.
name a cancer that is aggresive in nature such that it is untreatable
inflammatory breast carcinoma
what is special about a “tumor of low-grade malignancy”?
some cancers that are locally aggresive and capable of causing extensive tissue destruction but virtually never metastasizes.
name two examples of low-grade cancers
dermatofibrosarcoma protuberans
ovarian cystadenomas
what are 6 characteristics of benign tumors?
expansions (growth pattern) slow growth rate normal cells little mitotic activity rare metastasis insignificant effect on host
what are 6 characteristics of malignant tumors
infiltrating growth pattern rapid growth rate near normal to anaplastic cells extensive mitotic activity common metastasis fatal effect on host
what is the most common form of cancer?
Carcinoma, arises in epithelial tissues.
what is a sarcoma?
malignant tumor of connective tissue origin.
what is a teratomas?
benign or malignant. Arise from primitive cells capable of differentiating into various mature cell lines
what is a hamartoma?
malformed overgrowth of normal tissue. Ex: bowel polyps in the PuetzJeher’s syndrome.
what is hypertrophy?
an increase in the size of individual cells in an organ or tissue. Response to physiological stimulus or pathological conditions
what is hyperplasia?
absolute increase in the number of cells in a tissue. typically by excess hormone output.
define metaplasia
change from one type of normal cells to another.
what is dysplasia (atypia) ?
abnormal change in the size/shape of cells and their contents. - consider as premalignant condition.
what is a synonym for severe dysplasia?
carcinoma-in-situ
Name 4 premalignant lesions
- leukoplakia
- adenomatous hyperplasia
- dysplasia
- villous colorectal polyps
what are some characteristics of ASCUS? (pap)
accounts for 50% of cervical dysplasia. It can evolve into LSIL.
what is LSIL? (pap)
predominant pathological condition associated with a class 3 pap. Requires colposcopy and f/u’s
what are characteristics of HSIL?
carcinoma-in-situ. 1/5 with HSIL will develop invasive cervical cancer. Lesion is ablated by cryosurgery or electrocautery.
what are two premalignant conditions associated with high risk of cancer
familial polyposis- hereditary-multiple intestinal polyps
sipples syndrome-aka multiple endocrine adenomatosis 2A- pt develop benign and malignant neoplasms of varios endocrine glands.
what are the 5 most common sites for carcinomas-in-situ ?
- cervix
- endometrium
- breast
- bladder
- colon
what is the primary therapy for most stage 1 tumors?
surgery
what is a form of adjuvant treatment for cancer?
drug or radiation therapies, can be added to improve prognosis.
name one type of screening techniques to uncover early cancers in tissues such as cervix, lung, stomach and bladder?
exfoliate cytologies,
- this is used when suspicious cells are found, the results are verified by biopsy.
what is an aspiration biopsy, and on what tissues is it pronominally used?
accomplished by inserting a needle to extract cells. commonly done on breast and thyroid lesions.
whats the difference between excisional and incisional bipsies
excisional- entire lesion is removed
incision- removal of a piece of the tissue (large masses)
where is the first place carcinomas spread?
lympnodes
what is a lymphadenectomy?
lymph node dissection.
what is radiation oncology?
involved the use of x-rays, gamma rays and charged particles. they are directed against tumor growths. doses measured in units.
how is radiation directed to minimize collateral damage?
the beam is aimed from many different angles to maximize dose delivered to tumor. Cancer cells are more radiosensitive than normal cells.
name cancers are particularly radiosensitive.
anaplastic tumors ex:
Hodskins, and testicular seminoma. the
name a type of cancer that is typically radio-resistant?
well differentiated cancers ex:
sarcoma
what are the benefits of pre and post - surgery radiation?
pre= reduce the risk of tumors spread during sugery post= eradicating residual tumor deposits, and destroy isolated tumor cells, and sterilize lympoh nodes
what is a con of mediastinal irradiation?
result in pulmonary fibrosis.
what is a con of radiation-provoked arterial lesions?
they have caused strokes and heart attacks, in young individuals tx’ed for hodgkins disease.
when would one choose to tx with chemotherapy
main treatment for metastatic cancer, and given to high-risk patients with localized cancer to boost long-term survival rates.
name a cancer that is curable using chemotherapy, and why?
vulnerability depends on growth factor, gestational choriocarcinoma is curable.
name 3 cancers that are only marginally responsive to chemotherapy
prostate, breast, and intestinal tumors. (if at all)
how is hodgkin’s treated?
combination of drugs, however survivors have revealed a disturbing increase in second cancers including leukaemia.
what 3 sections of a tissue are studied by a pathologist?
- gross description
- detailing of its microscopic features
- pathological diagnosis.
why would a pathologist recommend a second resection?
as a precaution, if the margin of the normal tissue surrounding the excised tumor was inadequate.
what kind of cancers would have re-resections?
melanomas, aggressive skin carcinomas, sarcomas, and whenever the margins of normal tissues are inadequate.
Name the prognostic factors contained in the pathology report
- degree of malignancy
- presence of lymph node matastasis
- presence of vascular invasion
- degree of mitotic acitvity
describe a grade-1 to 4 degree of malignancy
- well-differentiated
- moderately well-differentiated
- poorly differentiated
- undifferentiated (anaplastic)
what is included (qualities) whenefining a stage of cancer?d
- blood chemistries
- blood counts
- tumor marker assays
- explorator surgery
- endoscopy
- X-rays
why is it necessary to stage a cancer?
to choose the optimum form of therapy. There is a direct correlation between stage and prognosis of a cancer.
what is the extent of a disease between stages 0-4
- preinvasive (in-situ)
- localized,
- locally advanced (regional lymph node)
- involvement of regional organs or non-nodal sites
- distant metastasis, widely disseminated.
- letters are added to further subdivide staging
define the duke system used in colorectal carcinoma,
it categorizes tumors according to extent they have invaded the layers of the bowel wall.
What is the TNM system?
used to report cancer stages
T. size of the tumor
N number of lymph nodes involved
M. presence of distant metastasis.
what is an increasing tumor and a decreasing tumor type in our population?
^ bronchogenic
L stomach and cervical
what are tumor markers?
A rise in blood level of one of these substances following treatment of cancer can be evident of the tumors recurrence. CEA, AFP and PSA.
What are the 6 essential quesitons to be answered when evaluating a preposed insured with a hx of cancer?
- what, specifically, was the tumor?
- what was the stage of the cancer?
- Has interim medical surveillance been adequate?
- what is the probability of reoccurrence of the cancer?
- is there a risk of significant late complications from the tx?
- what is the prognosis?
