Cancer Classification 1 Flashcards
What is the scale used to evaluate a PSA test?
Gleason scale
Gleason scale: 1
Small, uniform glands
Gleason scale: 2
More space between glands
Gleason scale: 3
Infiltration of cells from glands at margins
Gleason scale: 4
Irregular masses of cells with few glands
Gleason scale: 5
- Lack of glands
- Sheets of cells
Fecal occult test aka
- Stool guaiac
- Hemoccult test
Subcategories of malignancy
- Carcinomas
- Sarcomas
- Blood-borne cancers
- Primary tumors of nerve tissue
85% of all cancers are of this subtype
Carcinomas
Carcinomas originate in these types of cells
Epithelial
- skin
- large intestine
- breast
- stomach
- lungs
Carcinomas are often (fast/slow) growing
Fast
Why do carcinomas often grow quickly?
- epithelial tissue grows rapidly
- replaces itself regularly
How do carcinomas spread?
- By invading local tissues
- Metastasize via lymphatics
Sarcomas develop from this type of tissue
Connective
What are the connective tissue types that sarcomas often develop from?
- bone
- muscle
- cartilage
- fibrous tissue
- fat
- synovium
What are the types of bone tumors?
Malignant
- Osteosarcoma
- Ewing’s sarcoma
Benign
- Osteoid osteoma
Osteosarcoma aka
Osteogenic sarcoma
What bones are commonly affected by osteosarcoma?
- long bones
- often around knee in femur or tib/fib
Osteosarcoma: age range
10-25
Osteosarcoma appears to be related to these
Growth spurts
Most deaths with osteosarcoma are attributed to:
Pulmonary metastases
What is the tx for osteosarcoma?
- surgery for tumor removal with wide margins
- some result in amputation, but often include limb salvage techniques
Osteosarcoma: survival?
- 5 year survival is 70%
- attributed to chemo and surgery combo
Osteosarcoma: malignancy, important things to notice
- extremely malignant with destructive lesions
- pain in lesion area
- pathological fx
What causes Ewing’s sarcoma?
Genetic translocation between chromosomes 11 and 22
Ewing’s sarcoma: age range
5-16
3 main risk factors for Ewing’s sarcoma
- Caucasian
- Parental smoking
- Parental occupation that includes exposure to pesticides
Where are the most common sites for Ewing’s sarcoma?
- pelvis
- femur
- tibia
- ulna
- metarsus
s/s to look for with Ewing’s sarcoma:
- pain (local bone pain)
- swelling
- fever
- fatigue
What is the most common symptom seen with Ewing’s sarcoma?
Local bone pain
Often occurs after another injury, which can delay dx
What is one of the most telling symptoms that differentiates osteosarcoma and Ewing’s sarcoma?
Fatigue
Ewing’s sarcoma is (fast/slow) growing and is composed of:
- fast
- islands of small, uniformly round cells of neural origin
Ewing’s sarcoma: 5 year survival
70%
What is an osteoid osteoma?
- non-cancerous, benign tumor
- NO potential for malignancy
Where are osteoid osteomas often seen?
- femur
- tibia
- near end of diaphysis
Who gets osteoid osteomas most often?
- men
- less than 25 y.o.
Osteoid osteoma: growth
- not progressive
- rarely grow larger than 1 cm in diameter
s/s of osteoid osteoma:
- pain
- swelling
- warmth
- tenderness
- may see painful scoliosis (scoliosis isn’t normally painful early on)
What is a major clue that would signal an osteoid osteoma? Why?
Aspirin/NSAIDs significantly relieve pain (more than expected)
tumor is prostaglandin sensitive
What are the top 3 malignant tumor types from connective tissue in order?
- Osteosarcoma
- Chondrosarcoma
- Ewing’ sarcoma
Tx for osteoid osteoma
Most pts choose surgical excision
Who primarily gets malignant bone tumors?
- children and young adults
- less than 1% of the population
What is the most malignant tumor that occurs in cartilage?
Chondrosarcoma
Chondrosarcoma is (slow/fast) growing
- slow
- can be present for years before pain is noticed
Most carcinomas are classified as grade:
I or II
Chondrosarcoma: risk of mets in comparison with osteosarcoma
Less
With chondrosarcomas, there is an increased risk for:
- thrombus formation
- mets to lung, other bones, or organs
What things should you look for that might indicate a sarcoma?
- persistent swelling or lump in soft tissue
- pain
- warmth
Who often gets sarcomas in general?
Younger people less than 25 y.o.
Sarcomas invade this way
Local invasion
