Cancer Diagnosis & Treatment Flashcards

1
Q

What is grading of neoplasms based on?

A

degree of differentiation of tumor cells and the number of mitoses within the tumor (histological method)

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2
Q

what is staging of neoplasms based on?

A
  • size of primary neoplasm
  • extend of spread to regional lymph nodes
  • presence/absence of metastasis
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3
Q

which is more valuable: grading or staging

A

staging

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4
Q

what system do we use to grade neoplasms?

A

I (well-differentiated)
II
III
IV (poorly differentiated/anaplastic)

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5
Q

what system is used to stage neoplasms?

A

TNM system:
- T = primary tumor size (0-4)
- N = regional lymph node involvement (0-3)
- M - metastasis (0-1)

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6
Q

what staging T value may be given for a carcinoma in situ?

A

T0

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7
Q

what staging T value may be given for a tumor greater than 7cm?

A

T4

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8
Q

what staging N value may be given for a neoplasm with no spread to lymph nodes?

A

N0

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9
Q

what staging N value may be given for a neoplasm that has spread to one lymph node, or one anatomic group of lymph nodes (eg. axillary nodes)?

A

N1

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10
Q

what staging N value may be given for a neoplasm that has spread to two or more lymph nodes or anatomic groups of lymph nodes on one side of the diaphragm (eg. axillary + supraclavicular)?

A

N2

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11
Q

what staging N value may be given for a neoplasm that has spread to two or more lymph nodes or anatomic groups of lymph nodes on both sides of the diaphragm (eg. axillary + inguinal)?

A

N3

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12
Q

what staging M value may be given to a neoplasm that has no metastatic spread?

A

M0

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13
Q

what staging M value may be given to a neoplasm that has metastasized?

A

M1

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14
Q

what part of the TNM system is the greatest prognostic indicator?

A

M value

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15
Q

what histological grading system is used specifically for prostate cancer?

A

Gleason score

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16
Q

how does the Gleason score work?

A
  • scores between 2-10 (good to bad)
  • score derived from adding grades from 2 histological sites
  • each grade ranked accordingly from 1-5
  • score based on deviation from normal prostatic architecture and relative loss of complete “gland units”
17
Q

name 5 methods of cancer diagnosis

A
  • histological/cytological methods
  • immunochemistry
  • molecular identification
  • flow cytometry
  • tumor markers
    (we do NOT have diagnostic imaging for cancer)
18
Q

name 3 histological/cytological methods of diagnosing cancer

A
  • excision/biopsy
  • needle aspiration
  • cytologic smears
19
Q

name examples of cytologic smears used to diagnose cancer

A

pap smear
sputum smear

20
Q

name a method of molecular identification used to diagnose cancer

A

immunocytochemistry (Ab that looks for mutations-> biopsy & examine for pigmentation of Ab)

21
Q

what is flow cytometry?

A

cell counting (eg. CBC for WBCs)

22
Q

what are tumor markers?

A

biochemical indicators of the presence of a tumor

23
Q

name 5 examples of tumor markers

A
  • estrogen receptors
  • alpha-fetoprotein (AFP)
  • carcinoembryonic antigen (CEA)
  • prostate specific antigen (PSA)
  • CA125
24
Q

what are 3 things that evaluating tumor markers accomplish?

A
  • help support diagnosis of cancer
  • indicate success of therapy (less after treatment)
  • may indicate “return” of cancer
25
Q

what 3 tumor markers are primarily associated with breast carcinomas?

A

estrogen receptors
HER2
progesterone receptors (PR)

26
Q

what 2 tumor markers are normal in a fetus?

A

alpha-fetoprotein (AFP)
carcinoembryonic antigen (CEA)

27
Q

alpha-fetoprotein (AFP) is a tumor marker for what types of cancer?

A

liver carcinoma
testicular carcinoma

28
Q

carcinoembryonic antigen (CEA) is a tumor marker for what types of cancer?

A

colon, pancreas, breast carcinoma

29
Q

CA125 is a tumor marker for what type of cancer?

A

ovarian carcinoma

30
Q

name examples of current cancer treatment modalities

A
  • surgical excision
  • chemotherapy
  • radiation therapy
  • combined therapies/induction therapy
  • anti-hormonal/immunotherapy/stem-cell transplants
31
Q

name 2 types of radiation therapy

A

conformal radiotherapy
localized therapy

32
Q

how does radiation therapy treat cancer?

A

damages dividing cells

33
Q

what type of cancer treatment irradiates large expanses of the body?

A

localized [radiation] therapy

34
Q

what type of cancer treatment 3-dimensionally pinpoints an area to be de-bulked?

A

conformal radiotherapy

35
Q

what is the most common form of cancer treatment?

A

combined therapies (eg. surgery/chemo/radiation)