Cancer Diagnosis & Treatment Flashcards
What is grading of neoplasms based on?
degree of differentiation of tumor cells and the number of mitoses within the tumor (histological method)
what is staging of neoplasms based on?
- size of primary neoplasm
- extend of spread to regional lymph nodes
- presence/absence of metastasis
which is more valuable: grading or staging
staging
what system do we use to grade neoplasms?
I (well-differentiated)
II
III
IV (poorly differentiated/anaplastic)
what system is used to stage neoplasms?
TNM system:
- T = primary tumor size (0-4)
- N = regional lymph node involvement (0-3)
- M - metastasis (0-1)
what staging T value may be given for a carcinoma in situ?
T0
what staging T value may be given for a tumor greater than 7cm?
T4
what staging N value may be given for a neoplasm with no spread to lymph nodes?
N0
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)?
N1
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)?
N2
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)?
N3
what staging M value may be given to a neoplasm that has no metastatic spread?
M0
what staging M value may be given to a neoplasm that has metastasized?
M1
what part of the TNM system is the greatest prognostic indicator?
M value
what histological grading system is used specifically for prostate cancer?
Gleason score
how does the Gleason score work?
- 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”
name 5 methods of cancer diagnosis
- histological/cytological methods
- immunochemistry
- molecular identification
- flow cytometry
- tumor markers
(we do NOT have diagnostic imaging for cancer)
name 3 histological/cytological methods of diagnosing cancer
- excision/biopsy
- needle aspiration
- cytologic smears
name examples of cytologic smears used to diagnose cancer
pap smear
sputum smear
name a method of molecular identification used to diagnose cancer
immunocytochemistry (Ab that looks for mutations-> biopsy & examine for pigmentation of Ab)
what is flow cytometry?
cell counting (eg. CBC for WBCs)
what are tumor markers?
biochemical indicators of the presence of a tumor
name 5 examples of tumor markers
- estrogen receptors
- alpha-fetoprotein (AFP)
- carcinoembryonic antigen (CEA)
- prostate specific antigen (PSA)
- CA125
what are 3 things that evaluating tumor markers accomplish?
- help support diagnosis of cancer
- indicate success of therapy (less after treatment)
- may indicate “return” of cancer
what 3 tumor markers are primarily associated with breast carcinomas?
estrogen receptors
HER2
progesterone receptors (PR)
what 2 tumor markers are normal in a fetus?
alpha-fetoprotein (AFP)
carcinoembryonic antigen (CEA)
alpha-fetoprotein (AFP) is a tumor marker for what types of cancer?
liver carcinoma
testicular carcinoma
carcinoembryonic antigen (CEA) is a tumor marker for what types of cancer?
colon, pancreas, breast carcinoma
CA125 is a tumor marker for what type of cancer?
ovarian carcinoma
name examples of current cancer treatment modalities
- surgical excision
- chemotherapy
- radiation therapy
- combined therapies/induction therapy
- anti-hormonal/immunotherapy/stem-cell transplants
name 2 types of radiation therapy
conformal radiotherapy
localized therapy
how does radiation therapy treat cancer?
damages dividing cells
what type of cancer treatment irradiates large expanses of the body?
localized [radiation] therapy
what type of cancer treatment 3-dimensionally pinpoints an area to be de-bulked?
conformal radiotherapy
what is the most common form of cancer treatment?
combined therapies (eg. surgery/chemo/radiation)
