Cancer, O9 Part I EXAM 2 Flashcards
What color does cancer appear on the vocal folds?
White
What is the incidence of cancer?
roughly 1,200,000 new cases/year
What is the prevalence of cancer?
roughly 8,000,000
What is the percentage of laryngeal cancer out of all head and neck cancers diagnosed?
25% of all head and neck cancers are laryngeal cancer.
What is the percentage of laryngeal cancer of all cancers diagnosed each year?
2%
How many people die of cancer each year?
roughly 600,000 people.
– 46% men and 38% of women will be diagnosed with cancer in their lifetime
What is the incidence of laryngectomies per year?
roughly 5,000-7,000 laryngectomies/year
What is the incidence of laryngeal cancer per year?
roughly 12,000/year
What is the prevalence of laryngeal cancer per year?
roughly 60,000 people living with laryngeal cancer/year
True or false: More more men than women are diagnosed with laryngeal cancer.
True – 4 men: 1 woman
What is the average age at diagnosis of laryngeal cancer?
63 years old
Talk about survival when it comes to laryngeal cancer.
- Survival rate is generally good FOR A FEW YEARS.
- There are other health issues that come with an elderly population made up primarily of smokers.
- These patients become your clients for a few years, and then often die.
Name the stages of normal cell life.
- Cell division
- Gap 1
- Synthesis period
- Gap 2
Talk about the stages of normal cell life: cell division
the cell divides.
Talk about the stages of normal cell life: gap 1
Lasts a minimum of 2 hours.
This is the most effective period if you were to interfere with a cell, BUT we don’t know what happens during gap periods.
Talk about the stages of normal cell life: synthesis
the period in which the cell is getting ready to divide; DNA replicates
Talk about the stages of normal cell life: gap 2
Lasts a minimum of 10 hours.
We don’t know what occurs during this period.
What is the fastest a cell can divide, and why is this important?
12 hours - important if you have a really fast-growing cancer, because it may not take very much time for the cancer to get serious)
Normal cell death – how many cells die off and get replaced in any 24 hour period of time?
3 billion!
What is the term used to describe normal cell death (programmed cell death)?
Apoptosis (means “to drop off” in Greek)
What happens when a cell stops getting communication from other cells around it?
The cell dies. This is a process intended to keep cells from wandering off and living where they shouldn’t (so that you don’t get an ankle cell living in your butt…)
What is the term for what happens when a cell wanders off and starts duplicating (instead of dying)?
Metastasis; different kinds of cancer cells tend to metastasize in different places.
a) Where does uterine and colon cancer metastasize to?
b) Breast cancer?
a) The liver
b) bones
Where does laryngeal cancer metastasize?
Brain and/or lungs; will also spread to the tissue/skin around it. It will grow through the spinal column, tongue, and jaw, and get into the lymph nodes, which spread everywhere.
-One of the largest concentrations of lymph nodes are in your neck.
What is “Necrosis”?
Cell death due to damage or disease - NOT normal cell death. With necrosis, there will be rapid cell replacement- will have a shortened g1 period in order to replace the damaged cells. (E.g., if you cut your arm, the skin will heal faster than normal cell replacement. But remember, the fastest a cell can replace itself is 12 hours, no matter what)
What organ in our body will grow back if it is damaged?
The liver. (Unless you have scerosis)
What is cancer, and when does it occur?
It is abnormal cell life.
[It occurs when there is damage to a cell’s suicide program. A cell wanders off and it does not die. The body’s immune system should then detect this cell and kill it, but if this does not happen, the cell duplicates itself and begins to grow. This is called loss of error control.]
What are the four ways that cancer can occur?
1) The cell suicide program - apoptosis - is damaged.
2) A cell stops receiving signal from the cells around it.
3) A cell wanders off and does not suicide AND the immune system does not detect it and kill it. The wandering cells begin to grow. This is known as a “loss of error control.”
4) Override: a cell’s duplication has created a defective gene that overrides the suicide program, so a cell switches on and lives forever, duplicating itself to more cells that have the override gene, and all of them live forever.
NOTE: neurons are supposed to have an override gene, since “neurons live as long as the moron.”
What five general things can cause cancer/alter the genetic blueprint?
- Inheritance, genetic function
- Chemicals/teratogens
- Carcinogens
- Viruses
- Radiation - alters genetic programs and fries genes. (we do not know what the mechanism is that alters the genetic blueprint.
List four risk factors for laryngeal cancer.
- Smoke, especially tobbacco smoke.
- Alcohol
- Poor nutrition
- GERD (acid reflux) - high correlation w/esophageal cancer and laryngeal cancer; and by extension, bulimia
What are two symptoms of GLOTTIC laryngeal cancer?
- Hoarseness (first signs)
- Persistent cough
NOTE: most laryngeal cancers begin on the vocal folds and most laryngeal cancers occur at the level of the glottis.
List seven symptoms of supraglottic cancer (above the glottis) - pharynx, nasopharynx, and oropharynx.
- Prolonged sore throat; feeling of lump in the throat the hurts.
- Dysphagia
- Prolonged sore throat; feeling of lump in the throat that hurts
- Persistent throat pain
- Persistent ear pain
- Dyspnea/stridor (rough, difficult breathing)
- Unexplained weight loss (cancer in general)
T, N, M Laryngeal Cancer Staging: what does “T” stand for?
Tumor - size and tissue that it encompasses
T, N, M Laryngeal Cancer Staging: what does “N” stand for?
Nodes - in laryngeal and pharyngeal cancer, you can also think of it as “neck”
- How much of the neck tissue is effected.
- This means that the cancer has travelled [metastasized] to the nodes, and the nodes are a super highway.
T, N, M Laryngeal Cancer Staging: what does “M” stand for?
Metastasis - the cancer has spread to distant sites. Laryngeal cancer will travel up to the brain and/or down to the lungs.
Describe Tx
Tx: a tumor has been identified but has not yet been assessed.
Describe T1
A tumor is in situ (on site). It is confined and small, and it appears to be sitting on the structure’s surface.
On the vocal folds, a T1 tumor appears to look like a mole. The vocal folds are still able to move.
Describe T2
Tumor is larger but still confined.
On the vocal folds, the bump appears to be a little bit larger. It may or may not affect the movement of the vocal folds yet. Arytenoids still function properly and have movement.
Describe T3
In this tumor size, more tissue is involved. Movement of the vocal folds is impaired, and the tumor has grown into the muscle tissue, potentially into the cartilage. The arytenoids are now affected and thus no longer have movement.
Describe T4.
This tumor is sizable. The larynx may no appear to be immobile. A tumor of this size is often accompanied by visible signs such as dysphagia, dyspnea (breathing problems), etc…
Describe node involvement of N0
No lymph node involvement.
Describe node involvement of Nx
Tumor is in the nodes, but its difficult to assess how many nodes are involved
The cancer has spread but you can’t assess it for whatever reason.
Describe node involvement of N1
The cancer has spread to the IPSILATERAL side of the lymph nodes in the neck (1 or 2 nodes only)
Describe node involvement of N2
The cancer has spread to the ipsilateral side of the lymph nodes in the neck, BUT there are more nodes involved and the tumor is larger.
Describe node involvement of N3
There is bilateral spreading to the lymph nodes (both sides of neck)
Describe a metastasis of M0
None; no spreading (first look in lungs, then brain)
Describe a metastasis of Mx
There is likely metastasis but it cannot be assessed.
Describe a metastasis of M1
There is most definitely metastasis.
Where does laryngeal cancer most commonly metastasize to?
Most common: lungs.
Can also go up to brain.
