Cancer, O9 Part I EXAM 2

Question 1

What color does cancer appear on the vocal folds?

Answer 1

White

Question 2

What is the incidence of cancer?

Answer 2

roughly 1,200,000 new cases/year

Question 3

What is the prevalence of cancer?

Answer 3

roughly 8,000,000

Question 4

What is the percentage of laryngeal cancer out of all head and neck cancers diagnosed?

Answer 4

25% of all head and neck cancers are laryngeal cancer.

Question 5

What is the percentage of laryngeal cancer of all cancers diagnosed each year?

Answer 5

2%

Question 6

How many people die of cancer each year?

Answer 6

roughly 600,000 people.

– 46% men and 38% of women will be diagnosed with cancer in their lifetime

Question 7

What is the incidence of laryngectomies per year?

Answer 7

roughly 5,000-7,000 laryngectomies/year

Question 8

What is the incidence of laryngeal cancer per year?

Answer 8

roughly 12,000/year

Question 9

What is the prevalence of laryngeal cancer per year?

Answer 9

roughly 60,000 people living with laryngeal cancer/year

Question 10

True or false: More more men than women are diagnosed with laryngeal cancer.

Answer 10

True – 4 men: 1 woman

Question 11

What is the average age at diagnosis of laryngeal cancer?

Answer 11

63 years old

Question 12

Talk about survival when it comes to laryngeal cancer.

Answer 12

• 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.

Question 13

Name the stages of normal cell life.

Answer 13

1. Cell division
2. Gap 1
3. Synthesis period
4. Gap 2

Question 14

Talk about the stages of normal cell life: cell division

Answer 14

the cell divides.

Question 15

Talk about the stages of normal cell life: gap 1

Answer 15

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.

Question 16

Talk about the stages of normal cell life: synthesis

Answer 16

the period in which the cell is getting ready to divide; DNA replicates

Question 17

Talk about the stages of normal cell life: gap 2

Answer 17

Lasts a minimum of 10 hours.

We don’t know what occurs during this period.

Question 18

What is the fastest a cell can divide, and why is this important?

Answer 18

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)

Question 19

Normal cell death – how many cells die off and get replaced in any 24 hour period of time?

Answer 19

3 billion!

Question 20

What is the term used to describe normal cell death (programmed cell death)?

Answer 20

Apoptosis (means “to drop off” in Greek)

Question 21

What happens when a cell stops getting communication from other cells around it?

Answer 21

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…)

Question 22

What is the term for what happens when a cell wanders off and starts duplicating (instead of dying)?

Answer 22

Metastasis; different kinds of cancer cells tend to metastasize in different places.

Question 23

a) Where does uterine and colon cancer metastasize to?

b) Breast cancer?

Answer 23

a) The liver

b) bones

Question 24

Where does laryngeal cancer metastasize?

Answer 24

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.

Question 25

What is "Necrosis"?

Answer 25

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)

Question 26

What organ in our body will grow back if it is damaged?

Answer 26

The liver. (Unless you have scerosis)

Question 27

What is cancer, and when does it occur?

Answer 27

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.]

Question 28

What are the four ways that cancer can occur?

Answer 28

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."

Question 29

What five general things can cause cancer/alter the genetic blueprint?

Answer 29

1. Inheritance, genetic function 2. Chemicals/teratogens 3. Carcinogens 4. Viruses 5. Radiation - alters genetic programs and fries genes. (we do not know what the mechanism is that alters the genetic blueprint.

Question 30

List four risk factors for laryngeal cancer.

Answer 30

1. Smoke, especially tobbacco smoke. 2. Alcohol 3. Poor nutrition 4. GERD (acid reflux) - high correlation w/esophageal cancer and laryngeal cancer; and by extension, bulimia

Question 31

What are two symptoms of GLOTTIC laryngeal cancer?

Answer 31

1. Hoarseness (first signs) 2. Persistent cough NOTE: most laryngeal cancers begin on the vocal folds and most laryngeal cancers occur at the level of the glottis.

Question 32

List seven symptoms of supraglottic cancer (above the glottis) - pharynx, nasopharynx, and oropharynx.

Answer 32

1. Prolonged sore throat; feeling of lump in the throat the hurts. 2. Dysphagia 3. Prolonged sore throat; feeling of lump in the throat that hurts 4. Persistent throat pain 5. Persistent ear pain 6. Dyspnea/stridor (rough, difficult breathing) 7. Unexplained weight loss (cancer in general)

Question 33

T, N, M Laryngeal Cancer Staging: what does "T" stand for?

Answer 33

Tumor - size and tissue that it encompasses

Question 34

T, N, M Laryngeal Cancer Staging: what does "N" stand for?

Answer 34

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.

Question 35

T, N, M Laryngeal Cancer Staging: what does "M" stand for?

Answer 35

Metastasis - the cancer has spread to distant sites. Laryngeal cancer will travel up to the brain and/or down to the lungs.

Question 36

Describe Tx

Answer 36

Tx: a tumor has been identified but has not yet been assessed.

Question 37

Describe T1

Answer 37

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.

Question 38

Describe T2

Answer 38

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.

Question 39

Describe T3

Answer 39

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.

Question 40

Describe T4.

Answer 40

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...

Question 41

Describe node involvement of N0

Answer 41

No lymph node involvement.

Question 42

Describe node involvement of Nx

Answer 42

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.

Question 43

Describe node involvement of N1

Answer 43

The cancer has spread to the IPSILATERAL side of the lymph nodes in the neck (1 or 2 nodes only)

Question 44

Describe node involvement of N2

Answer 44

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.

Question 45

Describe node involvement of N3

Answer 45

There is bilateral spreading to the lymph nodes (both sides of neck)

Question 46

Describe a metastasis of M0

Answer 46

None; no spreading (first look in lungs, then brain)

Question 47

Describe a metastasis of Mx

Answer 47

There is likely metastasis but it cannot be assessed.

Question 48

Describe a metastasis of M1

Answer 48

There is most definitely metastasis.

Question 49

Where does laryngeal cancer most commonly metastasize to?

Answer 49

Most common: lungs. Can also go up to brain.