Cancer staging Flashcards
1
Q
Cancer staging is based on what 4 factors?
A
- location of the primary tumor
- tumor size and extent of tumors
- lymph node involvement
- presence or absence of distant mets
2
Q
Diff types of staging?
A
- clinical staging: estimate of the extent of cancer based on results
- pathologic staging: surgical stage
- post-therapy/post-neoadjuvant therapy staging
- restaging
3
Q
Staging systems used?
A
- MC and useful system for most types of cancer is the TNM system
- American jt committee on Cancer (AJCC) and internation union for cancer control (UICC) maintain the TNM classification system
- each cancer is given a letter or number to describe the tumor, node, and mets
4
Q
TNM system - What does TNM stand for?
A
- T: primary tumor
- N: nodes
- M: mets
5
Q
What does T tell you?
A
- primary tumor:
size
how deep it has grown into the organ it started in
if it has grown into nearby tissues
6
Q
Tx?
T0?
Tis?
A
- Tx: means the tumor can’t be measured
- T0: means there is no evidence of a primary tumor
- Tis: means that cancer cells are only growing into most superficial layers, w/o growing into deeper tissues (cancer in situ)
7
Q
What do the numbers after the T mean?
A
- (T1-T4)
- describe the tumor size
- amt of spread into nearby tissues
- higher the T number, the larger the tumor and spread to nearby tissue
8
Q
What does the N stand for? Nx? N0?
Numbers?
A
- N: describes whether the cancer has spread to the lymph nodes
- NX: means nearby lymph nodes can’t be eval.
- N0: means nearby lymph nodes don’t contain cancer
- N1-N3 (increased nodes affected)
9
Q
What does M stand for? M0? M1?
A
- tells you whether cancer has spread to distant body parts
- M0: no cancer spread was found
- M1: means cancer has spread to distant organs or tissues
10
Q
What is stage grouping used for?
A
- once TNM has been determined, cancer is staged in roman numerals I-IV
- I is least advanced
- IV is most advanced
- some will be subdivided with A and B (IIA, IIB)
- stage 0 is carcinoma in situ for most cancers
11
Q
Stage grouping definitions?
A
- stage 0: carcinoma in situ
- stage I, II, III: higher numbers indicate more extensive disease, larger tumor size and or spread of cancer beyond the organ in which it first developed to nearby lymph nodes and or tissues or organs adjacent to location of primary tumor
- stage IV: cancer has spred to distant tissues or organs
12
Q
When is the stage of cancer determined?
A
- ONLY when the cancer is FIRST dx
- the stage doesn’t change over time
- surivial stats and info on tx by stage refers to the stage when the cancer was 1st dx
13
Q
what is restaging?
A
- term used to describe doing test to find the extent of cancer after tx
- a “r” is written b/f the new stage
14
Q
What is a carcinoma? diff types?
A
- MC type of tumor
- formed by epithelial cell
- adenocarcinoma: cancer that produce fluids or mucus
- basal cell: cancer that begins in base layer of epidermis
- squamous cell: epithelial cells that lie just beneath outer surface of skin, also line stomach, intestines, lungs, bladder and kidneys
- transitional cell: are epithelial cells called transitional epithelium or urothelium, tissue made of many layers of epithelial cells that get bigger and smaller (line bladder, ureters, renal pelvis)
15
Q
What is a sarcoma? MC ones?
A
- cancers that form in bone and soft tissue
- osteosarcoma: MC bone cancer
- MC soft tissue cancers:
leiomyosarcoma
kaposi sarcoma
malignant fibrous histiocytoma
16
Q
What is leukemia? Diff types?
A
- cancers that begin in the blood forming tissue of the bone marrow
- 4 common types:
ALL
AML
CLL
CML
17
Q
What is lymphoma? 2 main types? Which one has reed sternberg cells?
A
- cancer that begins in lymphocytes (T cells or B cells)
- Hodgkin lymphoma (Reed sternberg)
- Non-hodgkin
18
Q
What is Multiple Myeloma?
A
- cancer that begins in plasma cells
- see RBC rouleaux formation on peripheral blood smear
19
Q
How are brain and spinal cord tumors named?
A
- based on type of cell they formed and where tumor first formed in CNS
(glioma, astrocytoma, medulloblastoma)
20
Q
Other types of tumors?
A
- germ cell tumors
- neuroendocrine tumors: release hormones into blood
- carcinoid tumors
21
Q
Where are adenocarcinomas found?
A
- cancer that forms in mucus-secreting glands throughout the body
- lung cancer: non-small cell lung cancer, 80% of lung cancers
- prostate cancer: 99% of all prostate cancers
- pancreatic cancer: exocrine pancreatic cancer forms in pancreatic ducts
- esophageal cancer: glandular cells, MC type of esophageal cancer
- colorectal cancer:
cancer in intestinal gland cells that line inside of colon or rectum, 95% of colon and rectal cancers
22
Q
2 types of small cell lung cancer?
A
- oat cell
- combined small cell (uncommon)
- 10-15% of all lung cancers
23
Q
Nonsmall cell lung cancer? How common? Sub-types?
A
- 85-90% of lung cancers
- 3 main sub-types:
squamous cell carcinoma
large cell carcinoma
adenocarcinoma
24
Q
Where are carcinoid tumors located?
A
- lung: 10% of all carcinoid tumors 1-6% of all lung tumors 2 types: typical and atypical - GI (MC): form in stomach, small intestine, and rectum and appendix 50% of carcinoid tumors - GI
25
What are sqamous cell tumors? where are these found?
thin flat cells that look like fish scales
- found in tissue that forms surface of skin, lining of hollow organs, lining of respiratory tract and digestive tracts (cervix, head and neck, vagina, rectum)
26
What are clear cell tumors? Where are these found?
- clear or pale, filled with fluid or glycogen
- found in breast, skin, lower urinary tract, and organs of female reproductive system
- also found in renal cell carcinoma*
27
What is a germ cell carcinoma? Where do these show up?
cells that develop in the embryo and become the cells that make up the reproductive system
- tumors arise in the ovaries and the testes
- extragonadal sites:
head, chest, abdomen, pelvis, lower back (stay central - related to the descent of the testes)
28
Diff types of germ cell carcinomas?
- teratomas
- germinomas
- endodermal sinus tumor/yolk sac tumor
- choriocarcinoma
- embryonal carcinoma
29
What is a myxoma? It is the most common primary tumor of what?
- myxoid tumor of primitive connective tissue
| - MC primary tumor of the heart in adults
30
What is the path report?
- document that contains the dx determined by examining cells and tissue under a microscope
- report contains a gross description from the pathologist
31
What is included in the path report?
- Tissue bx: fine needle, open bx (punch, excisional), surgical excision, cytology
- tissue processing: permanent section - tissues are placed in fixative (formalin), then processed into additional solns and final is paraffin wax, then tissues are cut into thin slices and placed on slides and stained
frozen section: freezing and slicing tissue sample, takes 15-20 min
32
General layout of the report?
- pt information
- gross description
- micro description
- dx
- tumor size
- tumor margins
- other info
33
What does the term atypical mean?
- a vague warning but not worried enough to call it cancer
34
What is a carcinoma?
- neoplasm derived from epithelium
35
What is dysplasia?
- a atypical proliferation of cells
36
What is a granuloma?
- type of inflammation characterized by accumulations of macrophages which combine into giant cells
37
What is hyperplasia?
- proliferation of cells which isn't neoplastic
38
What is metaplasia?
- one type of cell is replaced with another type of cell
39
What does well differentiated mean?
- how much or how little tumor tissue looks like normal tissue it came from
- well-differentiated - looks like original tissue and is growing slowly
40
Poorly differentiated?
- lacks the structure and fxn of normal cells and growing uncontrollably
41
What is the mitotic rate?
- measure of how fast cancer cells are dividing and growing
