Chap 19 Cancer Medicine (Oncology) Flashcards
Cancer:
Malignant tumors:
- Cancer: characterized by unrestrained and excessive growth of cells
+ Think of a switch that gets turned on and can’t get turned off. - Malignant tumors: compress, invade, and destroy surrounding tissues
+ They do not ‘eat away’ anything-they invade
Cancer
- Bad News: Cancer is responsible for 20% of all deaths in the United States.
- Good News: More than half of people who develop cancer are cured.
Which cancers are the most common causes of cancer death for women?
Lung, breast, colorectal
Lung, colorectal, breast
Breast, lung, colorectal
Colorectal, breast, lung
. A For women, it is lung, breast, then colorectal
that are the most common causes of death from cancer
Which cancers are the most common causes of cancer death for men?
Lung, prostate, colorectal
Lung, colorectal, prostate
Prostate, lung, colorectal
Colorectal, prostate, lung
B. For men it is lung, colorectal, then prostate
that are the most common causes of cancer death for men.
- Characteristics of Tumors
Neoplasms (tumors):
Neoplasms (tumors): growths that arise from normal tissue
Malignant
\+ Multiply rapidly
\+ Invasive and infiltrative
\+ Undifferentiated
\+ Metastasize
Benign
\+ Grow slowly
\+ Encapsulated
\+ Differentiated
\+ Don’t spread
Invasive: xam lan, infiltrative: tham nhiem; Undifferentiated: vo dinh hinh; Metastasize: gay di can
What Causes Cancer?
Carcinogenesis
Carcinogenesis: transformation of a normal cell to a cancerous one
- Damage to genetic material
DNA function
Mitosis : su phan bao
Protein synthesis : su tong hop protein
Nucleotides :
Genes
Mutation : dot bien
- Carcinogenesis
- Environmental agents
\+ Chemical carcinogens
\+ Radiation
\+ Viruses (RNA and DNA)
\+ Oncogenes (ras/colon cancer, myc/lymphoma, and bcr-abl/chronic myelogenous leukemia)
- Heredity
+ Retinoblastoma, polyposis coli, Wilm’s tumors, Ewing’s sarcomas
Retinoblastoma: ung thu vong mac; Wilm’s tumors: ung thu than o tre em; Ewing’s sarcomas: ung thu xuong
Classification of Cancerous Tumors
Carcinomas:
Carcinomas: epithelial cell origin, 90% of all malignancies are carcinomas
Carcinomas: ung thu bieu mo
- CARCINOMAS AND THE EPITHELIAL TISSUES FROM WHICH THEY DERIVE (CONT’D
- Lung:
- Adenocarcinoma ( bronchioloalveolar)
- Large cell carcinoma
- Small (oat) cell carcinoma
- Squamous cell (epidermoid)
- Reproductive organs:
- Adenocarcinoma of uterus
- Carcinoma of the penis
- Choriocarcinoma of the uterus or testes
- Cystadenocarcinoma (mucinous or serous) of the overies
- Seminoma and embryonalcell carcinoma (testes)
- Squamous cell (epidermoid) carcinoma of vagina or cervix
- Skin:
- Basal cell layer: basal cell carcinoma
- Melanocyte: malignant melanoma
- Squamous cell layer: squamous cell carcinoma
CLASSIFICATION OF CANCEROUS TUMORS (CONT’D)
- Sarcomas
Sarcomas: connective tissue origin, 5% of all malignancies
CLASSIFICATION OF CANCEROUS TUMORS (CONT’D)
Mixed tissue tumors:
Mixed tissue tumors: tissues capable of differentiating into epithelial and connective tissue
- Pathological DescriptionsGross (without microscopy)
Cystic
Fungating
Inflammatory
Medullary
Necrotic
Polypoid
Ulcerating
Verrucous
Cystic-ovarian : nang buong trung
Fungating-colon : bieu mo da day
Inflammatory-breast:
Medullary-thyroid and breast : uyen giap dang tuy va nguc
Necrotic-loss of blood supply : hoai tu
Polypoid-colon: u loi o ruot
Ulcerating-stomach: loet da day
Verrucous-wartlike (gingiva): mun coc (nuu rang)
- Pathological DescriptionsMicroscopic
Alveolar
Carcinoma in situ
Diffuse
Dysplastic
Epidermoid
Follicular
Nodular
Papillary
Pleomorphic
Scirrhous
Undifferentiated
Alveolar (a): tui khi
-> tumor cells form patterns resembling small sacs ( muscle, bone, fat, cartilage)
Carcinoma in situ : ung thu tai cho
-> referring to localized tumor cells that have not invaded adjacent. (Cervix)
Diffuse (a,v): khuyet tan, lan ra
-> spreading evenly throughout the affected tissue ( Lymphomas)
Dysplastic (a): loan san
-> containing abnormal- appearing cells that are not clearly cancerous ( nevi, moles on skin)
Epidermoid (a): dang bieu mo
-> resembling squamous epithelial cells (thin, plate-like) (respiratory tract)
Follicular (a): co nang
-> Forming small glandular sacs. ( thyroid gland cancer, lymphomas)
Nodular (a): co nhieu u nho
Papillary (a): co hinh nhu’ len
-> forming small, finger like or nipple-like projections of cells). (Thyroid cancer)
Pleomorphic (a): co nhieu hinh dang
-> composed of a variety of types of cells. ( mixed cell tumors)
Scirrhous (a): thuoc khoi u cung
-> densely packed tumors, due to dense bands of fibrous tissue ( breast , stomach cancer)
Undifferentiated (a): khong phan biet duoc
-> lacking microscopic structures typical of normal cancers
- Grading and Staging of Tumors
Grade: degree of maturity or differentiation under the microscope
Stage: extent of spread in the body
- International TNM Staging System for Lung Cancer
Primary tumor (T) Tis Tx T1 T2 T3 T4
Regional Lymph Node N0 N1 N2 N3
Distant metastasis
M0
M1
TNM: tumor-node-metastasis
Primary tumor (T)
Tis : Carcinoma in situ.
Tx : Positive malignant cytologic findings, no lesion observed.
T1 : Tumor 3 cm diameter or associated-obstructive pneumopathy.
T3 : Tumor with direct extension into the chest wall, diaphragm, mediastinum, pleura, or pericardium.
T4 : Tumor invades the mediastinum or presence of malignant pleural effusion
Regional Lymph Node
N0 : No node involvement
N1 : Ipsilateral ( same side as for the primary tumor) bronchopulmonary or hilar nodes involved.
N2 : Ipsilateral mediastinal nodes or ligament involved.
N3 : Contralateral mediastinal, hilar node, supraclavicular (collarbone) nodes involved.
Distant metastasis
M0 : No metastasis
M1 : Metastases present with site specified (e.g., brain, liver)
Cancer Treatment: Surgery
Debulking procedure:
Adjuvant (assisting) radiation therapy and/or chemotherapy:
- Debulking procedure: may be used to remove as much of primary tumor mass as possible
- Adjuvant (assisting) radiation therapy and/or chemotherapy: after removal of primary tumor to prevent recurrence at distant sites
debulk (v): cat bo khoi luong lon; Adjuvant: ta duoc, chat ho tro
- CANCER TREATMENT: SURGERY (CONT’D)
Cauterization:
Core needle biopsy:
Cryosurgery:
En bloc resection:
Excisional biopsy:
Exenteration:
Fine needle aspiration biopsy:
Fulguration:
Incisional biopsy:
Cauterization: burn
Core needle biopsy: small sample from center
Cryosurgery: freeze
En bloc resection: resection of a large block of tumor and tissue (breast)
Excisional biopsy: removal and biospy
Exenteration: removal of organ
Fine needle aspiration biopsy: Fluid removal from lesion
Fulguration: High frequency electrical current
Incisional biopsy: incison into a lesion or a specific part of a lesion
Fulguration (n): su chop loe, frequency: tan so; electrical current: dong dien
*Cancer Treatment: Radiation Therapy (Radiation Oncology)
Brachytherapy
Electron beams
External beam radiation (teletherapy)
Fractionation
Gray (Gy)
Linear accelerator
Photon therapy
Proton therapy
Radiocurable tumor
Radioresistant tumor
Radiosensitive tumor
Radiosensitizers
Simulation
Stereotactic radiosurgery
Brachytherapy: radiation
Electron beams: Close to patient or implanted
External beam radiation (tele therapy): beam is far from patient
Fractionation: Radiation doses split into intervals
Gray (Gy): absorbed dose of radiation energy
Linear accelerator: increases the velocity of subatomic particles
Photon therapy: the smallest unit of radiation therapy
Proton therapy: uses protons, less damaging to other tissues
Radio curable tumor: tx may be radiation only
Radio resistant tumor: self explanatory
Radiosensitive tumor: appears to be sensitive to radiation
Radio sensitizers: drugs that make cells more sensitive to radiation
Simulation: Use of computer to simulate the cancer scenario and tx
Stereotactic radio surgery: Surgery using radiation to destroy the lesion
- Radiation Therapy Side Effects
Alopecia
Fibrosis
Infertility
Mucositis
Myelosuppression
Nausea and vomiting
Pneumonitis
Secondary tumors
Xerostomia
Alopecia (baldness)
Fibrosis (increase in connective tissue)
Infertility (inability to contribute to conception of a child)
Mucositis (inflammation and ulceration of mucous membranes)
Myelosuppression (bone marrow depression)
Nausea and vomiting
Pneumonitis
Secondary tumors (new types of tumors)
Xerostomia (dryness of mouth)
Chemotherapy, Biological Therapy, and Differentiating Agents
Alkylating agents
Antibiotics
Antimetabolites
Antimitotics
Hormonal agents
- Alkylating agents- directly damage DNA to prevent the cancer cell from reproducing
- Antibiotics- anti-tumor antibiotics that interfere with enzymes involved in DNA replication
- Antimetabolites- are a class of drugs that interfere with DNA and RNA growth by substituting for the normal building blocks of RNA and DNA-
- Antimitotics-Mitotic inhibitors are often plant alkaloids and other compounds derived from natural products. They can stop mitosis or inhibit enzymes from making proteins needed for cell reproduction.
- Hormonal agents-Drugs in this category are sex hormones, or hormone-like drugs, that change the action or production of female or male hormones
adjuvant therapy
alkylating agents
anaplasia
angiogenesis
adjuvant therapy: Assisting primary treatment
alkylating agents: Synthetic chemicals containing alkyl groups that attack DNA
anaplasia: Loss of differentiation of cells
angiogenesis: Process of forming new blood vessels
antibiotics
antimetabolites
antimitotics
apoptosis
antibiotics: Chemicals produced by bacteria or primitive plants; inhibit growth of cells
antimetabolites: Chemicals that prevent cell division; inhibit formation of substances needed to make DNA
antimitotics: Drugs that block cell division
apoptosis: Programmed cell death
benign tumor
biological response modifiers
biological therapy
brachytherapy
benign tumor: Noncancerous growth (neoplasm)
biological response modifiers: Produced by normal cells; directly block tumor growth or stimulate immune system to fight cancer
biological therapy: Use of the body’s own defenses to destroy tumor cells
brachytherapy: Use of radiation placed directly on or within the cancer
combination chemotherapy
dedifferentiation
deoxyribonucleic acid (DNA)
differentiating agents
combination chemotherapy: Use of several chemotherapeutic agents together in treatment of tumors
dedifferentiation: Loss of differentiation of cells
deoxyribonucleic acid (DNA): Genetic material within the nucleus of a cell; controls cell division and protein synthesis
differentiating agents: Drugs that promote tumor cells to differentiate, stop growing, and die
differentiation
electron beams
encapsulated
external beam irradiation
differentiation: Specialization of cells
electron beams: Low-energy beams of radiation for treatment of skin or surface tumors
encapsulated: Surrounded by a capsule; benign tumors are encapsulated
external beam irradiation: Applying radiation to a tumor from a source outside the body
fields
fractionation
genetic screening
grading tumors
fields: Dimensions of body areas undergoing irradiation
fractionation: Giving radiation in small, repeated doses
genetic screening: Testing family members to determine if they have inherited a cancer-causing gene
grading tumors: Evaluating the degree of maturity of tumor cells
gray (gy)
gross description of tumors
infiltrative
invasive
gray (gy): Unit of absorbed radiation dose
gross description of tumors: Visual appearance of tumors to the naked eye
infiltrative: Extending beyond normal tissue boundaries into adjacent tissues
invasive: Having the ability to enter and destroy surrounding tissue
irradiation
linear accelerator
malignant tumor
mesenchymal
irradiation: Exposure to any form of radiant energy such as light, heat, or x-rays
linear accelerator: Large electronic device that produces high-energy x-ray beams for treatment of deep-seated tumors
malignant tumor: Tumor having the characteristics of continuous growth, invasiveness, and metastasis
mesenchymal: Embryonic connective tissue
metastasis
microscopic description of tumors
mitosis
mixed-tissue tumors
metastasis: Spread of a malignant tumor to a secondary site
microscopic description of tumors: Appearance of tumors when viewed under a microscope
mitosis: Replication of cells
mixed-tissue tumors: Tumors composed of different types of tissue
modality
molecularly targeted drugs
morbidity
mucinous
modality: Method of treatment, such as surgery, chemotherapy, or irradiation
molecularly targeted drugs: Anticancer drugs designed to block the function of growth factors, their receptors, and signaling pathways in specific tumor cells
morbidity: Condition of being unwell; deficient in normal function
mucinous: Containing mucus
mutation
neoplasm
nucleotide
oncogene
mutation: Change in DNA; may be spontaneous or caused by chemicals, radiation, or viruses
neoplasm: New growth; benign or malignant tumors
nucleotide: Unit of DNA composed of a sugar, phosphate, and a base
oncogene: Region of DNA in tumor cells or in viruses that causes cancer
palliative
pedunculated
photon therapy
protocol
palliative: Relieving, but not curing symptoms
pedunculated: Possessing a stem or stalk
photon therapy: Radiation therapy using energy in the form of x-rays or gamma rays
protocol: Detailed plan for treatment of an illness
