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P & P I > Chapter 1 WS Part 2 > Flashcards

Chapter 1 WS Part 2 Flashcards

1
Q

early symptom of laryngeal cancer

A

very hoarse voice

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2
Q

What region of the larynx are the true vocal cords located in?

A

glottic or glottis

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3
Q

Explain why laryngeal cancer has a much better prognosis than ovarian cancer?

A

Early symptoms of laryngeal cancer cause patients to seek medical attention in the early stage. Ovarian cancer has such vague symptoms that medical attention is not sought until the cancer has progressed to a later stage. In general, the later the stage at diagnosis, the worse the prognosis

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4
Q

screening test for cervical cancer

A

pap smear

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5
Q

screening test for colorectal cancer

A

fecal occult blood testing and colonoscopy

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6
Q

screenng test for breast cancer

A

mammogram

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7
Q

Define “sensitive” with regard to screening tests?

A

The test must be able to give a true-positive result. It can identify a tumor in its early stages. Ex. Pap Smear can help detect carcinoma of the cervix before the disease become invasive. A sensitive test will not result in a false-negative finding

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8
Q

Define “specific” with regard to screening tests?

A

The test must be able to give a true-negative result. Also a specific test will be able to identify a specific type of cancer. Ex. PSA test for prostate cancer

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9
Q

What is a “false Negative” finding?

A

Test shows that there appears to be no cancer present when actually there is cancer. A “false Positive” finding indicates disease is present when it isn’t

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10
Q

what info in obtained in a workup

A

the type, location, and size of the tumor;
the degree the tumor has invaded normal tissue;
the presence or absence metastasis,
lymph node involvement and
possibilities of different treatment regimens.

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11
Q

what is tumor staging

A

means of defining the tumor size and extension of the tumor at the time of diagnosis

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12
Q

important reasons for tumor staging

A

Provides a means of communication about the tumors,
helps determine best treatment,
aids in the predicting the prognosis,
provides a means for continuing research.

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13
Q

UICC

A

International Union Against Cancer

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14
Q

AJCC

A

American Joint Committee on Cancer

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15
Q

How has advanced imaging technology aided in the treatment of cancer

A

Treatment has become more effective because much of the guesswork is eliminated which allows for smaller treatment volumes as only areas of known disease are being treated. This limits the dose to normal tissue which then causes fewer short term and chronic treatment side effects to the patient

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16
Q

Explain the TNM staging system.

A

T-defines the size or extent of the primary tumor (1-4 or x

N-designates the status of lymph nodes and extent of lymph node involvement (0-4 or x)

M defines the presence and extent of metastasis (0, 1, or x).

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17
Q

What staging system is used for gynecologic cancers

A

international federation of gynecology and obstetrics (FIGO)

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18
Q

what is clinical staging

A

Staging that is performed without the use of invasive procedures. Staged using physical exam, imaging studies

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19
Q

what is surgical/pathologic staging

A

Offers the most accurate information about the tumor and the extent of disease spread. The physician can perform a biopsy of suspicious looking tissue, obtain a sample of lymph nodes for microscopic examination, and observe the tumor and surrounding tissues and organs

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20
Q

what are BRCA1 and BRCA2 genes and how are they related to breast and ovarian cancer?

A

These are gene mutations.
BRCA1 (BReast CAncer number 1) found on chromosome 17 and BRCA2 (BReastCAncer number 2) found on Chromosome 13.
These gene mutations are linked to hereditary breast and ovarian cancers. `

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21
Q

how is the grade of a tumor determined

A

by examining the cells under a microscope

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22
Q

what is the grade of a tumor based on

A

based on the degree of differentiation

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23
Q

What are the four categories of differentiation for grading a tumor?

A

Well differentiated –cells characteristics are most like the original cells,
moderately well differentiated,
poorly differentiated, and
undifferentiated-cells are barely distinguishable from the original cells

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24
Q

what is the purpose of a tumor board and who are the participants

A

Purpose: to allow cancer specialists to work together to review information about newly diagnosed tumors and devise effective treatment plans that also allow the patient to maintain a high quality of life if possible.

Participants: surgeons, radiation oncologists, medical oncologists, radiologists, pathologists, social workers, plastic surgeons, and other medical personnel

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25
Q

define palliation

A

Noncurative treatment to relieve pain and suffering.

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26
Q

a patient with what size tumor is the best candidate for surgery

A

small tumors that have not spread to neighboring tissues or organs

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27
Q
  1. Would a patient with cancer to the nasopharynx be a good candidate for surgery?

why or why not?

A

no

accessibility is difficult because the cancer is close to the base of the brain and the cranial nerves

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28
Q

two examples of surgical prodcedures being use for palliation

A

Removal of an obstruction of the bowel for symptom relief

cutting nerves to reduce or eliminate pain caused by the tumor.

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29
Q
  1. List the benefits of patients with laryngeal cancer or prostate cancer or breast cancer having radiation therapy treatment rather than surgery
A

Laryngeal cancer- preserves the voice;
Prostate-helps preserve sexual function;
Breast-better cosmetic results (less disfigurement

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30
Q

what is a radical mastectomy

A

Sometimes referred to as the Halstead mastectomy. It involves the removal of the breast with overlying skin, the pectoralis muscles, and all the axillary lymph nodes

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31
Q

what is a sentinel node

A

The primary drainage lymph node located closest to the tumor `

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32
Q

describe instances in which rad therapy is used for palliation

A

1) Bone metastasis to relieve pain and reduce risk of pathological fractures.
2) To reduce the size of a tumor that is pressing on nerves

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33
Q

What is the difference between an x-ray and a gamma ray.

A

The mechanism of production. X-rays are produced by the interaction of electrons striking a target, whereas gamma rays are produced through radioactive decay

34
Q

what radioactive source is used in a machine that treats with gamma rays

A

Cobalt 60

35
Q

What type of external beam treatment is used to treat superficial tumors.

A

electrons

36
Q

what is brachytherapy

A

Is a short distance therapy, which uses radioactive materials (cesium-137, iridium 192, palladium 103, iodine 125). These radioactive materials can be placed next to or directly into the tumor.
The energy of the radioactive sources is low so a high dose can be delivered to the tumor, while the nearby normal tissues receive a very small dose. P

37
Q

Permanent seed implants for prostate cancer uses what two types of radioactive material

A

Palladium 103 or iodine 125

38
Q
  1. What is the difference between low-dose brachytherapy (LDR)and high-dose brachytherapy(HDR)?
A

LDR-Brachytherapy at a dose rate of less than 2 Gy/hr.

HDR-Brachytherapy treatment at a dose rate that exceeds 12Gy/hr.

It takes longer to deliver a prescribed dose using LDR than it does for HDR. As a result, LDR treatments usually involves the radioactive material being placed in the patient and the patient staying in the hospital until the prescribed dose is delivered. HDR is what you will see most often at clinic. The patient will come in and have a radioactive source placed inside the body via catheters. The source will stay in the patient for a designated period of time then the source will be removed

39
Q

What are cytotoxic drugs?

A

drugs that have the ability to kill cancer

40
Q

Describe the different methods of administering chemotherapeutic agents

A 
oral-by mouth 
intra-arterial injection 
anracavitary
intraperitonel 
intrathecal
intravenous
41
Q

what is lupron

A

An injectable hormone therapy used to treat prostate cancer. It is injected under the skin or into a muscle. It can help slow down cancer growth.

42
Q

why do radiation therapist need to know about chemo drugs

Give 2 examples.

A

Some chemo drugs have a synergistic effect with radiation.

Adriamycin is toxic to the heart and in combination with radiation therapy has a much greater toxic effect.
Bleomycin and radiation has a greater toxic effect on lungs

43
Q

what are radiosensitizers

A

Chemicals and drugs that help enhance the lethal effects of radiation

44
Q

what are radioprotectors

A

Certain chemicals and drugs that diminish the response of cells to radiation

45
Q

explain immunotherapy

A

Immunotherapy is treatment that uses certain parts of a person’s immune system to fight diseases such as cancer by either stimulating a person’s own immune system to work harder or smarter to attack cancer cells or by giving a person immune system components, such as man-made immune system proteins.

46
Q

what are monoclonal antibodies

A

Researchers produce antibodies to react to a specific antigen. The patient is given the monoclonal antibodies that seek out and destroy the specific antigen found on the surface of the tumor cells.

47
Q

what are interferons

A

Naturally occurring body proteins capable of killing or slowing the growth of cancer cells

48
Q

define prognosis

A

An estimation of the life expectancy of a cancer patient based on all the information obtained about the tumor and from clinical trials.

49
Q

define exophytic tumors

A

tumors grow outward

50
Q

define endophytic tumors

A

tumors grow inward

51
Q

which has better prognosis (Endo/exophytic) tumors

A

Exophytic tumors has better prognoses as they do not tend to invade and ulcerate underlying tissues and does not invade blood vessels and lymphatic vessels until later in in the disease.

52
Q

three ways cancer mets

A

blood, lymph, and seeding

53
Q

where does prostate cancer most commonly mets

A

bones

54
Q

how does ovarian cancer mets

A

seeding to the abdominal cacity

55
Q

in what manner and where does medulloblastoma of the brain metastasize

A

Via seeding into the spinal canal by means of the cerebrospinal fluid

56
Q

What tumor-related factors are significantis prognostic factors?

A

Grade, stage, tumor size, status of lymph nodes, depth of invasion, and histology

57
Q

What patient-related factors are significate prognostic factors?

A

age, gender, race, and medical condition

58
Q

main prognostic indicator for breastcancer

A

statusof axillary lymph nodes

59
Q

main prognostic indicator for soft tissue sarcoma

A

histologic grade

60
Q

what is purpose of clinical trials

A

to provide research-based evidence about specific treatment effectiveness. To determine the most effective treatment with the fewest long-term side effects.

61
Q

what are retrospective studies

A

Studies that review information from a group of patients treated in the past.

62
Q

what are prospective studies

A

A clinical trial that is planned before treatment, with eligibility criteria for patient selection.

63
Q

explain randomized studies

A

Several methods of treatment are used to determine which method results in the best outcome. Patients are randomly selected for one of the types of treatment (patient had to meet the eligibility requirements first). The purpose of it being randomized is to eliminate any unintentional “stacking of the deck” and to increase the accuracy of the results and conclusions.

64
Q

How is information about the status of the disease reported at the end point of survival reporting

A

As Alive with NED, disease free, or Alive with disease

65
Q

How are treatment failures classified at the end point of survival reporting

A

Local, locoregional, and distant and are based on tumor recurrences at the primary or nearby lymph node sites or metastatic disease.

66
Q

advantages to retrospective studies

A

info can be quickly obtained; dont have to wait years to see results of a treatment

67
Q

advantages to prospective studies

A
  • investigators know the info that is essentail to the study, leading to a more complement and accurate documentation of study
  • better control of external factors that may influence the results
68
Q

disadvantages of retrospective studies

A
  • complete info about the treatment is not always available
  • outside factors may have influenced the treatment, results were not controlled, and may ot have been documented accurately
69
Q

disadvantages to prespective studies

A
  • long amount of time needed to observe the results of a particular treatment (could be 5 years or longer)
70
Q

used to determine the maximum tolerance dose for a specific treatment

A

phase I

71
Q

Used to determine whether the Phase I treatment is significantly effective-given the acute and/or long-term side effects- to continue study.

A

phase II

72
Q

Used to compare the experimental treatment with standard treatment with a randomized sample

A

phase III

73
Q

patients alive at the endpoint and those who have died are counted.

A

absolute survival reporting

74
Q

includes patients who died from other causes and had no evidence of disease (NED) at the time of their deaths.

A

adjusted survival reporting

75
Q

the normal mortality rate of a similar group of people based on factors such as age, gender, and race.

A

relative survival reporting

76
Q

Requires an infusion pump connected to a catheter that has been placed in an artery near the tumor. Used for retinoblastoma

A

intr-arterial injection

77
Q

The drugs are instilled directly into the cavity. Ex. bladder cancer-drugs administered into the bladder

A

intracavitary

78
Q

ntroduced into the abdomen through a catheter or implanted port. May be used with stomach cancer or ovarian cancer. May be done following debulking of a tumor after surgery to kill left behind cancer cells that may have broken off.

A

intraperitonel

79
Q

Instilled into the space containing cerebrospinal fluid.

A

intrathecal

80
Q

who must perform intrathecal injection?

A

a physician

81
Q

administrered by using a syringe entering the vein directly or piggybacked with other fluids

A

intravenous

P & P I (24 decks)

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