Chapter 10 Flashcards
This disease primarily affects individuals older than age 65 and affects more men than women.
Can spread to lymph nodes, liver, lungs, and bone.
Roughly 5,000 cases annually in USA.
Gastric cancer
(often found in esophagus, colon, and anus)
What are the 5 layers of the stomach?
mucosa
submucosa
muscularis
subserosa
serosa
The stomach is composed of what 5 parts?
cardia
fundus
corpus
antrum
pylorus
Gastrointestinal stromal tumors (GIST), formerly called leiomyosarcomas, now classify as ____________ of the gastrointestinal tract.
carcinomas
Initially it was believed that origin of stomach cancer was in nerve or muscle (so related to sarcomas), but now is believed to originate in __________.
interstitial cells of Cajal
These cells are known as the pacemakers of the gastrointestinal tract because they send signals to provide muscle movements.
What are these cells called?
interstitial cells of Cajal
This disease affects more than 40,000 people annually.
Primarily men and individuals over age 65.
Common sites of spread are lymph nodes, lungs, bone, hepatic portal vein, and hepatic artery.
Hepatocellular carcinoma (HCC)
The ______ is the largest organ in the abdomen and is a site of metastases for many cancers.
liver
Blood tests may be performed to check for _______ levels, which are indicator for HCC.
alpha-fetoprotein (AFT)
FDG uptake can be variable in the liver and IS not particulary sensitive in HCC. Detection of the disease may be difficult in ___ to ___ percent of cases be cause of the ________ of the disease.
30% to 50%
appearance of the disease
This disease kills about 50,000 people each year.
AKA exocrine cancer
Pancreatic cancer
Gland in the abdomen that is between the spine and stomach.
6 inches long and resembles pear shape.
Divided into 3 sections head, body, tail.
Pancreas
Most pancreatic cancers begin in the _____.
ducts
Carcinoma of the pancreas typically spreads to the what 3 areas?
peritoneum, liver, lungs
False-positive results may be a problem when differentiating pancreatic cancer from _______.
pancreatitis
This disease is more common in women and typically affects those older than 65 years old.
Malignancy in the kidneys
renal carcinoma
Kidneys make a hormone called ________, which signals the bone marrow to make more red blood cells.
erythropoietin
Most kidney cancers are ________.
renal cell carcinomas
What are some rare types of renal cancer?
transitional cell tumors or urothelial carcinomas
renal sarcomas
Wilm’s tumors
This renal cancer originates in the kidneys, more common in pediatriccs patients, about 6% of all childhood cancers make up from this.
Wilm’s tumor
PET/CT can be used at times to distinguish benign tumors from malignant processes such as _____, ______, and ______ in the kidneys.
renal adenomas, oncocytomas, and angiomyolipomas
________ cancer is separated from colorectal cancer both in description and CMS coverage guidelines depending on region of the country.
Anal cancer
________ occurs when older cells form masses instead of dying, or new cells form growths caused by mutations instead of demonstrating normal characteristics.
colorectal carcinoma
What age is recommended that examinations and procedures be preformed for colorectal cancer screening?
50s
Some individuals with elevated _____ levels have colorectal cancer or other conditions such as inflammatory bowel disease.
CEA levels
PET/CT can assist in detection of recurrence of metastases possibly in what?
Pericolonic fat, mesenteric lymph nodes, peritoneum, periportal nodes, or Virchow’s node
The lymphatic drainage for most of the body is via the ________.
left subclavian vein
Mets of colorectal cancer can lead to what other 2 cancers?
lymphoma and breast cancer
Colorectal cancer metastasizes to where frequently?
Liver then to lymphatic system
Bladder should be voided before PET scan for colorectal scan.
T or F?
True
The top of the uterus is called the _____,
middle of the uterus is the _______, and the bottom of the uterus is the ________.
fundus, corpus, cervix
The uterus has what 2 layers?
endometrium and myometrium
______ or ______ is the most common cancer of the female reproductive organs. (forms in the tissue)
Is only approved for initial treatment strategy.
Uterine cancer or endometrial cancer
____ develops in the muscle of the uterus.
uterine sarcoma
Most endometrial cancers are _____. ______ are cancers that begin in the cells that make and release mucus and other fluids.
(same answer for both blanks)
Adenocarcinomas
Where does uterine cancer metastasize to?
cervix, bladder, rectum
This cancer predominately affects women younger than 55 years old.
13,000 new cases each year.
Spreads to the lymph nodes (iliac and retroperitoneal), lungs, bones, liver.
Invade vagina, pelvic wall, bladder, rectum.
______ cancers are slow growing and can typically be found with routine pap tests.
PET is not covered for diagnosis but is covered for initial staging and subsequent treatment monitoring.
cervical cancer
Cervical cancer is almost always linked to ______, and is preventable and curable when detected early.
human papillomavirus (HPV)
How many types of ovarian cancers are there?
2
This ovarian cancer begins in the egg cells.
Ovarian carcinomas Germ cell tumors
This ovarian cancer is more prominent an dis a cancer that forms on the outside of the ovary.
20,000 new cases every year.
Ovarian epithelial cancer
Labs for ovarian cancer may be checked for _____, which is a substance found on the surface of normal ovarian tissue and malignant tumors of the ovary.
CA-125
Most women are older than 55 years old.
_____ can invade, shed, or spread.
Metastasizes to lungs, liver, peritoneal cavity, retrovesical space.
Surgery or intraperitoneal chemotherapy (delivered directly to abdomen and pelvis)
Is covered for both initial treatment strategy, which before 2009 was known as diagnosis and initial staging, and for subsequent treatment strategy, which includes treatment monitoring, restaging, and detection of suspected recurrence.
Ovarian Cancer
Many men have ________, which results in problems with voiding but is not malignant.
Benign prostatic hyperplasia (BPH)
The prevalent form of prostate cancer is _____ that occurs in the glandular tissue, but the incidence of this malignancy is decreasing.
adenocarcinoma
A rare form of prostate malignancy is _______ or ______ which tends to spread earlier but does not produce prostate-specific antigen (PSA).
neuroendocrine cancer or small-cell anaplastic cancer
This cancer affects men older than 65, in many cases men are not aware of the presence of disease, it may be discovered at stage II or III on digital rectal exam (DRE).
Prostate cancer
The _____ score ranges from 2 to 10 based on comparison to normal cells. The higher the score, the greater the difference from normal cells.
Gleason score
As prostate cancer progresses, it can extend beyond the prostate into the ________, which are the structures that aid in the production of semen. The bladder, rectum, lymph nodes can also be involved in last stage carcinoma.
seminal vesicles
______ is only indicated for subsequent treatment PEt imaging in patients with prostate cacner recurrence and elevated PSA levels.
F-18 fluciclovine
Seminomas and nonseminomas are types of what cancer?
Testicular cancer
Slow growing tumors that are very effectively treated with radiation therapy.
Seminomas and nonseminomas?
Seminomas
Grow very quickly.
Seminomas and nonseminomas?
Nonseminomas
_______ cancer affects men younger than 40 and is highly curable with early detection. Blood panels measure for AFP, Beta-hCG, and LDH levels (blood labs can detect earlier than imaging)
Testicular carcinoma
If testicular cancer spread it would spread to……
left testicular veins, lymphatics, or in med-retroperitoneum, pelvic lymph node basin
____ is the largest organ of the body.
Skin
_____ cancers are the most prevalent type of cancer of all.
skin cancer
Melanoma accounts for about __% of all skin cancer.
1%
What are risk factors for melanoma?
-Having more than 50 moles
-develop in the eye or intestines
Melanoma begins in the cells that make the pigment melanin which are called…
melanocytes
100,000 new cases every year.
Slightly more common in men than women
Disease on extremities is seen more commonly on women, whereas men have more on the trunk.
Classified in stages ) to IV. Peak metastases reached 1 to 2 years from diagnosis. Then palliative care at end stage.
Melanoma
What are some nonmelanoma skin cancers?
basal cell skin cancer, dermatofibrosarcoma protuberans, Merkel cell carcinoma, and squamous cell.
Sarcomas are rare and only account for ___% of cancers overall. Large family of tumors that can start in any type of ___________or ________tissue.
1%
connective or supportive
What are the types of bone?
long and flat
Three common cells in our bone are…..
osteoblasts, osteoclasts, and bone marrow
_______ cancer in the bone that develops in the osteoid tissue of the bone.
More common in males and most likely to occur in adolescence.
Osteosarcoma
_________ begins in the tough, flexible cartilage pads that end the bones and line the joints.
Chondrosarcoma
________ sarcoma family of tumors occur s in bone, soft tissue such as muscle, fat, fibrous tissue, and blood vessels.
Accounts for 1% to 2% of childhood tumors.
Ewing’s
________ is a soft tissue sarcoma that is known for malignant tumors of the skeletal muscle, _________ are cells that will eventually form muscles.
Commonly presents in the arms or legs and accounts for about 3% of all childhood cancers. (affects boys more than girls)
Rhabdomyosarcoma
rhabdomyoblasts
Fat tissue tumors are called _______, and smooth muscle tumors are called ________.
liposarcomas
leiomyosarcomas
___________ can originate anywhere in the body but are commonly found in the adrenal glands, lungs, ovaries, pancreas, rectum, small intestine, stomach, and thyroid.
_________ are heterogeneous cancers that can be both slow and aggressive growing, with the latter quickly metastasizing to other parts of the body.
What is this cancer?
Neuroendocrine tumors (NET)
How are neuroendocrine tumors typically treated?
neoadjuvant treatments (short and long-acting somatostatin therapy) and surgical resection
What are the primary radiopharmaceuticals used for somatostatin receptor-positive tumor imaging?
Ga-68 Dotatate, Cu-64 Dotatate, Lu-177 Dotatate
How long should either short or long somatostatin therapy not be performed before PET exam?
Short- 12hrs prior
Long-4 to 6 weeks prior
Cu-64 dotatate comes from hot lab looking like what?
clear, colorless to slightly yellow single calibreated dose
What society sets gold standards for staging system?
American Joint Committee on Cancer (AJCC)
What do the letters for TNM staging system mean?
T- classified as the primary tumor and further defined into levels depending on the cancer type.
N-denotes nodal disease and is usually followed by a numeric classification
M- defines metastasis, M0 indicating no metastasis and M1 indicating metastasis
F-18 NaF has been used for 30 years for imaging of the _____ to evaluate the spread or malignancy of osteogenic activity.
skeleton
F-18 Fluorothymidine (FLT) is an analog of _____.
(which is a major contributor to DNA synthesis)
thymidine
_______ imaging agent can be used to track tumor proliferation, stage disease, and monitor recurrence in certain tumors.
F-18 FLT
______, or deprivation of oxygen, can be a marker in tumor growth. As tumor grows larger it outgrows its blood supply.
Hypoxia
________ is an agent that looks at hypoxia or tumors causing.
Cu-64 diacetyl-bis (ATSM)
1 in ____ adults will have some form of malignancy.
1 in ____ children will have some form of malignancy.
6 adults
330 children (mostly under 14 years old)
