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Oncology > Diagnosis and Integrative Oncology > Flashcards

Diagnosis and Integrative Oncology Flashcards

1
Q

Diagnosis of cancer encompasses

A

Confirmation of the presence, location of primary tumor, identification of the type grade and stage, presence of tumor markers

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2
Q

Carcinomas

A

M/c type of cancer
From epithelial ells
Include lung, breast, and colon

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3
Q

Leukemias

A

From immature white blood cells that grow in bone marrow

Generally found in circulation, not in masses

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4
Q

Lymphomas

A

From lymph nodes and other immune tissues

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5
Q

Sarcomas

A

From connective tissue cells, incl bone, cartilage, fat, and muscle

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6
Q

Melanomas

A

From melanocytes

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7
Q

Myelomas

A

From bone marrow plasma cell

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8
Q

Cancer grade is based on…

A

Appearance and behavior under the microscope

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9
Q

Cancer grade tells us….

A

How differentiated the cancer cells are, how frequently they are dividing, and how likely they are to spread

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10
Q

Cancer cell differentiation refers to…

A

How cancer cells look and function compared to normal cells

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11
Q

Levels of differentiation + grades

A 
GX: cannot be assessed 
G1: Well differentiatied, low grade
G2: Moderately differentiated, intermediate grade 
G3: Poorly differentiated, high grade
G4: Undifferentiated, high grade
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12
Q

Differentiation levels which behave most agressively and have worse prognosis

A

Poorly differnetiated or undifferentiated

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13
Q

Low grade cancers are usually ___ differentiated and tumors are ___ growing

A

Well differentiated, slower growing

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14
Q

Grading system for breast cancer

A

Nottingham Score

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15
Q

Nottingham score grade is based on? (3)

A
  1. Level of differentiation (amount of gland formation)
  2. Nuclear pleomorphism (how “ugly”)
  3. Mitotic activity (hot much dividing)
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16
Q

Nottingham grades and scores

A

Grade 1, low grade, 3-5
Grade 2, imtermediate grade, 6-7
Grade 3, high grade, 8-9

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17
Q

Grading system for prostate cancer

A

Gleason score

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18
Q

Gleason score based on ?

A

Sum of the two most common patterns of glandular architecture

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19
Q

Gleason scores meaning

A

Gleason 2-6: well differentiated
7: moderately differentiated
8-10: poorly differentated or undifferentiated

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20
Q

Grading plays an important part in ___ and is implicated in ____

A

treatment, prognosis

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21
Q

Cancer stage is based on

A

Location of the primary tumor, size of the tumor, amount of local invasion, amount of spread into the lymph nodes, amount of distant metastasis

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22
Q

Stage of cancer plays an important role in … (3)

A

1.Determining the most 2.effective treatment
3.Estimating prognosis and risk of recurrence
Determining eligibility for a clinical trial

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23
Q

Clinical staging is based on …

A

Information gathered at diagnosis

- PE, lab test results, imaging studies and scopes, biopsy

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24
Q

Clinical staging is used to …

A

plan the initial treatment

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25
Pathological staging is based on ...
microscopic examination of tissue after it's removed by surgery
26
Pathological staging is used to...
plan additional treatment, estimate prognosis, and plan followup
27
The initial stage of cancer changes as the cancer progresses/ recurs (T/F)
FALSE - it does not change
28
Stage groupings (general)
Stage 0 - in situ, pre-cancer Stage I & II - organ/ location is began, or localized spread Stage III - spread further into surrounding structures or lymph nodes Stage IV - spread to distant site
29
Radiography CAN/CANNOT detect cancers and is used as ...
Can, preliminary view of chest and abdominal organs
30
Bone scan uses ___ to find ____
radioactive tracer, cancer in the bone
31
CT scan is used to...
detect cancer and determine size, location, and extend of disease for clinical staging Guide biopsy and radiation therapy planning, evaluate tx outcomes, monitor for recurrence
32
PET scan uses ___ to find ____
radioactive-labelled glucose, areas of high metabolism
33
PET scan is used to...
detect cancer, determine the extend of stage, evaluate effectiveness of treatment, and monitor for recurrence
34
Ultrasound is effective at ___ and can be used to ___
distinguishing between cystic and solid masses, detect possible tumor or guide biopsy
35
Ultrasound is ineffective at ...
detecting brain, lung, or intestinal tumors | cannot penetrate bone
36
MRI provides detailed images of the ___ (3)
brain, spinal column, and liver
37
MRI is used to ....
detect cancer, determine stage, evaluate effectiveness of tx, and monitor for recurrence
38
IV contrast medium is sometimes used in... (2)
CT and MRI
39
Tumor markers can be used in these clinical situations (6)
1. Screening 2. Diagnosis 3. Prognosis 4. Determining treatment 5. Measuring response to treatment 6. Recurrence surveillance
40
Tumor marker for breast cancer
CA15-3/ CA27.29
41
CA15-3/CA27.29 is found in ___ and used to ___
Blood, assess whether treatment is working or disease has recurred
42
CA19-9C is a tumor marker for... (4)
Pancreatic, gallbladder, bile duct, gastric
43
CA19-9C is found in ___ and used to ___
assess whether treatment is working
44
Tumor marker for ovarian cancer
CA-125
45
CA-125 is found in ___ and used to ____
Blood; help in diagnosis, assess response to treatment, evaluate recurrence
46
Complete response
Absence of all signs and sxs of cancer for >1 month
47
Partial response
>50% reduction of measurable tumor mass for >1 month
48
Stable response
<50% reduction to 15% increase in tumor growth
49
Progressive disease
>25% growth of tumor
50
Important prognostic factors
type of cancer, subtype of cancer, size of tumor, location of cancer, spread of cancer, grade, stage
51
Performance status reflects...
extent of disease and how it may affect a person's ability to tolerate treatment
52
Cancer-specific/ disease-specific survival
% of patients w/ specific type and stage of cancer who have not died of their cancer in a time frame after dx
53
Relative survival
% of cancer patients who have survived for certain period of time compared to those who do not have cancer
54
Overall survival
% of people with specific type and stage of cancer who have not died of any cause during timeframe after dx
55
For consent to be considered valid .... (3)
1. It must be voluntary 2. The patient must have the mental capacity to consent 3. The patient must be properly informed
56
For consent to be voluntary ... (2)
1. Pts must be free to consent or refuse | 2. Obtained w/out duress or coercion
57
Pt is considered to have capacity for consent if they understand the .... (3)
1. Nature of the proposed investigation or treatment 2. Anticipated effects of tx and alternatives 3. Consequences of refusing tx
58
Pt must be informed of ___ to qualify as informed consent .... (6)
1. Dx 2. Nature of proposed tx 3. Expected outcome of tx 4. Expected outcome if declined 5. Reasonable alternatives 6. Material risks and special risks
59
Goals of naturopathic support during active treatment (4)
1. Optimize nutritional status 2. ensure no negative herb/ nutrient - tx interactions 3. Manage adverse effects and prevent long term sequelae 4. Support the effects of treatment
60
Goals of naturopathic support after active treatment (4)
1. Support recovery from lingering a/e 2. Prevention of recurrence or delaying progression 3. Maintain QOL 4. Support palliative and end-of-life care
61
Naturopathic approach to cancer (6)
1. Regulate inflammation 2. Support and balance immune function 3. Regulate blood sugar and insulin 4. Regulate hormones 5. Support digestion 6. Support detoxification and repair mechanisms

Oncology (7 decks)

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