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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
Q

Pathological staging is based on …

A

microscopic examination of tissue after it’s removed by surgery

26
Q

Pathological staging is used to…

A

plan additional treatment, estimate prognosis, and plan followup

27
Q

The initial stage of cancer changes as the cancer progresses/ recurs (T/F)

A

FALSE - it does not change

28
Q

Stage groupings (general)

A

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
Q

Radiography CAN/CANNOT detect cancers and is used as …

A

Can, preliminary view of chest and abdominal organs

30
Q

Bone scan uses ___ to find ____

A

radioactive tracer, cancer in the bone

31
Q

CT scan is used to…

A

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
Q

PET scan uses ___ to find ____

A

radioactive-labelled glucose, areas of high metabolism

33
Q

PET scan is used to…

A

detect cancer, determine the extend of stage, evaluate effectiveness of treatment, and monitor for recurrence

34
Q

Ultrasound is effective at ___ and can be used to ___

A

distinguishing between cystic and solid masses, detect possible tumor or guide biopsy

35
Q

Ultrasound is ineffective at …

A

detecting brain, lung, or intestinal tumors

cannot penetrate bone

36
Q

MRI provides detailed images of the ___ (3)

A

brain, spinal column, and liver

37
Q

MRI is used to ….

A

detect cancer, determine stage, evaluate effectiveness of tx, and monitor for recurrence

38
Q

IV contrast medium is sometimes used in… (2)

A

CT and MRI

39
Q

Tumor markers can be used in these clinical situations (6)

A
  1. Screening
  2. Diagnosis
  3. Prognosis
  4. Determining treatment
  5. Measuring response to treatment
  6. Recurrence surveillance
40
Q

Tumor marker for breast cancer

A

CA15-3/ CA27.29

41
Q

CA15-3/CA27.29 is found in ___ and used to ___

A

Blood, assess whether treatment is working or disease has recurred

42
Q

CA19-9C is a tumor marker for… (4)

A

Pancreatic, gallbladder, bile duct, gastric

43
Q

CA19-9C is found in ___ and used to ___

A

assess whether treatment is working

44
Q

Tumor marker for ovarian cancer

A

CA-125

45
Q

CA-125 is found in ___ and used to ____

A

Blood; help in diagnosis, assess response to treatment, evaluate recurrence

46
Q

Complete response

A

Absence of all signs and sxs of cancer for >1 month

47
Q

Partial response

A

> 50% reduction of measurable tumor mass for >1 month

48
Q

Stable response

A

<50% reduction to 15% increase in tumor growth

49
Q

Progressive disease

A

> 25% growth of tumor

50
Q

Important prognostic factors

A

type of cancer, subtype of cancer, size of tumor, location of cancer, spread of cancer, grade, stage

51
Q

Performance status reflects…

A

extent of disease and how it may affect a person’s ability to tolerate treatment

52
Q

Cancer-specific/ disease-specific survival

A

% of patients w/ specific type and stage of cancer who have not died of their cancer in a time frame after dx

53
Q

Relative survival

A

% of cancer patients who have survived for certain period of time compared to those who do not have cancer

54
Q

Overall survival

A

% of people with specific type and stage of cancer who have not died of any cause during timeframe after dx

55
Q

For consent to be considered valid …. (3)

A
  1. It must be voluntary
  2. The patient must have the mental capacity to consent
  3. The patient must be properly informed
56
Q

For consent to be voluntary … (2)

A
  1. Pts must be free to consent or refuse

2. Obtained w/out duress or coercion

57
Q

Pt is considered to have capacity for consent if they understand the …. (3)

A
  1. Nature of the proposed investigation or treatment
  2. Anticipated effects of tx and alternatives
  3. Consequences of refusing tx
58
Q

Pt must be informed of ___ to qualify as informed consent …. (6)

A
  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
Q

Goals of naturopathic support during active treatment (4)

A
  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
Q

Goals of naturopathic support after active treatment (4)

A
  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
Q

Naturopathic approach to cancer (6)

A
  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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