Diagnosis & Staging Flashcards
What lab tests are commonly used to diagnose cancer?
- Lab tests (chemistry - high or low can be d/t Ca)
- CBC (particularly for leukemias)
- Cancer gene mutation testing
- Cytogenetic analysis (changes in chromosomes in WBC’s or bone marrow)
- Immunophenotyping (identifies cells based on antigens presented; good for blood cancer monitoring)
- Sputum cytology
- Tumor marker tests (presence, levels or activity that may be signs of cancer)
- Urinalysis (Dx kidney and urothelial Ca)
- Urine cytology (bladder Ca dx)
What are common tumor imaging techniques?
- MRI scan (visualizes tissue hidden by bone)
- xray
- CT scan (not useful when surrounded by bone; shows difference in tissue density)
- PET scan
- Nuclear medicine
- Contrast within these studies can better visualize malignancies
- Ultrasound
What tumor marker is specific for prostate Ca?
PSA
What tumor marker is specific for testicular Ca?
AFP and HCG
What tumor marker is specific for ovarian Ca?
CA-125
What tumor marker is specific for melanoma Ca?
S100
What are examples of invasive diagnostic imaging?
- Endoscopy
- Biopsy
What is a pathology report?
- Document containing diagnosis as was determined by examining cells and tissues under a microscope
- Can contain information about size, shape and appearance of specimen (the gross description)
- Critical in cancer diagnosis and stating and therefore tx options; treatment options for cancers from within the same organ can differ significantly based on the histopathology
What is absolutely necessary before diagnosing cancer?
A histologic tissue confirmation, often obtained by biopsy
What is a tumor grade?
The description of a tumor based on how abnormal the tumor cells and tissue look under a microscope
What does ‘ well differentiated’ mean?
- The cells of the tumor and organization of its tissue are close to those of normal cells and tissue
= Tend to grow at a slow rate
What does “undifferentiated” or “poorly differentiated” mean?
Abnormal looking cells and may lack normal tissue structures
What does stage refer to?
The size and/or extent of the primary tumor, and whether or not Ca cells have spread in the body
What is the difference between grade 1-4 tumors?
G1: Well differentiated (low grade)
G2: Moderately differentiated (intermediate)
G3: Poorly differentiated (high grade)
G4: Undifferentiated ( high grade)
What is the TNM system?
- Most widely used cancer staging system
- T = size and extent of main tumor
- N = number of nearby lymph nodes with Ca
- M = indicates if it has metastasized
What are the different types of T staging?
TX: Non-measurable tumor
T0: Main tumor cannot be found (abnormal cells may be present)
T1-4: Size/extent of main tumor. The higher the number = the larger the tumor or the more it has grown into nearby tissues
What are the different types of N staging?
NX: Ca in lymph nodes cannot be measured
N0: No Ca in nearby lymph nodes
N1-3: Number and location of lymph nodes with Ca (higher number = more)
What are the different types of M staging?
MX: Met cannot be measured
M0: Ca has not spread
M1: Ca has spread
What Ca types have different staging systems?
Brain and spinal cord tumors and blood cancers
After numbers have been determined for TMN, many cancers are said to be in 1 of 5 stages. Describe them:
Stage 0: Early cancer present only in the layer of cells where it began
Stage I, II or III: Higher stage = Ca with greater tumor size and/or spread
Stage IV: Ca has spread to another organ(s)
What are the two different types of tumor markers?
- A tumor marker is anything present in/produced by cancer cells, or characteristics present in response to Ca
- Can detect how aggressive Ca is, whether it can be treated with targeted therapy, or to track treatment response
1) Circulating tumor markers: found in the blood, urine or other body fluids
2) Tumor tissue markers: found in actual tumors, typically from the biopsy. used for diagnosis, stating, prognosis and treatment selection
