Exam 5: Cancer

Question 1

Neoplasm:

Answer 1

Tumors “new growth” not all are life threatening

Question 2

Differentiation:

Answer 2

Extent that neoplastic cells resemble normal cells both structurally and functionally

Question 3

Anaplasia:

Answer 3

Total cellular disorganization, abnormal cell appearance and cell dysfunction

Question 4

Benign:

Answer 4

Non-invasive tumor; well differentiated, remains localized and cohesive

Question 5

Malignant:

Answer 5

Invasive tumor; range from well to poorly differentiated, destructive to surrounding tissue

Question 6

Metastasis:

Answer 6

Process by which malignant cells travel to distant sites and away from site of origin

Question 7

TNM:

Answer 7

Tumor Nodal Metastasis system: staging system that classifies tumor

Question 8

Tumor suppressor genes:

Answer 8

Function to control and restrain cell growth

Question 9

Oncogene:

Answer 9

Gene that has a potential to cause cancer; often mutated and or expressed at high levels.

Question 10

Proto-oncogene:

Answer 10

Normal genes that stimulate and regulate cells movement through the cell cycle; resulting in cellular growth and proliferation

Question 11

Vascular endothelial growth factor (VEGF):

Answer 11

Substance that provides capability to develop new blood vessels

Question 12

Angiogenesis:

Answer 12

Growth of new blood vessels

Question 13

Paraneoplastic Syndrome:

Answer 13

Unexpected pathological disorder provoked by the presence of cancer. Pathological disorder could occur because of excess secretion of hormones or enzymes related to location of a cancer growth. See page 952 as well as T40-2.

Question 14

Cachexia:

Answer 14

Progressive and profound weight loss, weakness, anemia,

Question 15

Tumor cell markers:

Answer 15

See Table 40-5 page 953 Products of cancer cells; these might be hormones, enzymes, antigens, or antibodies Important in diagnosis, tracking progression and evaluation of therapies. Found in blood, spinal fluid or urine; these fluids can be sent to lab to check for tumor cell markers

Question 16

Carcinoembryonic antigen (CEA):

Answer 16

Tumor cell marker found in fetal development

Question 17

Alpha-fetaprotein:

Answer 17

Antigen used as a tumor marker

Question 18

Digital Rectal Exam (DRE):

Answer 18

An examination in which a provider inserts a lubricated, digit “finger” into the rectum to feel for abnormalities.

Question 19

Grade I

Answer 19

indicates that the cells are well-differentiated

Question 20

Grade II

Answer 20

indicates cells are moderately differentiated

Question 21

Grade III

Answer 21

indicates poorly differentiated or anaplastic cells

Question 22

Stage 0

Answer 22

Abnormal cells are present but have not spread to nearby tissue. Also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer.

Question 23

Stage I, Stage II, and Stage III

Answer 23

Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.

Question 24

Stage IV

Answer 24

The cancer has spread to distant parts of the body.

Question 25

frequent sites of mets for each

Answer 25

lung -> bone, brain
colon -> liver
breast -> bone, brain, liver, lung
prostate -> vertebrae
melanoma -> brain

Question 26

Non-Small Cell Lung Cancer (NSCLC) -

Answer 26

NSCLC is more common (80%) lung CA, slow growing and spreading

Question 27

Adenocarcinoma

Answer 27

NSCLC (alveoli) - Most common (more in women).Periphery -> bronchoalveolar. Usually large at time of diagnosis -> mets early. May not be associated with smoking or exposure*

Question 28

Squamous cell carcinoma

Answer 28

NSCLC (center) - Found in the center of the lung next to an air tube (bronchus), detected in sputum. Grows slowly -> spreads to major bronchi. Paraneoplastic syndrome: hypercalcemia

Question 29

Large cell carcinoma

Answer 29

NSCLC (any part) - Can occur in any part of the lung. Highly anaplastic (poorly differentiated). Difficult to categorize as squamous or adenocarcinoma. Tends to grow and spread faster. Poor prognosis spread to distant sites early.

Question 30

Small Cell Lung Cancer (SCLC)

Answer 30

• Almost always associated with cigarette smoke, treated with chemotherapy. Small oval cells that grow in clusters, rapid growth and most malignant -> mets early. Poorest prognosis (only 10% over 2yrs). Arises out of bronchus. Paraneoplastic complications common. Small cell carcinoma & Combined small cell carcinoma

Question 31

Luminal A:

Answer 31

Slow-growing cancers, 90% cure rate, often found on screening mammograms.

Question 32

Luminal B:

Answer 32

Aggressive cancers that invade blood vessels and lymph nodes.

Question 33

Basal:

Answer 33

Very aggressive, rapidly growing cancer that lacks estrogen, progesterone and HER2 receptors.

Question 34

HER2 Positive:

Answer 34

Overproduction of HER2 -> Signals breast cancer to grow and spread.

Question 35

Tumor cell markers:

Answer 35

most: CA125, CEA
breast: HER
prostate: PSA

Question 36

Colorectal cancer

Answer 36

Adenomatous polyps, Change in BM, rectal bleeding, rectal/abdominal mass. Colonoscopy, FOBT

Question 37

Ovarian cancer

Answer 37

Risk increases w/ more periods (early menarche, late menopause, no pregnancies), BRCA gene

Question 38

Pancreatic cancer

Answer 38

Most (85%) are adenocarcinomas of the pancreatic ducts in head, body or tail -> Can spread quickly anywhere – common metastasis sites are the liver, peritoneum, and lungs. Most discovered due to symptoms at a metastasis site rather than disruption of pancreatic function. Pain, jaundice, and weight loss. DVT less common. Lowest 5 year survival rate (10%) of all major cancers. Very poor.

Question 39

Prostate cancer

Answer 39

Enlarged on DRE, impacts urination, large inguinal lymph nodes. 98% survival at 5 years.

Question 40

Bladder cancer

Answer 40

Cause is not fully understood but thought to be carcinogens that are excreted in the urine and stored in the bladder. Products/chemicals used in the manufacture of rubber, textiles, paint, chemicals, and petroleum. Smoking & age. Urothelial carcinoma of cells that line bladder. Can be low-grade noninvasive tumors or high-grade tumors that invade bladder wall and metastasize