Exam 5: Cancer Flashcards
Neoplasm:
Tumors “new growth” not all are life threatening
Differentiation:
Extent that neoplastic cells resemble normal cells both structurally and functionally
Anaplasia:
Total cellular disorganization, abnormal cell appearance and cell dysfunction
Benign:
Non-invasive tumor; well differentiated, remains localized and cohesive
Malignant:
Invasive tumor; range from well to poorly differentiated, destructive to surrounding tissue
Metastasis:
Process by which malignant cells travel to distant sites and away from site of origin
TNM:
Tumor Nodal Metastasis system: staging system that classifies tumor
Tumor suppressor genes:
Function to control and restrain cell growth
Oncogene:
Gene that has a potential to cause cancer; often mutated and or expressed at high levels.
Proto-oncogene:
Normal genes that stimulate and regulate cells movement through the cell cycle; resulting in cellular growth and proliferation
Vascular endothelial growth factor (VEGF):
Substance that provides capability to develop new blood vessels
Angiogenesis:
Growth of new blood vessels
Paraneoplastic Syndrome:
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.
Cachexia:
Progressive and profound weight loss, weakness, anemia,
Tumor cell markers:
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
Carcinoembryonic antigen (CEA):
Tumor cell marker found in fetal development
Alpha-fetaprotein:
Antigen used as a tumor marker
Digital Rectal Exam (DRE):
An examination in which a provider inserts a lubricated, digit “finger” into the rectum to feel for abnormalities.
Grade I
indicates that the cells are well-differentiated
Grade II
indicates cells are moderately differentiated
Grade III
indicates poorly differentiated or anaplastic cells
Stage 0
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.
Stage I, Stage II, and Stage III
Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.
Stage IV
The cancer has spread to distant parts of the body.
frequent sites of mets for each
lung -> bone, brain
colon -> liver
breast -> bone, brain, liver, lung
prostate -> vertebrae
melanoma -> brain
Non-Small Cell Lung Cancer (NSCLC) -
NSCLC is more common (80%) lung CA, slow growing and spreading
Adenocarcinoma
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*
Squamous cell carcinoma
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
Large cell carcinoma
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.
Small Cell Lung Cancer (SCLC)
- 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
Luminal A:
Slow-growing cancers, 90% cure rate, often found on screening mammograms.
Luminal B:
Aggressive cancers that invade blood vessels and lymph nodes.
Basal:
Very aggressive, rapidly growing cancer that lacks estrogen, progesterone and HER2 receptors.
HER2 Positive:
Overproduction of HER2 -> Signals breast cancer to grow and spread.
Tumor cell markers:
most: CA125, CEA
breast: HER
prostate: PSA
Colorectal cancer
Adenomatous polyps, Change in BM, rectal bleeding, rectal/abdominal mass. Colonoscopy, FOBT
Ovarian cancer
Risk increases w/ more periods (early menarche, late menopause, no pregnancies), BRCA gene
Pancreatic cancer
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.
Prostate cancer
Enlarged on DRE, impacts urination, large inguinal lymph nodes. 98% survival at 5 years.
Bladder cancer
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
