Lecture 7 2/12/25 Flashcards
How is the extent of cancer in the body determined?
-physical exam
-diagnostic tests
What does cancer stage impact?
-treatment
-prognosis
How are the diagnostic tests performed selected?
-predicted biologic behavior
-common metastatic sites
-likelihood of metastasis
What are the characteristics of carcinoma metastasis?
-most common route is lymphatic route
-settles in regional lymph nodes and lungs
What are the characteristics of sarcoma metastasis?
-most common route is hematogenous route
-settles in liver and lungs
Which tumors are likely to spread by direct implantation?
-mesothelioma
-ruptured hemangiosarcoma
What is important to know before staging?
knowing the tumor type or having a strong suspicion
What are the characteristics of biopsy and histopathology?
-gold standard for tumor identification
-can give definitive tumor diagnosis
-can allow for tumor grading
-invasive
-can have complications
What are potential tools used for biopsy?
-punch biopsy needles
-tru-cut biopsy needles
What are the characteristics of FNA and cytology?
-quick and non-invasive
-inexpensive
-minimal complications
-may not provide definitive diagnosis
What can be sampled via FNA?
-lung nodules
-intra-abdominal organs
-lymph nodes
-skin/subcutaneous masses
-bone marrow
-effusions
-bone
What are the typical tools for FNA?
-22 gauge needle
-6 cc syringe
What are the two techniques for FNA?
-syringe on
-syringe off
What are the steps of staging via physical exam?
-use a nose to tail approach, including the oral cavity and a rectal exam
-palpate for skin and SQ masses
-measure and map all masses
-take pictures
Which diagnostic tests can be done to determine cancer staging?
-CBC
-chem/lytes
-UA
-radiographs
-ultrasound
-CT
-MRI
-serum protein electrophoresis
-coagulation profile
-buffy coat analysis
Which aspects of the CBC are evaluated in cancer staging?
-RBC count and morphology
-WBC count
-platelet count
-presence of abnormal cells in circulation
Which aspects of the chem/electrolyte panel are evaluated in cancer staging?
-renal function
-liver function
-globulins
-glucose
-calcium
Which aspects of the UA are evaluated in cancer staging?
-USG
-sediment
-abnormal cells
Which cancers can be assessed with chem/electrolyte readings?
-globulins: multiple myeloma and lymphoma
-glucose: insulinoma
-calcium: lymphoma and anal sac carcinoma
Which cancer is assessed with serum/urine protein electrophoresis?
multiple myeloma
Which cancers are assessed with coagulation profiles?
-lymphoma
-hemangiosarcoma
Which cancer is assessed with buffy coat evaluation?
feline mast cell tumors
What is assessed on thoracic radiographs?
-met check
-intrathoracic lymphadenopathy
-pleural effusion
What is assessed on abdominal radiographs?
-organ size and shape
-enlarged sublumbar lymph nodes
-ascites
-bony metastasis
What is assessed on abdominal ultrasound?
-organ echotexture
-masses within organs
What is assessed on CT and MRI?
-pulmonary metastasis (CT)
-brain tumors (MRI)
Which other imaging modalities can be used in cancer staging?
-thyroid scan
-bone scan
What are some of the commonly used staging schemes?
-TNM for solid tumors (tumor, node, metastasis)
-WHO I-V for lymphoma
What are the characteristics of the Tumor part of the TNM scheme?
-measures size and invasiveness of primary tumor
-size cut-offs vary with tumor type
-T0 ALWAYS indicates microscopic dz
What are the Tumor size cutoffs for oral tumors?
T1: <2 cm
T2: 2-4 cm
T3: >4 cm
What are the Tumor size cutoffs for canine mammary tumors?
T1: <3cm
T2: 3-5 cm
T3: >5 cm
What are the characteristics of the Node part of the TNM scheme?
-N0 indicates clean draining node
-N1 indicates metastatic disease present in the draining node
What are the characteristics of the M part of the TNM scheme?
-M0 indicates no distant metastasis
-M1 indicates presence of distant metastasis
What is the staging for oral tumors?
0: T1, N0, M0
1: T2, N0, M0
2: T3, N0, M0
3: Any T, N1, M0
4: Any T, Any N, M1
