medical mgmt of CA Flashcards
how can drs Identify when a tumour is primary or secondary
When they look at the cells in the secondary site they can often identify by the cell str where the site of origin was
in general what is the cause of CA in young vs old
In young people cancers tend to be the result of a cell that has genetic issue during regen. For older people its often env toxins
if you have lung CA and it mets to the brain how do you describe this
Metastasis to a new tissue is still the same cancer, e.g. Lung cancer that metastasizes to bone is “lung cancer with bone metastasis”
what are the categories of causes of CA
Viral/Bacterial Physical (X-rays, UV rays) Chemical Genetic Dietary Hormonal
how do incidence of CA and age correlate? who is the following found in brain tumours testicular CA leukemia
Most CA is in those over 65 but can occur in any age group
Testicular CA in young men
Leukemias and brain tumours in kids
what are the SPECIFIC s/s of CA
how does it present in early stages
signs and symptoms vary widely
Can be vague in early stages –
t or f CA is sometimes detected before s/s appear
T Is sometimes detected before signs appear
at what point in CA is pain experienced
Pain is usually not experienced until the cancer is well-developed
other than using Screening tests for detection of cancer before it causes signs and symptoms what is it used for
Some of the screening tests are good for seeing how treatment is going
what kinds of CA can have a genetic link?
what can genetic testing lead to?
Genetic testing – can help identify people with specific susceptibility
Some breast cancers, ovarian, colon have genetic links
Genetic testing can lead to some preventative severe measures (radical mastectomy if many indicators of BR CA)
she probably taught us these for our own benefit but how do you do BR self exam and TSE?
what is done to investigate colon? cervix?
BSE: do in wk after menstrual cycle every month so you get used to it, good to put hand behind head, start up in axilla, press firmly, check nipple for puckering and pulling
TSE: start at the top of the scrotum as they are often there.
Colonography or colonoscopy to screen for colon cancer; pap test
At age 40 you start mammograms. When 50 they start doing stool tests.
what are blood tests looking for/helping to detect
Blood tests –
Tumour markers, leukemias, lymphomas
many types of imaging may be used to detect suspected cancer
which diagnostic imaging is cheap and often used for finding tumours because results are received quickly
Imaging –
MRI, CT scan, fluoroscopy, ultrasound, endoscopy, nuclear med images, PET scan
Often U/S to check for tumours as theyre cheaper and results are received quickly
why can biopsy be so challenging for pt
Biopsy-the pt may have to be opened for this. The pt can receive local anaesthetic for the biopsy which is the painful part.
The technician/nurse explaining the procedure before hand can dec anxiety for pt and help them through process
why is tumour grading and staging done
Done prior to treatment:
for baseline data
to help identify the best treatment options
to aid in prognosis
if a tumour is a low grade is it more or less responsive to tx?
The lower the grade (the less aggressive the cell) the more responsive to Tx it may be!!!!!!!!!!
t or f rapidly proliferating cells can be very responsive to tx
sometimes the very rapidly proliferating cells are very responsive to tx as long as we get it in time
what is the TNM system for?
what is it based on?
which type of tumours is TNM good for and what will this not work on?
TNM system - for classifying how far a tumour has spread
Based on imaging and/or biopsy
Solid tumours only, not CNS or blood cancers
T = extent (or size) of primary tumour, N = lymph node involvement, M = extent of metastasis
E.G. a colon tumour may be referred to as T1 N0 M0
how is tumor staging done
biopsy specimens,
surgical excision of the tumour or part of the tumour
tissue scrapings (Pap test)
body fluids (CSF)
secretions or washings (bronchial)
The lower the grade, the more responsive to treatment it may be
what does Tx mean
what does T1 vs T 4 mean
N0- what number
M0- what number
tx-means primary tumour cant be assessed
t1 hasnt invaded through mucosa
t4 has invaded surrounding organs
N0-3
M 0-1
grading
purpose
from what to what?
where
o Seek to define type of tissue from which T originated + degree to which T cells retain functional and histological characteristics of origin (differentiation)
o Samples come from tissue scrapings, body fluids, secretions, biopsy, washings, sx
o Graded I-IV
o Grade I: well-differentiated T, closely resembles tissue of origin
o Grade IV: poorly or undifferentiated; are more aggressive, less response to tx
what would examples of primary prevention of CA be
- Concerned with reducing risks of disease through health promotion
- Majority of risk factors for CA modifiable
- Avoid carcinogens, dietary mods, lifestyle – smoking cess, dec caloric intake, inc physical activity
- Clinical trials being done on meds that help prevent occurrence
examples of secondary prevention
o Colon/rectum fecal occult blood test q 2yr
o Prostate PSA testing + DRE (afte 50 or 40yrs for those at risk)
o Skin watch skin changes
o Testicles TSE regularly after 15yrs
o Breast clinical breast exam, breast self exam (BSE), mammography (after 50 yrs q 2yrs)
o Cervical PAP q1-3yrs, those who are/have been sexually active
if pt has suspected CA what kind of evaluativ process will they go through
1) Determine presence and extent of tumour
2) Identify possible spread (mets) or invasion of other body tissues
3) Evalfx of involved and uninvolved body systems + organs
4) Obtain tissues and cells for analysis, including T stage + grade
what are the 3 general differing goals of CA tx
Cure
Prolong survival
Palliation (to relieve symptoms)
what is biologic response modifier therapy addressing
-the issue is that the CA is our own cels and body is slow to address it. This med helps the body to recog CA cells as unique.
what is the most form of CA tx
sx
