Medical Oncology Flashcards
Most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. Types of epithelial cell types include adeno-, basal cell -, squamous cell -, transitional cell -.
Carcinomas
Cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments)
Sarcomas
Cancer of the blood forming tissues of the bone marrow.
Leukemia
Cancers that begin in the lymphocytes (T or B cell). Hodgkin vs. Non-Hodgkin
Lymphoma
Other types of cancers include?
Melanomas
Brain/spinal cord tumors
germ cell tumors
neuroendocrine tumors
multiple myeloma
S/Sx of cancer
Nagging cough/hoarseness
new dysphagia
Unexpected weight loss
changes to bladder/bowel habits
new thickening or lumps/bumps on the body
unusual bleeding or discharge
changes in blood counts
new mole or changed mole
night sweats
fatigue
Cancer screening modalities include?
colonoscopy
mammograms
PAP/HPV tests
PSA
low-dose CT scan to screen for early lung cancer
Early Detection of Cancer in Average-Risk Asymptomatic People
Breast:
Age 40-54?
Age 55+?
Mammography screened annually
Biennial screening if overall health is good/life expectancy is 10+ years
Early Detection of Cancer in Average-Risk Asymptomatic People
Cervix:
Age 25-65
Age 65+
Primary HPV test every 5 years with FDA approved primary test
PAP & HPV DNA every 5 years
Pap test alone every 3 years
d/c screenings if results were negative in the past 10 years, with the most recent test w/n the past 5 years
Early Detection of Cancer in Average-Risk Asymptomatic People
Colorectal
Age 45+?
High-sensitivity gFOBT or fecal immunochemical test (FIT) q1 year
Multi-target stool DNA test q3 years
Flex sig q5years
Colonoscopy q10 years
CT colonography q5yrs
Early Detection of Cancer in Average-Risk Asymptomatic People
Endometrial
Menopausal women should be informed about risks and symptoms of endometrial cancer and encouraged to report unexpected bleeding
Early Detection of Cancer in Average-Risk Asymptomatic People
Lung
Age 50-80 w/ 20+ pack year smoking hx should undergo low dose helical CT shouold undergo annual screening in generally healthy adults regardless of whether or when they have quit
Early Detection of Cancer in Average-Risk Asymptomatic People
Prostate
Age 50+ PSA with or w/o DRE Men w/ 10+ year life expectancy should have an opportunity to be screened for prostate cancer. AA males should have this discussion at age 45.
Tumor Markers
Alpha fetoprotein (AFP):
CA 19-9:
CA 125:
Carcinoembryonic antigen (CEA):
Human chorionic gonadotropin (HCG):
PSA:
HCC, germ cell tumors
Pancreatic
Ovarian
GI cancers / Colorectal
Choriocarcinoma, germ cell tumors, liver cancers
Prostate
Staging
TNM System:
The T refers to what?
The N refers to what?
The M refers to what?
The size and extent of the primary tumor
The number of nearby lymph nodes that have cancer
Whether the cancer has metastasized. Has the cancer spread from it’s origin to other parts of the body?
Grading:
The cancer cells look fairly normal. Generally grow slower and often have a better prognosis?
Low-grade (well-differentiated) cancers
Grading:
The cancer cells look more abnormal. Generally grow more quickly, so they may need different treatments than low-grade cancers.
High-grade (poorly differentiated) cancers
Staging
Abnormal cells are present but have not spread to nearby tissue. Also called Carcinoma in situ, or CIS. CIS is not cancer, but may become cancer.
Stage 0
Staging
Cancer is present. the higher the number, the larger the cancer tumor and teh more it has spread into nearby tissues.
Stage I, II, and III
Staging
The cancer has spread to distant parts of the body.
Stage IV
Appropriate imaging required to complete staging may include?
MRI
US
Endoscopy/EUS
Bone scans
PET-CT
CT CAP w/ contrast
Local Therapy
Intended to treat a tumor at the site w/o affecting the rest of the body.
i.e. Surgery, ablation, TACE, radiation, HIPEC
Systemic Therapy
Drugs that are given PO, IM, IV that reach cancer cells anywhere in the body
i.e. chemotherapy, immunotherapy, targeted therapy, hormone therapy
Neoadjuvant therapy can be what?
chemo/radiation to shrink the tumor prior to surgical intervention
Adjuvant therapy refers to therapy when?
after surgery or other major intervention to kill remaining cancer cells that have broken away from primary tumor and remain in the bloodstream/tissues that are undetectable by imaging.
