Neoplasms Flashcards
List factors that influence cancer survival.
Stage at diagnosis
Aggressiveness of the tumor
Early detection
Quality of treatment servicesAgeSexCo-morbid health conditionsSocio-economic status
Increase in size of cells
Hypertrophy
Increase in number of cells
Hyperplasia
What are the characteristics of benign neoplasms?
EncapsulatedWell-differentiatedDevelop slowlyDo not infiltrate surrounding tissueRarely recur after surgical removal
What are the characteristics of malignant neoplasms?
- Anaplastic * Can invade surrounding tissue * Can enter the bloodstream or lymph * Causes metastasis * Poorly differentiated
List the causes of cancer
- External exposure to carcinogens * Internal factors like hormones, immune conditions and inherited mutations
Listprimary cancer prevention guidelines.
Consume diet rich in fruits, vegetables, whole grains low in saturated/trans fats Eliminate active and passive exposure to cigarette smoke Limit skin exposure to sunlight Limit use of alcohol Avoid excessive exposure to radiation/radon Avoid chemical agents known to be carcinogenic Increase physical activity Maintain healthy weight Protect against STIs
External factors that can cause cancer
- Chemicals * Radiation * Viruses (Papillomaviruses)
Internal factors that can cause cancer
- Hormones * Immune conditions * Inherited mutations
Seven warning signs of cancer
Change in bowel or bladder habits Asore that doesn’t heal Unusual bleeding or discharge Thickening or lump Indigestion or difficulty in swallowing Obvious change in a wart or mole Nagging cough or hoarseness
List some cancer symptoms
- pain * fatigue * anorexia and cachexia
List disorders associated with cancer.
- anemia * leukopenia * thrombocytopenia * infection
List factors predisposing patients with cancer to infection.
- Age * Tumor * Leukemias * Lymphomas and other mononuclear phagocyte malignancies * Surgical treatment
Gross (naked eye) descriptions of neoplasms
polypoid
What are the two types of polypoid tumors?
- sessile * pendunculated
What does a sessile tumor look like?
wide, flat, base
What does a pedunculated tissue look like?
stalk shaped, narrow based
What does a fungating tumor look like?
mushroom appearance, wider base where cells tend to grow over each other in a mushroom cap-like formation
What does a verrucous tumor look like?
Resembles warts
List some microscopic description terms of neoplasms.
- carcinoma in situ (v early stage cancer) * diffuse * dysplastic * epidemoid * follicular * papillary * pleomorphic * scirrhous * undifferentiated
The earliest possible stage you can catch cancer
carcinoma in situ
Sebaceous cyst tumor that don’t tend to be cancerous
follicular
Type of tumor where you can’t tell what type of cell it was because it has changed so drastically
Undifferentiated
List classification categories.
- carcinoma (epithelial tissue) * sarcoma (connective tissue) * mixed-tissue * lymphoma (lymphatic tissue) * glioma (glial cells of CNS) * leukemia * germ cell tumor (germ cells of ovaries and testicles
What is being determined when staging a tumor?
- the size and extent of tumor spread
Staging generally uses a common international format known as _________.
TNM Staging System
What does TNM stand for?
Tthe size or extent of the primarytumorNthe extent of regional lymphnodeinvolvementMthe number of distantmetasteses
Once TNM have been determined, they are combined to assign a stage number of __, __, __, or __.
I, II, III, IV
The most advance stage of cancer
IV
Grading of tumors is determined through ______ examination.
microscopic
Grade is assigned based on the degree of ______ of the tumor cells.
Differentiation
The tumor cells still retain features of the tissue cells from which they are derived.
Well-differentiated
The tumor do not resemble the tissue from which they are derived
poorly differentiated
Prostate cancer’s own grading system
The Gleason grade
Why was the Gleason grade designed?
Designed with the knowledge that prostate cancer has different patterns of growthand thatmultiple patterns coexistin the prostate.
Size and extent of tumor spread is important information used for _____ and _____.
- prognosis * treatment modality
TNM in charts are written asT1N2M0with the ____ indicating the varying degrees of each letter.
subscript
T or F. The higher the grade, the better the prognosis.
False. The lower the grade, the better the diagnosis
T or F. Grading numbers go from Grade 1 to 3.
True
What do Gleason grades 1 to 5 indicate?
- small uniform glands * more stroma between glands * distinctly infiltrative margins * irregular masses of neoplastic glands * only occasional gland formation
Enzymes, antigens and hormones produced by some tumors or cancer that may be present in blood in higher-than-normal levels
tumor marker
T or F. The presence of a tumor marker alone can be used to diagnose cancer.
False. Some benign tumors may stimulate production of these markers and elevated cancer markers aren’t always present especially in the early stages
What are other uses for measuring tumor markers?
- Tracks the progress of tumor growth- Measures the effectiveness of treatment- Identifies possible recurrence of tumor
PSA
Prostate-Specific Antigen
What type of cancer produces PSA?
prostatic cancer
What other exam should be done after a PSA screen?
digital rectal examination (DRE) to identify any abnormalities
What type of cancer may be indicated with elevated CA 125?
ovarian cancer
CA 19-9?
colorectal cancer
CA 15-3
breast cancer
Why is the test measuring carcinoembryonic antigen used?
To monitor the spread or metastasis of colorectal cancer and other cancers
Used to screen for fetal neural tube defects
Alpha fetoprotein (AFP)
If a maternal AFP doesn’t return to normal after giving birth, what type of cancer may be indicated?
liver or germ cell cancer
Physician may relate the results as normal or abnormal because surface cervical cells may appear abnormal but aren’t always malignant
Bethesda System
Preinvasive cancer that hasn’t invaded deeper tissues and contains only surface cells
carcinoma in situ
New abnormal growth of surface layers of cells
cervical intraepithelial neoplasia (CIN)
Appearance of abnormal changes on the surface of the cervix; contains a large number of precancerous cells
Squamous intraepithelial lesion (SIL)
Not cancer but may develop into very early cancer of the cervix
dysplasia
Mammograms should be performed on an ___ basis for women older than ___ years of age to detect breast disease.
Mammograms should be performed on an annual basis for women older than 40 years of age to detect breast disease.
What is the goal of cancer treatment?
To eradicate every cancer cell in body
What is the purpose of neoadjuvant therapy?
To shrink tumor to aid in surgical removal
When surgery is done to cure cancer, what is the surgeon trying to achieve?
To cure (achieving negative margins around the tumor)
What else may be removed at the time of surgery and why?
regional lymph nodes to see whether cancer has entered the lymphatic system
List chemotherapy side effects
alopecia, anorexia, vomiting, diarrhea, anemia, bruising, infertility
Uses medication to kill cancer cells but also destroys rapidly dividing normal cells
chemotherapy
Can be effective against hormone dependent cancers
hormone therapy
Hormone therapy can involve _____ of hormone producing glands or the use of ____
surgical removal, drugs
Hormone therapy drugs can either suppress hormone ____ or block the _____ of hormones
Hormone therapy drugs can either suppress hormone synthesis or block the action of hormones
One common example of a hormone therapy drug used to block the action of hormones in breast cancer
estrogen receptor modulator Tamoxifen
Immunotherapy uses _____ that target certain products of cancer cells not found in normal cells
monoclonal antibodies
Monoclonal antibodies in immunotherapy can trigger an _____ against the tumor cell
immune response
Monoclonal antibodies in immunotherapy can deliver a lethal dose of _____ to the cell
radiation
Monoclonal antibodies in immunotherapy can release a deadly _____ inside the cell
chemical
Brand names of the four antibodies approved for use by the FDA
- Herceptin2. Rituxan3. Campath4. Mylotarg
What types of cancers are patients who have undergone prior cancer treatment predisposed to developing?
lymphomas and leukemias
What are the advantages of stereotactic radiosurgery over regular radiation therapy?
- Normal tissues experience less TOXICITY- Only ONE TREATMENT is required - Short or no RECOVERY time- Offers hope in sites considered INOPERABLE by conventional surgeryTOTRI
Current cancer vaccine research is focused on ____
treating cancer inpatients who already have the disease (triggering immune response to attack/kill cancer cells)
Cancer research into inherited forms is focused on ____ and ___ genes which are genetic switches that cause healthy cells to become disorderly
oncogenes and tumor suppressor
What is the difference between stereotactic radiosurgery and regular radiation therapy?
Traditional RT involves giving small doses of radiation while SRS involves many beams of low dose radiation coming in at different angles` to converge on one point, so that the tumor gets intense radiation but the normal tissue only gets a small amount
Rare but still the second leading cause of death in children (after trauma)
cancer in children
Unique feature of cancer in children is short ____ time
latency
In children, ___ already have metastases at the time of diagnosis
80%
Most cancer in children originate from the ____ layer
mesodermal germ
Little or no pain is associated with early stages of cancer, but often occurs in later stages; The general mechanisms associated with cancer that cause pain are:
pressure (tumor pressing on surrounding tissues), obstruction, invasion, stretching of visceral surfaces, tissue destruction, inflammation
What is the most frequently reported symptom of cancer and cancer treatment?
fatigue
What can anorexia lead to, and what is the name of the syndrome that can result?
cachexia
What blood condition is common in patients with a malignancy, and why does it occur?
anemia,caused by malnutrition, chronic bleeding = iron deficiency, chemotherapy, malignancies of the blood forming organs
What conditions can tumor invasion of the bone marrow cause?
leukopenia thrombocytopenia
Complication of cancer and death commonly result from what cause?
infection
What is a gross pathological examination of a tissue?
done with the naked eye, before the tissue is prepared for microscopic study
What are the common terms associated with gross description? What does each one look like?
polypoid, fungating, verrucous
Microscopic description: An epithelial tumor that hasn’t broken through the basement membrane of the site
carcinoma in situ (CIS)
Microscopic description: The tumor is spread evenly throughout the affected tissue
diffuse
Microscopic description: a tumor that displays highly abnormal alteration in ____, ____, and ___ of the adult cell, but not clearly ____ in appearance.
Dysplastic: a tumor that displays highly abnormal alteration in size, organization and shape of the adult cell, but not clearly cancerous in appearance
Microscopic description: a tumor that arises from ____ deviating from normal epidermal cells
Epidermoid; arises from aberrant epidermal cells
Microscopic description: a tumor that arises from a _____ cyst.
follicular; sebaceous cyst
Microscopic description: the formation of small, finger-like or nipple-like projections of cells
papillary
Microscopic description: tumor composed of a variety of cells (mixed)
pleomorphic
Microscopic description: tissue that is hard, densely packed, and overgrown with _____ tissue.
schirrous
Microscopic description: tumor that has been altered to a more embryonic type, or toward a malignant state
undifferentiated
How are neoplasms classified?
cell TYPEtissue of ORIGINdegree of DIFFERENTIATIONANATOMIC siteFUNCTIONTOD SF type, origin, differentiation, site, function
Carcinomas are composed of _____ tissue
Carcinomas are composed of epithelial tissue
Sarcomas are composed of ____ tissue
Sarcomas are composed of connective tissue
Mixed-tissue cancers are composed of tissue that is capable of differentiating into both _____ and _____ tissue
Mixed-tissue cancers are composed of tissue that is capable of differentiating into both epithelial and connective tissue
Lymphoma is a cancer of the ____ tissue of the lymph nodes and vessels
Lymphoma is a cancer of the lymphatic tissue of the lymph nodes and vessels
Gliomas are composed from the _____ cells of the CNS
Gliomas are composed from the neuroglial cells of the CNS
Leukemia is cancer of the _____ organs, primarily ______
Leukemia is cancer of the blood forming organs, primarily bone marrow
Germ cell tumors arise in the ______ and ______
Germ cell tumors arise in the ovaries and testes.
What is the most common childhood cancer?
leukemia
What are the two main types of lymphoma?
Hodgkin lymphoma, non hodgkin lymphoma
What are the 3 general embyonic tumor types, and where does each tend to occur?
neuroblastoma - SNSWilms tumor - kidneyretinoblastoma - retina (unilateral, hereditary)
What is the most common type of soft tissue sarcoma?
rhabdomyosarcoma
What are the two main types of bone tumors?
osteosarcoma ewing sarcoma
How are dysplasia, SIL, CIN and CIS different?
DYSPLASIA: changes in appearance (mild, moderate, severe) that can develop into early cervical cancerSIL: appearance of abnormal changes on the surface of the cervixCIN: new abnormal growth of surface layers of cellsCIS: preinvasive cancer that contains only surface cells
Usually done in conjunction with a perfusion scan to diagnose pulmonary emboli
ventilation lung scans
T or F. Carcinomas are solid tumors
True
T or F. Carcinomas are the least malignant neoplasms
False. Most
Leukemias involve abnormal growth or _____ of blood-forming cells that infiltrate and replace normal bone marrow
proliferation
Embryonic tumors originate during ______ life
intrauterine
Embryonic tumors are often names with the word ____ which refers to the immature nature of the cells
blast
T or F. Carcinomas almost never occur in children because they result from environmental carcinogens and reqire a long period from exposure to the appearance of the carcinoma
T
