Oncology Flashcards
1 way to get rid of cancer and why
stop smoking b/c lung cancer is #1
what are the two leading causes of death in 2012 according to CDC?
1] heart disease
2] cancer
how much activity should children and adolescents engage in?
1 hour of moderate or vigorous
atleast vigorous 3x a week
how many cups of veggies and fruits should you eat per day?
2.5
two leading causes of death in children
1] accidents
2] cancer
the most commonly diagnosed cancers for children in 2011
1] leukemias
2] brain and central nervous system cancer
define differentiation
physical and structural changes as they develop to form different tissues
dysplasia
disorganized cells
cells are changing morphology
metaplasia
hyperplasia
increased # of cells
increased tissue mass
tumor
abnormal new growth with no purpose and can harm host organism
dysplastic, harmless, will not spread
benign
spreading of the primary site of cancer
metastasis
cells from the local area of the structure
primary tumor
cells that have metastasized from another structure
secondary tumor
increased activity occur with what type of gene?
dominant
decreased activity occurs with what type of gene?
recessive tumor suppressor gene
classification system bases (5)
cell type tissue of origin degree of differentiation anatomic site benign or malignant
epithelial classification cell type
carcinomas, most common in adults
connective and muscle
sarcomas
nerve
names for tissue involve (astrocytoma)
lymphoid
lymphomas
hematopoietic
leukemias
other cell types
reproductive glands, thyroid
- describes the extent of the disease at time of diagnosis to help determine treatment planning, prognosis, and compare results of treatment
- reflects the rate of growth, extent of neoplasm and prognosis
staging
measure of differentiation
aggressivenes of tumor
helps determine treatment plan and prognosis
grading
low>medium>high
define TNM classification
t= tumor size= 0-4 n= regional lymph nodes= 0-4 m= metastasis= 0 if none, 1 if there is
carcinoma in situ
premalignant, preinvasive
stage?
zero
early stage, cancer is localized to primary organ
stage 1
increased risk of regional spread because of tumor size or grade
stage II
local cancer has spread regionally but may not be disseminated to distant regions
stage III
cancer has spread and disseminated to different sites
stage IV
age > 50 years old unexplained weight loss fever fatigue pain family or previous history of CA
red flags in history
screening for cancer: C A U T I O N
Change in bowel or bladder habits A sore or bruise that does not heal Unusual bleeding or discharge Thickening or lump Indigestion or difficulty swallowing Obvious change in wart/mole Nagging cough or hoarseness
4 ways to diagnose CA
tissue biopsy
CBC
cellular markers
MRI, CT scan
tumor marker for bowel, stomach, pancreas, lungs, breast
CEA
alpha-fetoprotein
testicular
beta-2 microglobin
lymphoma
PSA
prostate
3 ways to treat CA
surgery
chemotherapy, radiation (XRT)
hormonal therapy
ionizing radiation and particle radiation
destroy CA cells dividing in cellular DNA
limited destruction of surrounding tissue (Cyberknife)
irradiation (XRT)
chemical agents to destroy CA cells
can be a combination of therapy drugs
remission
chemotherapy
changes in oncogenes and tumor suppressor genes
non-small cell lung caner (85-90%)
dense cells in an ovoid shape that usually arise from bronchial submucosa
small cell lung cancer (10-15%)
mutation of the KRAS gene leads to
rapid cell proliferation
two genetic lesions for NSCLC
1] mutation of epidermal growth factor –> overexpression
2] mutation of KRAS gene –> rapid cell proliferation
TNM for lung cancer
T= size N= nodules in same or contralateral lobes M= local vs. extrathoracic
stage 1 lung cancer
confined to lung, no metastases
stage II lung cancer
tumors with hilar or peribronchial node involvement
locally advanced, mediastinal or cervical lymph node metastases and with extension to chest wall
stage III lung cancer
tumor with distant metastases, malignant pleural or pericardial effusions
stage IV lung cancer
what is the most common invasive type of breast cancer?
%?
invasive ductal carcinoma
70%
for surgery treatment of breast cancer, what assists in staging?
SLNB: sentinel lymph node biopsy
what are hormonal therapies used for with breast cancer?
ER+ (estrogen receptive)
block effect of estrogen in breast tissue
SERMs
block tissues from producing estrogen
Als
aromotase inhibitors
2 monoclonal antibodies for breast cancer
herceptin
avastin
where do the primary tumors of NS neoplasms occur?
brain
spinal cord
CNS neoplasms- frontal lobe tumor symptoms
issues with vision
seizures
changes in personality
CNS neoplasms- cerebellum symptoms
short term memory loss
poor coordination
CNS neoplasms- temporal lobe symptom
difficulty speaking or comprehending
between the hemispheres
above brainstem and cerebellum
supratentorial
CNS neoplasm- symptom in supratentorial
focal deficits
also: seizures, headache, mental status changes, mimics TIA
CNS neoplasm symptom in brainstem and cerebellum
ataxia- wide BOS
also: vomiting, facial droop, dysphagia, dysarthria, weakness, visual changes
these symptoms occur for what and where?
personality changes, decreased inhibition, hemiplegia, seizures, anosmia (smell), visual changes
CNS neoplasm- frontal lobe
these symptoms occur where and for what?
pain in a band with valsalva
pain worse in supine
depends on level affected
CNS neoplasm- spinal cord tumors
3 subdivisions of CNS neoplasms
gliomas
tumors from supporting structures
PNETs (primitive neuroectodermal tumors)
ex of gliomas
astrocytomas
glioblastomas
ex of tumors form supporting structures
meningiomas
pituitary adenomas
PNETs occur in who?
children
glial cells do what?
support, insulate and metabolically assist neurons
GBM
gliobastoma multiforme
most common and deadliest primary brain tumors in adults
GBM
what disease has a low survival rate and forms spiderweb throughout brain so its hard to cure?
GBM
arachnoid layer of meninges
meningioma
third most common primary brain tumor
pituitary adenoma
vestibular system- tinnitus, vertigo, balance issues
acoustic _____?
neurinoma/neuroma
diagnosis for what? MRI with contrast CT scan PET scam fMRI cerebral angiography xrays CT guided stereotactic technique
CNS neoplasms
MSK tumors metastasize to what?
lung
liver
bone
whats the ratio for MSK tumors? for men:women
3:1
risk factors for what tumor?
antineoplastic drugs
radiation
toxic chemicals in workplace
MSK tumors
symptoms for what tumor? pain fractures swelling fever presence of a mass
MSK tumor
MSK malignant bone tumor is most common in what bone and where?
long bones
distal femur, proximal tibia and fibula
osetosarcoma symptoms
pain and swelling
maligant nonosteogenic primary tumor in bone or soft tissue
ewing’s sarcoma
main risk factors of Ewing’s sarcoma
parental occupation (exposure to pesticides) parental smoking
also: caucasian, chromosomal translocation b/w 11-22
Ewing’s sarcoma diagnosis looks like what?
radiographs with moth-eaten appearance
50% of all soft tissue sarcomas in kids under 15 y/o
rhabdomyosarcoma
