patho xam 5 - cancer Flashcards
Which cancers are usually caught in late stages because they are hard to screen for?
Ovarian - early s/s are easy to dismiss
Pancreatic
What is the difference between a carcinoma and a sarcoma?
carcinoma - epithelial
bladder, pancreatic - adenocarcinoma, lung
Sarcoma - connective tissue
just oma - benign; sarcoma or carcinoma - malignant
pre-invasive lesion, does not cross the basement membrane
carcinoma in situ, cancer in situ
Which types of cancers are disseminated from the beginning?
hematological
vs “solid tumors”
poorly differentiated, do not resemble cells of nearby tissue or origin
malignant
grows by expansion
benign
VS. malignant - secretes VEGF to support angiogenesis
eg. Cushing’s syndrome in lung cancer
paraneoplastic syndrome
7 warning signals of cancer
- change in bowel or urinary habits
- sore that doesn’t heal
- unusual bleeding or discharge
- thickening/lump
- indigestion or dysphagia
- obvious change in wart or mole
- nagging cough or hoarseness
What markers are used for lung, breast and ovarian, and which is specific to breast?
CA125, CEA
breast -HER2
breast cancer which is characterized by overexpression of estrogen and progesterone receptors?
ER+ (estrogen receptor positive)
Staging or grading? differentiation
Grading - I (well-differentiated), II, III (poorly differentiated)
Staging or Grading? TNM system
Staging
T- size
N- lymph node involvement
M - metastasis
BRCA1 and BRCA2 genes
autosomal dominant - defective tumor suppressor genes
related to ovarian and breast
Clinical manifestations of breast cancer?
non-tender, firm, irregular borders, adhered to chest wall or skin
upper, outer quadrant, nipple discharge, unilateral swelling, skin/nipple retraction, peau d’orange
why is the breast self-exam less relevant, but still necessary?
50% of palpable tumors have already metastasized. 90% of palpable breast masses are non-cancerous
for which cancer is pleural effusion (SOB) and venous thrombosis an acute symptom?
Ovarian - type and severity of sx does not reliably correspond to disease state
risk factors: endometrosis, asbestos exposure early menarche, late meno, BRCA/1st degree relative, nulligravity
rare to have paraneoplastic syndromes
for which cancers is diet a bigger concern?
prostate and colorectal
word for loss of body fat/anorexia and weight loss associated with cancer
cachexia
Rank by order associated with smoking
small cell carcinoma > adenocarcinoma
Differentiate between non small cell carcinomas
squamous cell - detect in sputum, slow growing, hypercalcemia
large cell - any part of lung, poorly differentiated, faster spreading/early malignancy
adenocarcinoma - most common nsclc, least associated with smoking, more common in women, usually large at dx
prognosis for SCLC
10% live 2 years post dx
metastasizes early through blood, arises out of bronchus, small oval cells
SIADH, hypercalcemia, anemia
paraneoplastic complications common with lung cancer
elevated bilirubin/liver, pain, jaundice
pancreatic cancer
differential risk for african american pop’n
bladder cancer - half the risk vs white
prostate - highest risk of developing/dying from
