Principles of Oncology 1 Flashcards
What are the four defining features of cancer?
- Unregulated cell division
- Avoidance of cell division
- Tissue invasion
- The ability to metastasize
How many deaths are caused by cancer in the US?
1 in 4
How many people will be diagnosed with cancer in their lifetime?
40%
What is the most significant risk factor for cancer?
Age
What group are cancers most deadly in?
African Americans
What are the top 3 cancers in the US?
- Breast
- Prostate
- Lung
What are the top 3 causes of cancer deaths in the US?
- Lung
- Breast
- Prostate
What determines if an environmental exposure will cause cancer?
How long and how often the person is exposed
What percentage of cancers are directly linked to tobacco?
30%. 80% of lung cancers are smoker related
Are light cigarettes more safe?
No because people smoke them more often and deeper
What kinds of cancer does physical activity reduce the risk of?
Colon and breast cancer
Diets high in what have an increased risk of cancer?
Fat
What cancers does EBV cause?
Burkitt’s lymphoma, nasal T cell lympoma
What cancers do estrogens cause?
Endometrial, liver, and breast
What cancers do alcohol cause?
Liver, esophagus, head and neck
What cancers does H pylori cause?
Gastric cancer and gastric MALT lymphoma
What cancers do hepatitis B and C cause?
Hepatitis
What cancers do UV light cause?
Skin cancer
What cancers do tobacco cause?
Upper aerodigestive tract, bladder
What age are mammograms recommended?
40 or 10 years before age of family onset
What age are colorectal screenings recommended?
45
What age is cervical cancer screening recommended?
21-65 (can reduce from 3 years to 5 years at 30)
What is CAUTION?
Change in bowel or bladder
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in the breasts, testicles, etc
Indigestion or difficulty swallowing
Obvious change in size, color, shape, or thickness of a wart, mole, or mouth sore
Nagging cough or hoarseness
What do you need to make a cancer diagnosis?
Tissue biopsy
How should you communicate bad news to a patient?
- Assess your patient’s understanding
- Give a warning shot
- Use words that your patient can understand
- Be quiet and listen
- Provide additional information
- Develop a plan for follow-up care
What is the incidence of depression in cancer patients?
25%
What is clinical staging based on?
Physical exam and imaging
What is pathologic staging based on?
Surgical inspection and biopsy
What is the TNM staging?
T = tumor size
N = node involvement
M = metastasis
What are the determinants of treatment outcome?
- stage of disease
- physiologic reserves
What is the Karnofsky score and ECOG interpretations?
Older patients and those with a Karnosfsky performance status <70 or ECOG performance status >/= 3 have a poor prognosis unless the poor performance is a reversible consequence
What is the definition of cure?
Treatment has successfully eradicated all traces of a person’s cancer, and the cancer will never recur
What is the definition of remission?
Signs and symptoms of a person’s cancer are reduced. Remissions can be partial or complete. In complete remission all signs and symptoms of cancer have disappeared
What is the definition of relapse?
Return of signs and symptoms of a person’s cancer - treatment of a relapse is known as salvage therapy
What is palliative care?
Goal is to improve quality of life by improving symptoms and side effects, the goal is not to cure
Can you diagnose with tumor markers?
No
What is the best use of a tumor marker?
Assess the response to a treatment
What causes HCG elevation?
Pregnancy, gestational trophoblastic disease, gonadal germ cell tumor
What causes calcitonin elevation?
Medullary cancer of the thyroid
What causes a Fetoprotein elevated?
Hepatocellular carcinoma, gonadal germ cell tumor, cirrhosis, hepatitis
What causes a carcinoembryonic antigen (CEA) elevation?
Adenocarcinoma of the colon, pancreas, lung, breast, and ovary. Pancreatitis, hepatitis, IBD, smoking
What causes a lactate dehydrogenase elevation?
Lymphoma, Ewing’s sarcoma, hepatitis, hemolytic anemia, many others
What causes an elevated prostate-specific antigen?
Prostate cancer, prostatitis, prostatic hypertrophy
What causes an elevated CA-125?
Ovarian cancer, lymphomas, menstruation, peritonitis, pregnancy
What causes an elevated CA 19-9?
Colon, pancreatic, breast cancers. Pancreatitis, ulcerative colitis
