Principles of Oncology- Exam 2 Flashcards
How does cancer develop?
when the body’s normal control mechanism stops working, abnormal mutations accelerate cell division rates or inhibit normal controls on the system
aka unregulated cell division, avoidance of cell death, tissue invasion, ability to metastsize
Describe a cancer cell when compared to a normal cell
normal: small uniformly shaped nuclei with relatively large cytoplasmic volume, conformity in cell size and shape, lower levels of dividing cells, cell tissue clearly demarcated
Cancer: large, variable shaped nuclei, small cytoplasmic volume, lots of variation in cell size and shape, disorganized, loss of normal specialized features, elevated expression of certain cell markers, large number of dividing cells, poorly defined tumor boundaries
_____ of deaths in the US is caused by cancer
1 in 4
Cancer is the ____ leading cause of death in the United States
second
_____ is the most significant risk factor for cancer
age
**What are the top 4 types of cancer among all races and genders? (in order)
- female breast
- prostate
- lung
- colon and rectum
**What are the top 4 cancer DEATHS
- Lung
- Female breast
- Prostate
- Colon and rectum
_____ is the most common type of cancer in men. ____ in female
prostate
breast
The individual chance that someone will develop cancer in response to a particular, single environmental exposure depends on ________ and _____ that person was exposed.
how long
how often
Name some additional things that can influences your chances for cancer.
Exposure to certain environmental factors (including diet, hormones)
Genetic makeup
Age and gender
Healthy lifestyle is what kind of prevention?
primary prevention
Mammograms are an example of _____ prevention
secondary prevention
Treating prostate cancer is an example of ______ prevention
tertiary prevention
What is the primary focus of primary prevention?
is to prevent a cancer from ever developing or to delay the development of a malignancy
primary prevention may include the use of _____ or ______ to prevent or significantly reduce the risk of developing a malignancy.
chemopreventive agents
prophylactic surgery
_____ is the most common preventable cause of cancer death;
Tobacco
Smokeless tobacco also represents a substantial health risk. Linked to ????
dental caries, gingivitis, oral leukoplakia, and oral cancer
_____ is linked to carcinogens in tobacco dissolved in saliva and swallowed
Esophageal cancer
_____ is associated with reduced risk of colon and breast cancers
physical activity
In observational studies, _____ is associated with a reduced risk of colonic polyps and invasive cancer of the colon
dietary fiber
**Heavy drinkers have an increased risk of cancers of the ???
*head, *liver, *neck *esophagus
**Epstein-Barr virus is linked to ____
Burkitt’s lymphoma, nasal T cell lymphoma
**H. pylori is associated with ____
Gastric cancer, gastric MALT lymphoma
**Hepatitis B or C is associated with ____
Liver cancer
**HIV is associated with ____
non-Hodgkin’s lymphoma, Kaposi’s sarcoma, squamous cell carcinomas (especially of the urogenital tract)
**HPV is associated with _____
Cervix cancer, head and neck cancer
**Sunlight is associated with ____
skin cancer
**Tobacco including smokeless tobacco is associated with _____
Cancer of the upper aerodigestive tract, bladder
Secondary prevention refers to the ??? of subclinical, asymptomatic, or early disease in individuals without obvious signs or symptoms of cancer
early detection and treatment
Secondary cancer prevention includes ???? for developing malignancy and implementing ????? based on the risk assessment
identifying people who are at risk
appropriate screening recommendations
____ proportion of persons with the disease who test positive in the screen
sensitivity
____ proportion of persons who do not have the disease that test negative in the screening test
specificity
_____ proportion of persons who test positive that actually have the disease
positive predictive value
_____ proportion testing negative that do not have the disease
negative predictive value
Ages ____ have the option to start screening with a mammogram every year.
Women ____ should get mammograms every year
40-44
45 to 54
Women _____ can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least _____
55 and older
10 more years.
Women who are at high risk for breast cancer based on certain factors should get a ????? typically starting at age 30.
breast MRI and a mammogram every year,
Define what ACS considers women at high risk for breast cancer
Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on family history.
Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing)
Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
Had radiation therapy to the chest before they were 30 years old
Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes
What is the age recommendations for colorectal cancer screenings
Beginning at age 45 (through age 75)
Colonoscopy every 10 years
What is the cervical screening recommendations?
age 21 to 29 get a pap smear every three years as long as they are normal
What are the detection signs of cancer?
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in the breasts, testicles or elsewhere
Indigestion or difficulty swallowing
Obvious change in the size, color, shape or thickness of a wart, mole, or mouth sore
Nagging cough or hoarseness
What are some classic signs of cancer?
Classic symptoms: Nightsweats, Unexplained weight loss or loss of appetite, Persistent low-grade fever
Chronic pain, especially in the bones
Persistent fatigue
**The diagnosis of cancer relies most heavily on ??? and should never be made without obtaining ____
invasive tissue biopsy
tissue
Staging determines the ???; helps determine ____ and best _____
extent of disease
prognosis
treatment plan
The first priority in patient management is to ???? of disease.
determine the extent
_____ is the first major determinant of treatment outcome/prognosis
Tumor burden
For most cancers, the extent of disease is evaluated by a variety of noninvasive and invasive diagnostic tests and procedures, called ____
staging
What kind of staging is based on physical examination, radiographs, isotopic scans, CT scans, and other imaging procedures?
Clinical staging
_____ takes into account information obtained during a surgical procedure, which might include intraoperative palpation, resection of regional lymph nodes and/or tissue adjacent to the tumor, and inspection and biopsy of organs commonly involved in disease spread.
Pathologic staging
What is the most widely used system of staging?
TNM (tumor, node, metastasis) system
codified by the International Union Against Cancer and the American Joint Committee on Cancer
Which type of cancer cannot be grouped on the basis of anatomic considerations?
leukemia, myeloma, and lymphoma
_____ is a determinant of how a patient is likely to cope with the physiologic stresses imposed by the cancer and its treatment
Physiologic reserve
**What does a high Karnofsky performance index indicate? What number is considered high?
100-High: able to do normal ADLs by themselves
0-Low: death, very sick
**What is the ECOG performance scale?
0= full active and functional
5= dead
Treatment recommendations depend upon _____, _____, and _____
extent of disease
prognosis
patient wishes
**_______ treatment has successfully eradicated all traces of a person’s cancer, and the cancer will never recur
Cure
**______ signs and symptoms of a person’s cancer are reduced. Remissions can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared.
remission
**_____ return of signs and symptoms of a person’s cancer - treatment of a relapse is known as “salvage” therapy
relapse
**_____ provided to improve a patient’s quality of life; to prevent or treat the symptoms and side effects of the disease and its treatment, in addition to the related psychological, social, and spiritual problems. The goal is not to cure.
Palliative care
Tumor markers (are/are not) specific enough to permit a diagnosis of malignancy to be made.
are not
The marker is best used to assess response to treatment.
____ is the MC of cancer overall
lung cancer
**Human chorionic gonadotropin (HCG) is associated with ____
Gestational trophoblastic disease, gonadal germ cell tumor
pregnancy
**Calcitonin is associated with ____
Medullary cancer of the thyroid
**α Fetoprotein is associated with ____
Hepatocellular carcinoma, gonadal germ cell tumor
Cirrhosis, hepatitis
**Carcinoembryonic antigen (CEA) is associated with ____
Adenocarcinomas of the colon, pancreas, lung, breast, ovary
Pancreatitis, hepatitis, inflammatory bowel disease, smoking
**Lactate dehydrogenase is associated with ____
Lymphoma, Ewing’s sarcoma
Hepatitis, hemolytic anemia, many others
**Prostate-specific antigen is associated with ____
prostate cancer
Prostatitis, prostatic hypertrophy
**CA-125 is associated with ____
Ovarian cancer, some lymphomas
Menstruation, peritonitis, pregnancy
**CA 19-9 is associated with ____
Colon, pancreatic, breast cancer
Pancreatitis, ulcerative colitis
