Ready To Study: The Cancer Patient Part 2

Question 1

1. X-Rays
2. Endoscopy
3. Urine and Stool tests
4. Blood tests for tumor markers
5. Ultrasound
6. Magnetic Resonance Imaging (MRI)
7. Computed Tomography (CT Scan)
   These are the methods used that are used to determine the location and type of _______ suspected.

Answer 1

cancer

Question 2

A _______ is a type of exfoliative cytology that means we are scraping some cells off of an area and sending those cells to the lab to be examined under a microscope. They are going to look to see if it looks like a cervical cell or if it looks different than it should.

Answer 2

Pap Smear
Study Tip: It’s very useful because remember what cancer cells have in common that would make this a useful test. They are NONCOHESIVE. They are not cohesive and normal cells are cohesive, if your cells weren’t cohesive your leg would fall off or something. Cancer cells are just dying to get somewhere else so they exfoliate VERY easily.

Question 3

_________ cytology can also performed on other body areas and some secretions, they can do it in the lungs, so they’ll do a bronchoscopy, and they can get a brushing of the cells to slough those cells off and study them. American Cancer Society recommends _______ exams in women who are sexually active and/or have reached age 18.

Answer 3

Exfoliative

Annual

Question 4

A Pap smear is a Microscopic examination of cells prepared slide for a cytotechnologist.
Useful because of what biological property of the cancer cells?

Answer 4

Non cohesiveness

Question 5

Biopsy is the removal of a tissue specimen for microscopic study. The picture is showing that through needle ________ they just put the biopsy tip of the needle into the area where the tumor is and take a tissue sample and take it to the lab to look at it.

Answer 5

aspiration

Question 6

They can do a laparoscopy procedure and get some tissue samples as well as ________ surgery which involves just cutting the tissue out.

Answer 6

excision

Question 7

These secretions are produced normally but they will be overproduced due to a cancer.
What is this defined as?

Answer 7

Tumor Markers

Question 8

These are antigens expressed on the surface of tumor cells or substances released from normal cells in response to the presence of a tumor.
What is this defined as?

Answer 8

Tumor Markers

Question 9

These are not used for diagnosing on their own, they are used for screening, they can help in diagnosis, and can help in establishing a prognosis, also used to monitor treatment, and detecting recurrent diseases.
What is this defined as?

Answer 9

Tumor Markers

Question 10

What does prognosis mean?

Answer 10

What’s the outlook, do you have a good prognosis, a great prognosis, or a grim prognosis this means that’s there’s not a lot of hope for their survival.

Question 11

A tumor marker as you see in this picture the different types of tumor markers that there are.
Lung cancer secrete both _______ and _______.
What is this defined as?

Answer 11

CA125

CEA

Question 12

Blood tests for _______ are used to detect substances that might be present in the body as a result of there being a cancer.

Answer 12

tumor markers

Study Tip: Some cancers do put out chemicals and things that are detectable in these tests.

Question 13

_______ is a tumor marker that is listed under lung, breast, stomach, pancreas, colon, and ovarian cancer.

Answer 13

CEA

Question 14

CEA tumor markers means __________ and that’s telling you there are cancer cells present.

Answer 14

carcinogenic embryonic antigen

FYI

Question 15

___________ test is fine but just so you know it’s not very specific of what type of cancer it is. This test tells us there is something going on but it doesn’t tell us what.

Answer 15

Carcinogenic embryonic antigen

FYI

Question 16

You see the _______ tumor marker can be present in both the breast and the lungs.
_______ is present in amniotic fluid and also present when there is liver cancer. You do not have to memorize these different markers, just need to see and be familiar about them and what they mean.

Answer 16

CA125
AFP is alpha fetal protein
FYI

Question 17

The _______ means how helpful the marker is it to us, how sensitive it is meaning that it’s detected early in the disease process and there’s very few false negatives so it’s going to be there and it’s going to tell us what we want to know, and it’s very sensitive so it picks up on small amounts or it’s there w/ a small amount of disease. What is this defined as?

Answer 17

value of a marker

Question 18

Present early and few false negatives. What is this defined as in relation to the value of a tumor marker?

Answer 18

Sensitivity.

Question 19

Specific to the cancer and not elevated in other diseases. What is this defined as in relation to the value of a tumor marker?

Answer 19

Specificity.
Study Tip: CEA is specific to cancer it’s not specific to one type of cancer but it is specific to cancer. This is one of the 1st markers Drs. look for when they would do a CEA on a person to see how they were progressing in their treatment and whether or not the cancer had come back.

Question 20

This means that if your marker level is high there is a high amount of tumor growth. There’s equality there. The level of this marker accurately reflects tumor growth. What is this defined as in relation to the value of a tumor marker?

Answer 20

Proportionality.

Question 21

Readily available, easy to use, not cost prohibitive. What is this defined as in relation to the value of a tumor marker?

Answer 21

Feasibility.

Question 22

________ is done to determine the progress of the growth of the malignancy, we get a piece of tissue through a biopsy and we examine it under microscopic examination to determine the level of differentiation and number of mitoses. Ex. how fast it’s growing.

Answer 22

Staging and Grading

Question 23

What distinguishes Grades I, II, III, and IV. Increasing anaplasia or lack of differentiation?

Answer 23

Grade 1 is a well differentiated cell so the mutation in the genetic components of the cell happen farther along in differentiation and then it progressively goes to lack of differentiation. Grade 4 is a lack of differentiation or anaplasia.
Study Tip: There are 2 things here; grading has to do with how quickly it’s growing, remember the less differentiation the more rapidly it grows.

Question 24

Staging has to do with whether or not there is metastasis.
This determines whether or not it has spread.
Stage ___ is very small it is not going to have spread anywhere all the way up to Stage ___ which is going to be spread to other organs.

Answer 24

0

4

Question 25

This can be done with a tumor node metastasis system. There is an assigned value to each of these three things and then the letters are read off in order to tell you the progress of the disease. What clinical staging system is this?

Answer 25

TNM System

Question 26

Tumor:
___ > Tumor cannot be adequately assessed
___ > No evidence of primary tumor
___ > Tumor in situ (means it’s staying right where it is, hasn’t spread anywhere else)
___ > Progressive increase in tumor, size of involvement. [T1-T4]
What do you document?

Answer 26

Tx
T0
Tis
T 1 - 4
Ex. T1 is localized in one area of the body. T2 & 3, with
T2 lymph nodes on one side of the diaphragm have been affected,
T3 lymph nodes on both sides of the diaphragm have been affected.
T4 is metastasis to a distant location.

Question 27

Nodes:
___ > Regional lymph nodes cannot be assessed
___ > No evidence of regional node metastasis
___ > Increasing involvement or regional lymph nodes [N1-N3]
What do you document?

Answer 27

Nx
N0
N 1-3

Question 28

Metastasis:
\_\_\_ > Not assessed
\_\_\_ > No distant metastasis
\_\_\_ > Distant metastasis present, specify sites of metastasis in documentation.
What do you document?

Answer 28

Mx
M0
M1

Question 29

That is just an example of how the TNM system is used.

You might have someone that is TIS N0 M0 what does this mean?

Answer 29

This means tumor in situ, no regional known metastasis and no distant metastasis.

Question 30

Be aware that we are dealing with people here and a lot of the treatments that are done with cancer like surgery. You come in and you need your gallbladder out and you have surgery, you’re a surgical patient and you come in and you have a malignant growth removed from your bowels, you’re both a cancer patient and a surgical patient so there’s a lot more _______ of treatment there. That is just something to keep in mind.

Answer 30

complexity

Question 31

Goal depends on the patients preference.
You have to decide what your goals are going to be before you decide the treatment you’re going to have.
Goals of treatment for the patient with cancer.
What are the three most common goals?

Answer 31

Curative because we want to get rid of this disease and we’re going to send them on to live a long healthy life.
Controlling cancer growth.
Palliative which is done to relieve symptoms.

Question 32

What are the 4 most common modalities for treatment of cancer?

Answer 32

Surgery
Radiation
Chemotherapy
Biotherapy

Question 33

Diagnosis of cancer can be done in several different ways. We can use an ________, _______, _______, or an _________ to actually visualize the masses.

Answer 33

X-ray
MRI
CT scan
Ultrasound

Question 34

___________ can get an up closer look at the bowels, this diagnostic test is used for urine and stool tests.

Answer 34

Endoscopy

Study Tip: Endoscopy > They can get tissue samples through from the end of the endoscope.