Types Of Cancer Flashcards
Carcinoma
Formed by epithelial cells
80-90% of all cancers
Column like shape
Multiple myeloma
Begins in plasma cells
Build up in bone marrow and form tumors in bones
B cell malignancy of the plasma cells characterize by specific hallmark symptoms
Most common cancer
In descending order:
Breast, lung/bronchus, prostate, colorectal, melanoma, bladder, NHL
Most common cancer in men
Prostate, lung, colorectal
Most common cancer in women
Breast, lung, colorectal
Oncogene: HER2/neu
Breast, gastric, gastroesophageal junction
Oncogene: ALK
Lung, Anaplastic large cell lymphoma
Oncogene: BCR/ABL
Leukemia
Oncogene: RAS
Bladder, lung, breast, ovarian
BRCA1/BRCA2
Tumor suppressor genes that encounter a recessive mutation in which both in pair are damaged
TP53
Tumor suppressor genes that encounter a recessive mutation in which both in pair are damaged
> 50% of all cancers
Risk factor: HIV
Kaposi sarcoma, cervical, head & neck lymphomas
Risk factor: UV radiation
Nonmelanoma skin cancer
What is the main risk factor for SCLC?
Tobacco use
Which lung cancer is fast growing, disuse, and aggressive? And often diagnosed at advanced stage?
SCLC
What is the most common type of lung cancer?
NSCLC
Specifically, adenocarcinoma
What are the risk factors for breast cancer?
Age (>45)
Prolonged exposure to ovarian hormones, particularly estrogen
What are the risk factors for NSCLC?
Tobacco use, radon gas, asbestos, 2nd hand smoke, occupational hazards, radiation, TB, fam hx of lung cancer
What are S&S for local or regional lung cancer?
Cough, wheezing, stridor, hemoptysis, pleuritic pain, SOB, atelectasis, PNA, pleural effusions
What are S&S for advanced lung cancer?
Fatigue, cough, dyspnea, decreased appetite and weight
What are S&S of a pancoast tumor (lung)?
Horner syndrome (drooping eyelid, absence of sweating, sinking of eyeball, constricted pupil on same side as tumor), radiating pain shoulder to forearm
What are the risk factors for gastric cancer?
H pylori infection
Age
Male
Hispanic/AA/Asian islander/Native American
Diet low in fruits & veg/high in salted or smoked foods
Chronic GI conditions
Cigarette smoking
Pernicious anemia
Fam hx gastric cancer/familial adenomatous polyposis/hereditary nonpolyposis colon cancer syndrome (Lynch’s syndrome)
Obese
Previous stomach surgery
Type A blood
Works in coal, metal, rubber
EBV infection
What are the risk factors for colorectal cancer?
Age, hx of CRC, polyps, ovarian CA, bowel disease, 1st degree relative with CRC, lynch syndrome, AA/Ashkenazi Jews, diet high in red or processed meats and low in fruit & veg, obesity, physical inactivity, heavy alcohol consumption, smoking, type II DM, insulin use
59% or colon cancer patients will be diagnosed with what?
Liver Mets
20% on initial diagnosis
20-30% after primary treatment
Which cancer are these S&S of?
Fatigue, feeling of incomplete stooling, and pain, bloating, change in bowel habits, black tarry stools or bright red, jaundice
Colon cancer
Which cancer are these S&S of?
Change in bowel habits, bright red bleeding, painful defecation
Rectal cancer
What are the risk factors for anal cancer?
Receptive anal intercourse, many life partners, HPV infection, cigarette smoking
What are the risk factors for pancreatic cancer?
Age, male, AA, Type II DM, stomach conditions, chronic pancreatitis, cirrhosis, genetic predisposition (Lynch, BRCA mutations), 1st degree relatives with pancreatic cancer
Smoking, smokeless tobacco, obesity, physical inactivity, occupational exposure to pesticides, dyes, chemical in metal refining, diet high in fat, coffee, heavy alcohol consumption
What is often the 1st symptom of pancreatic cancer?
Jaundice
What are the risk factors for cervical cancer?
Exposure to HPV, multiple sexual partners, cigarettes, Early age at 1st intercourse, immunosuppression, hx of STDs, long-term use of oral contraceptives, older age, lack of screening, multiple live births, exposure to diethylstilbestrol in utero
What are S&S of cervical cancer?
Irregular bleeding, persistent vaginal discharge, dyspareunia (painful intercourse)
Late symptoms: pelvic pain radiating to legs, incontinence of urine or stool into vagina, weight loss, fatigue
What are the risk factors for endometrial cancer?
Htn, DM, obesity, increased estrogen exposure, tamoxifen, metabolic syndrome, nulliparity, polycystic ovarian syndrome, endometrial hyperplasia, fam hx
What is the most lethal gynecological cancer?
Ovarian
What are the risk factors for ovarian cancer?
1st degree relative with hx ovarian cancer, fam hx breast ca, endometriosis, nullipathy, use of talc, Jewish, pelvic inflammatory disease, Lynch syndrome, use of post menopausal hormone therapy, obesity and height
Which cancer are these S&S of?
Pelvic mass, abdominal pain, distention, bloating, constipation, vaginal bleeding, urinary symptoms, fatigue, watery vaginal discharge?
Ovarian cancer
What are the risk factors for kidney cancer?
Smoking, occupational health exposures to cadmium, herbicides, trichorethylene, obesity, HTN, fam hx kidney cancer, advanced kidney disease, male gender, AA/American Indian/Alaska Natives, meds (phenacetin, diuretics), high fat/protein diets, diet low in antioxidants, genetic and hereditary diseases (Cowden syndrome, Von Hippel-Lindau disease, papillary RCC, leimyoma RCC, Birt-Hogg-Dube syndrome, renal oncocytoma
What cancer are these S&S of?
Hematuria, back pain, mass on one side, fatigue, anorexia, weight loss, fever with no infection, anemia
Kidney cancer
What are the risk factors for bladder cancer?
SMOKING, male, Caucasian, age, occupational exposure (makers of rubber, latex, textiles, dyes, paint), occupation such as hair dresser, painter, machinist, printers, truck drivers, chronic ongoing bladder infections, hx bladder cancer, bladder birth defects, prior chemo that damages bladder (cyclophosphamide), high arsenic in water, consistent dehydration, suppression with aristolochic acid, Cowdens, Lynch, RBI
What cancer are these S&S of?
Hematuria, change in bladder habits, lower back pain, decreased weight and appetite, swelling in feet, bone pain
Bladder cancer
What are the risk factors for prostate cancer?
Age >50, AA, North American, Scandinavian (lower Japan and China), inactivity, exposure to chlorinated pesticides and methyl bromide and agent orange, 1st degree relative, EPAC2, RNASEL, MSR1 (Lynch), CHEK2, CAPZB, PON2, BRCA2
What are S&S of prostate cancer?
Few symptoms early, found during digital reveal exam
Late/advanced: hematuria, dysuria, bone pain, back pain, leg edema from nodal involvement, incomplete bladder emptying, frequency, hesitancy, urgency, nocturia
What type of prevention is a total body skin exam?
Secondary
What type of prevention is reducing exposure to sunlight and avoiding deliberate sun tanning?
Primary
What type of prevention is using sunscreen, retinoids, antioxidant, beta-carotene, vit C, vit E, dietary modifications, complementary therapies, reduction of immunosuppressive burden?
Tertiary
What are risk factors for nonmelanoma skin cancer?
UV light, light hair and eye color, burn easily or difficult to tan, Northern Europe ancestry, contact with arsenic (well water, insecticides, medical), precursor lesions such as actinic keratosis, exposure to radiation, chronic inflammatory skin conditions, complication of burns or scars, tattoos, cigarette or pipe smoking, genetics, immunosuppression (organ transplant), infections such as HPV
What are the risk factors for malignant melanoma?
UV light, blistering and peeling, intermittent exposed areas, use of tanning bed before age 35, skin phenotype ( Fitzpatrick skin phototype II), melanocytic Nevi (adults > 100 moles), fam hx melanoma, previous melanoma, non-melanoma, actinic keratosis
What are the risk factors for head and neck cancer?
Alcohol, tobacco, use of betel quid (buy and tobacco combo used in Southeast Asia), poor oral hygiene, EBV, HPV (more often in young Caucasian males oral-general sex, increased incidence in tonsillar cancer) radiation exposure, occupational exposure to carcinogens, male
5 year survival for cancer of lip
90%
5 year survival for cancer of hypopharynx
32%
Where do neurologic system cancers spread?
Rarely outside brain or CNS
What are risk factors for neurologic system cancers?
Possibly radiation? RT to brain in childhood leukemia, genetic syndromes: neurofibramotosis, li-Fraumeni, Turcot syndrome, Von Hippel-Landau disease
What cancer are these S&S of?
Nausea and vomiting, headache (especially in morning), snore is, change in sensations, loss of balance, falls, seizure, weakness, fatigue,’personality changes, loss of bladder or bowel, pain
Neurologic system cancers
How do you stage neurologic system cancers?
Considered localized unless they cross the midline or the tentorium or unless they are described as having “drop” mets in spinal cord
Regional: crossing midline or tentorium invades bone, blood vessel, nerves, spinal cord
Distant: circulating cells in CSF, extension to nasal cavity, nasopharynx, posterior pharynx, outside CNS
Do not use TNM
What is the 5 year survival for neurologic system cancers?
35%
Lymphomas
Cancers of the immune system arising from malignant lymphoid clone of B cell, T cell, or NK type
What are risk factors for leukemia?
Ionizing radiation, chemo (esp alkylating agents), chemicals such as benzene, genetic predisposition, antecedent hematologist disorders, viruses (HTLV-1), genetic abnormalities (Downs syndrome), fam hx (esp CLL), cig smoking for AML and parental smoking before and after birth for AML & ALL in children, possibly obesity
Does CLL progress fast or slow?
Slow, usually asymptomatic and found in blood test
What are the risk factors for lymphoma?
HL peaks on young adults and again in older adult. NHL increases with age.
Fam hx of lymphoma
Immunosuppression (solid organ transplant, HIV)
Viral exposure (EBV, Hep C)
Bacterial exposure (particularly H pylori)
What are “B” symptoms of lymphoma?
Fever, drenching night sweats, anorexia/weight loss
What nodes are typically involved in Hodgkin’s lymphoma?
Cervical, supravlavicular, mediastinal, 27% have splenic involvement
Where does nom-Hodgkins lymphoma typically spread?
Liver or spleen
Which cancer has Reed-Sternberg cells?
Hodgkin’s lymphoma
What are the hallmark features of multiple myeloma?
Presence of serum urine monoclonal Ig, monoclonal plasmacytosis, bony lytic lesions
What are the risk factors for multiple myeloma?
Age >60, male, AA, fam hx of MM, hx of plasma cell diseases, obesity, radiation exposure, and zoisite to chemical such as abestos, pesticide and agent orange, herbicides, benzene, and others used in rubber manufacturing or woodworking, professional fire fighting
What are the classic symptoms of multiple myeloma?
CRAB
Calcium elevation (>= 11.5)
Renal insufficiency (Cr>2)
Anemia (Hgb >2 below normal limit or <10)
Bone disease (punched out lytic lesions causing Swiss cheese presentation)
What is the pathophysiology of multiple myeloma?
The monoclonal proliferation of plasma cells produces an Ig fraction detectable in serum and urine called myeloma or M-spike
Bone destruction is caused by the production of osteoclastic factors by the malignant plasma cells causing the classic bone pain symptom
What cancer is Anna Arbor staging used for with “A” and “B?”
Hodgkin’s lymphoma
Which lymphoma is strongly associated with exposure to specific viruses?
Hodgkin’s lymphoma
What is the median age of diagnosis for Ewing’s sarcoma?
15
Where are the primary locations of Ewing sarcoma?
41% lower extremity
26% pelvis
16% chest wall
9% upper extremity
What age is osteosarcoma primarily diagnosed?
Adolescent and young adults
What are poor prognosis indicators of osteosarcoma?
Axial skeletal mets, small % tumor necrosis following treatment
What are poor prognosis indicators of soft tissue sarcoma?
Advanced age, tumor >5cm, high-grade or high motor iv activity
What are risk factors for soft tissue sarcoma?
Nervous nasal cell carcinoma syndrome, Gardner syndrome, Ali-Fraumeni syndrome, Tuberous sclerosis, Von Recklinghausen disease, Werner syndrome
Which are AIDS-defined malignancies?
Cervical cancer, Kaposi sarcoma, aggressive B cell NHL
What cancer is herpesvirus 8 (HHV-8) associated with?
Kaposi sarcoma
What cancer is Epstein-Barr virus (EBV) associated with?
Some NHL and HL
What cancer is HPV associated with?
Cervical cancers, most anal cancers, oropharyngeal, penile, vaginal, vulvar
What cancer is Hep B and Hep C associated with?
Liver
What cells does HIV attack?
WBCs, specifically CD-4 and T cells
What are S&S of Kaposi sarcoma?
Dark purplish or brownish spots on the skin (often lower extremities) or in the mouth
Affects lymph nodes (poss lymphedema)
Other organs such as digestive tract, lungs, liver, spleen
What cancer is more common in people living with HIV?
Lung cancer
What % of cancers in the US are related to obesity, physical inactivity, excess alcohol and poor nutrition?
20%
What are Tumor markers?
Proteins produced by cancer cells (and normal cells) but cancer cells produce at much higher rate
None accurate enough to be used as screening tool.
Where does kidney cancer most often metastasize to?
Lung
What may be the initial presentation of lunch cancer?
Pleural effusions
80% of people with multiple myeloma experience what symptom?
Peripheral neuropathy
Esp with bortezomib because many patients who receive this have been pretreated with neurotoxic agents
Which type of bone lesions do prostate and breast cancer have?
Osteoblastic
Decrease bone strength and increase risk of vertebral collapse
Which type of bone lesions do multiple myeloma, lung, thyroid,
Breast, kidney cancer have?
Osteolytic lesions
Most often associated with pathological fractures
