Unit I - Oncology

Question 1

neoplasia

Answer 1

new growth - tumor

Question 2

benign tumor

Answer 2

have a capsule and push surrounding tissue aside but do not invade surrounding tissue

Question 3

malignant tumor

Answer 3

• Ill defined edges, no capsule, locally invasive by direct extension
• usually larger than benign tumors because of autonomous growth
• metastasize, which means that cells break off from the parent tumor and move to a distant organ

Question 4

mechanisms of metastasis

Answer 4

hematogenous spread (blood vascular system)
lymphogenous spread (lymphatic system)

Question 5

neuroblastomas

Answer 5

usually in peripheral nervous system and may drive from nerve tissue in adrenal medulla
common in young children

Question 6

glioblastomas

Answer 6

glial cells, CNS tumors
grade I - mildly agressive
grade IV - very aggressive (glioblastoma multiforme)

Question 7

factors contributing to the metastatic quality of malignant cells

Answer 7

• lack of adhesiveness (cells do not adhere to each other)
• lack of contact inhibition (cells behavior is not governed by surrounding cells)
• increased motility (cells are active)
• lack of contact guidance (cell growth is independent of surrounding cells)

Question 8

morphologic qualities of malignant cells - dysplasia

Answer 8

cells have an abnormal appearance, such as irregular shape or nucleus

Question 9

morphologic qualities of malignant cells - early form of dysplasia

Answer 9

metaplasia - benign and potentially reversible change in which an adult cell changes from one type into another

Question 10

morphologic qualities of malignant cells - pleomorphism

Answer 10

cells have different sizes and shapes

Question 11

morphologic qualities of malignant cells - anaplasia

Answer 11

cells resemble embryonic cells, lack differentiation, and have a high reproductive rate

Question 12

cancer staging

Answer 12

process of describing the extent of the disease or the spread of the cancer from the site of origin
- essential in determining the choice of therapy and assessing prognosis

Question 13

stage of cancer is determined by

Answer 13

primary tumor’s size and location in the body, and whether or not it has spread to other areas of the body

Question 14

summary of cancer staging

Answer 14

1. in situ - cancer cells are present only in the layer of cells they developed in and have not spread to other parts of the body
2. invasion of local tissue - cancer cells have spread beyond original layer of tissue
3. invasion of regional lymph nodes
4. distant metastasis - cancer cells have spread to other organs in the body

Question 15

TNM staging system

Answer 15

assesses tumors in 3 ways:

1. extent of primary tumor (T)
2. absence or presence of regional lymph node involvement (N)
3. absence or presence of distance metastasis (M)

once the T,N,M are determined, a “stage” of I, II, II, or IV is assigned

Question 16

staging by cell type of origin

Answer 16

1. low grade (localized) - cell types resemble normal, fully differentiated cells
2. high grade (metastatic) - cell types are poorly differentiated and tend to metastasize early to distant organ sites

Question 17

endogenous cancers

Answer 17

show a familial or hereditary pattern

Question 18

exogenous cancers

Answer 18

from an external cause - environmental or behavioral factors that cause malignant mutations in cells

Question 19

pathogenesis

Answer 19

tumors form when there is an increased mitotic rate, DNA mutation, and hyperplasia

Question 20

oncogenes

Answer 20

porto-oncogenes: normal genes that can become oncogenes due to mutation
anti-oncogenes: suppressors, block cancer cells from forming (BRCA)

Question 21

cancer cells can spread to local tissue by

Answer 21

direct extension

Question 22

metastasis

Answer 22

cells break off from each other and travel to distant organ sites

Question 23

seeding

Answer 23

metastatic tumor cells depositing in highly vascular organs

Question 24

s/s of malignant neoplasm

Answer 24

pathologic fractures, pressure on tissue causing obstruction, erosion, bleeding, infection, anemia, hormones/metabloic disturbances, cachexia, palpable enlargement, migatory thrombophlebitis, pananeoplastic syndrome

Question 25

cancer pain

Answer 25

• pressure on nerves
• microscopic infiltration of nerves
• metastasis to bone

Question 26

cancer related fatigue

Answer 26

may occur as a result of the catabolic effects of the disease or may be due to treatment

Question 27

primary prevention

Answer 27

screening for risk factors and elimination of possible ones

Question 28

secondary prevention

Answer 28

utilizes early detection and treatment of local malignancies before they become invasive and spread

Question 29

tertiary prevention

Answer 29

focuses on managing symptoms and limit complications and preventing disability

Question 30

diagnosis and management of cancer

Answer 30

1. eliminate risk factors
2. screening procedures for early detection
3. treatments (radiation, chemotherapy, surgery, immunotherapy, angiostasis, rehab)

Question 31

5 year relative survival rate

Answer 31

survival rate observed for a group of cancer patients compared to the rate for those in general population

(5 year means it includes people who are living 5 years after diagnosis)

Question 32

basal cell carcinoma

Answer 32

nodule that appears on the skin as “pearly”

slow growing, may be observed ahead of becoming invasive

Question 33

squamous cell carcinoma

Answer 33

larger and more invasive

think, scaly nodule, usually older people, exposure to sunlight

Question 34

melanoma

Answer 34

malignant, skin cancer death, sun exposure

Question 35

ABCD’s for melanoma screening

Answer 35

A = asymmetrical
B = borders are irregular
C = color
D = diameter