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23 Cards in this Set
- Front
- Back
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Where are the markers from?
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1. produced only in tumor cells
2. produced by embryonal or tumor cells 3. produced by normal and cancer cells but higher rate in cancer cells. |
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carcinembryonic antigen (CEA)
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not useful for screening
used to monitor pt w/ history of colon cancer |
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CA-125
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protein found on cells that line pelvic organs and peritoneum
elevated in ovarian, cervical cancer, liver disease... monitor for disease recurrence or residual disease after treatment |
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hCG
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produced by placenta during pregnancy
elevated in tumors of germ cell origin used to monitor effectiveness of therapy |
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Alpha Fetoprotein
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HIgh in hepatic, testicular germ cell cancers, hepatitis, cirrhosis
aid in diagnosis of hepatic cancer incr serum leel in pt w/ disease remission |
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Breast cancer tumor marker: estrogen & progesterone
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Relative conc in tumor cell mass. Current method measures gene expression.
Postivie ER levels correlate w/ response to hormonal therapy --- incl benefits from adjuvant therapy |
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Breast cancer tumor marker: HER-2 (human epiderm GFR)
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associated w/ poor prognosis; predict responsiveness to some therapy ; predicts resistance to tamoxifen; predict benefit to anti-HER2 drugs
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Other markers
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CA 15-3 Antigen
CA 27.29 Antigen -- elevated; poor prognosis; monitor response to treatment; not used to screen BCL-ABL - CML; ALL: |
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T staging
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T = size and local spread
Tx, T0, Tis, T1-4 |
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N staging
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N=nodes
Nx, N0, N 1-3 N3 --> spread to 10nodes or more |
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M staging
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M = Metastasis
Mx, M0, M1 (distant metastasis) |
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Tumor grade
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grade 1 - 4
# of differenciation, # of mitosis |
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Local signs and symptoms
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Pain - compression & obstruction --> effect of tumor mass in GI tract, bronchus, sprinal cord, destruction of nerves
Mass Bleeding - tumor erosion of blood vessels Necrosis - destruction by proteases produced by tumor - impairs healing Effusion - involvment of serous surface of pericardium, pleura, peritoneum (ascites) Organ dysfunction - incr LFTs, bilirubin Hypercalcemia - osteolysis by bone metastasis CNS effect - Brain (HA, seizure, confusionn, gait) & Spinal cord (back pain, paralysis) |
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Anorexia - Cachexia
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in common solid tumors incl: lung, pancreatic, colon, liver cancer
Multifactorial cause. Results in hypermetabolic state, altered nutrient metabolism, persistent inflamm and production of cytokines and catabolic factors Progresses w/ disease Fat and skeletal muscle loss; decr. lean body mass NOT reversed with feeding unless cancer is treated |
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Fatigue
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Not relieved by sleep or rest
Peripheral fatigue - inability for peripheral neuromuscular system to perform tasks Central fatigue - difficulty initiating or performing voluntary activities |
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Sleep Disorders
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May be due to:
1. diagnosis of disease (depressed, anxiety) 2. side effects of treatment 3. symptoms of cancer - diff falling asleep; poor quality of sleep; nighttime awakening and restlessness |
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Anemia
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Blood loss; hemolysis; impaired RBC production due to nutritional deficiencies, BM involvement of cancer, decr. response to erythropoietin, side effect of treatment
Decr quality of life; fatigue; poorer prognosis; reduces ability to tolerate treatment |
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Paraneoplastic Syndrome
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Consequence of cancer but not directly caused by cancer --- distant effects
May be due to: - hormones or other proteins secreted by tumor - depletion of normal substances - host's response to tumor May be 1st sign of malignancy or recurrence of malignancy Wide range of syndrome: endocrine, neurologic, hematolic, dermatologic |
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SIADH
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Common in SCLC
HYPOnatremia; hypoosmolarity; HIGH excretion of sodium and urine; low plasma osmolarity Normal volume status! asymp unless severe --> fatigue, anorexia, HA, mental status, confusion, seizure |
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Ectopic ACTH production
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in SCLC; endocrine (carcinoid) tumors; other lung cancers; pancreatic
Trunk obesity; purple straie; hypertension, fatigue, moon face, edema, glucose intolerance, osteoporosis ACTH high in Cushing's |
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Hypercalcemia (> 2.6mmol/L)
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secretion of parathyroid hormone.
Caused by osteolytic metastases Anorexia, fatigue, muscle weakness, nausea, constipation, acute renal failure Common in LUNG, Breast cancer, Bone |
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Thromboembolic Disorders
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Incr risk of venous thrombosis due to hypercoagulable state [procoagulant sub produced by tumors]
COMMON cause of death in Cancer pts |
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Lambert-Easton Myasthenic Syndrome
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SCLC --- weakness in limbs
Tumor build antibodies against proteins invovled in Ca Channel of neurons |
