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141 Cards in this Set

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What is the number one cancer killer
lung cancer
Survival rates are based on what mark?
5 year mark, sometimes 10
What are the number one cancers diagnosed?
prostate and breast
What is an abnormal mass of proliferating cells?
neoplasm; tumor
What is a malignant neoplasm?
cancer
Describe benign neoplasms
local, cohesive (close together), centrifugal expansion with a well defined border, can be encapsulated, does not spread, grows leisurely
Describe malignant neoplasms
grow more rapidly and relentlessly, cells are not very cohesive, irregular growth, unencapsulated, attached, invade surroundings, and a discontinuous spread from metastasis
Anaplasia
all cells generate from stem cells but the cells start to lack differentiation and do not function as normal cells or die on schedule
What can anaplasia generate?
ectopic hormones
What is autonomy in cancer
uncontrolled cellular reproduction
What are telomere ends?
end of the cell division timeline; controls the timeline
What does cancer do to telomere ends?
allows their death and allows cell division to continue and so cancer cells rarely die off
What are the 2 types of malignant tumors
solid tumors and hematologic tumors
What are solid tumors
tend to stay in one place and they shed cells into blood and the lymph transport "seeds" from the site and throughout the body
What are hematologic tumors?
immediately associate with blood and lymph and spread from the start
What does it say if there's cancer in the lymph nodes?
there is probably metastasis and a worse prognosis
What can you do first to treat cancer to prevent spreading of seeds?
radiation and THEN surgery
Where does renal cancer spread?
bone adn lung
What do cancer cells secrete?
enzymes to break down protein and enter blood vessels
A tumor is detectable when it has how many cells
over a billion
Angiogenesis
cancer cells can make their own blood supply from large vessels
What is grading for cancer
based on cell characteristics
done only by biopsy and microscopic exam
Grades 1-4
Staging of cancer
the extent of cancer spread
done by xray, CT, scans, surgery, or biopsy
TNM system
tumor, nodes, metastasis
How to stage TNM with T
Tx is unassessed; T0 is no evidence, Tis is in situ, T1 is less than 2 cm, T2 is 2-5 cm, T3 is skin and muscle is involved
How to stage TNM with N
Nx is unassessed, N0 is no nodes, N1-3 is lymph node metastasis the larger the number, the worse the number of nodes
How to stage TNM with M
Mx is unassessed, M0 is no distant metastasis, M1 is distant metastasis
What are 5 causes of cancer?
mutation of normal cells, heredity, carcinogens, oncogenic viruses, defective immune systems
What are indirect carcinogens?
procarcinogens
What are the warning signs of cancer
Change in bowel or bladder habits, A nonhealing sore, unusual bleeding or discharge, Thickening or lump in tissue, Indigestion or difficulty swallowing, Obvious change in wart or mole, Nagging cough or continued hoarseness
Affects of cancer on body systems
bleeding, ulceration, cachexia (wasting), weight loss, pain, anemia, necrosis, obstruction, thrombosis, inappropriate hormones, weakness, bone destruction, effusions, infections
How often should you have a pap smear of the cervix
After intercourse, you should have one within 3 years and then annually. Or after age 21, you should have one annually regardless of sexual status.
How often should you have a mammogram
if you do not have family history, you should have one annually after age 40
How often should have a clinical breast exam
every 3 years for women ages 20s to 30s
How often should you do colon screenings
After age 50
Either every five years have a: flexible sigmoidoscopy OR CT colonography OR double contrast barium

OR

Colonscopy every 10 years

PLUS

Fecal Occult blood test every year
What is the only definitive diagnosis of cancer
biopsy
What are tumor markers?
antigens produced by the cancer cells found on the membranes that can help screen individuals at risk for cancer or can give clues about cancer diagnosis
What do you do if a patient has a positive tumor marker
do biopsy
What is tumor marker HCG?
either gestational tumor (like hydatiform mole)
What is tumor marker PSA
for prostate cancer
PSA
prostate specific antigen
PAP
prostatic acid phosphatase
What is tumor marker PAP
prostate cancer
What is tumor marker CA 125?
ovarian cancer
What is tumor marker CEA?
colorectal cancer
What is tumor marker Monoclonal IgG
multiple myeloma
What is normal WBC
4.5-10,000/mm3
What is a decrease in tumor cell markers
remission
Why do you monitor tumor cell markers
for remission
What are neutrophils
fight against bacterial infections by phagocytosis
What are eosinophils
weak phagocytes that trigger allergic reactions
What are basophils
carry histamine activating factors that can cause some allergies
What are monocytes
becomes macrophages which take part in phagocytosis to rid debris
What are lymphocytes?
immunity response cells: B and T cells
What is leukopenia
decreased total WBC
What is leukocytosis?
increased total WBC
What is neutropenia?
decreased neutrophils
What is leukemia?
malignant disorder of blood and blood forming organs that causes uncontrolled proliferation of dysfunctional WBCs (immature)
What does leukemia cause
overproduction of immature blast WBC which decreases production and function of other hematopoietic cells
What is the most common childhood cancer
leukemia
What is the 2nd leading cause of death in children
leukemia/cancer
What are the 2 major forms of leukemia?
acute and chronic
What is acute leukemia
undifferentiate immature blast cells with an abrupt onset of disease with a short survival time (if not cured)
What is chronic leukemia?
main cell appears mature but does not function normally; gradual onset with a prolonged clinical course and longer survival times
Leukemia is more frequent in
adults
What is ALL?
very immature leukemia cells that accumulate int eh bone marrow, destroying and replacing cells that produce normal blood cells
Can you have more than one type of leukemia/myeloma?
yes
ALL occurs most often in?
young children under 15 y/o, white children, and males
Peak incidence of ALL
2 and 6 years and over 45 years
What is cure rate of children with ALL and treatment?
over 80%
What is cure rate of ALL in adults with treatment
30-40%
What is cure rate of ALL in those over 60 years old with treatment
10-20%
What is death rate of ALL without treatment
3 months
What are manifestations of ALL?
decreased RBC, PLT, and changes in WBC

pallor, fatigue, petechiae, purpura, and fever
Why do you get pallor and fatigue with ALL
due to low RBC and anemia
Why do you get petechiae with ALL
decreased platelets
Why do you get fever with ALL
hypermetabolic state or secondary infection due to immature WBC
What might the WBC level be in ALL
over 100,000
Why can you get renal failure with ALL
cells breakdown, making high purines which metabolize into uric acid which damages the kidneys
Why do you get bone pain with ALL
infiltration of leukemic cells into other organs
What is a common site of infiltration with ALL
Central nervous system
What age does CLL affect?
over 50, most over age 60, and average age is 70
Does not occur in children
Who has highest incidence of CLL
men
What is survival rate of CLL
10-20 years
What is treatment for CLL
there is none!!!!!!!
What is the most common leukemia in adults?
AML
What age groups are affected by AML
all age groups but risk increases with age
What is survival rate of AML if untreated
few weeks to 5 months
What is survival rate of those with AML who are treated with bone marrow transplant
30-50% at least 5 years
Who tends to do better with AML treatment?
younger
What age does CML occur in?
over 60, very rare under age 20
In what is CML most common?
over age 60, men, Jews of Eastern European descent
What is the median survival of CML?
7-10 years (range 3-20 years)
What is the long term cure after transplantation with CML?
60-97%
What occurs in leukemias?
normal white cells do not differentiate correctly, which causes immature cells that proliferatue quickly and then crowd out normal cells and causes altered white cell activity
What is lymphocytic leukemia?
malignant proliferation of lymphoblasts which interfere with normal hematopoiesis
What is myelocytic leukemia?
malignancies of the stem cells
What are manifestations of leukemias?
bleeding dyscrasias, fatigue, anorexia, neuro changes, abdominal discomfort, bone pain, fever and symptoms of infection
What are some neuro changes you might see if the CNS is influenced by leukemia
headache, visual disturbances, change LOC
Why do you get infections with leukemia?
decreased neutrophils due to nonfunctional WBC
why do you get abdominal discomfort with leukemia?
lymphadenopathy, hepatomegaly, and splenomegaly
What are lymphomas?
malignant neoplasms of cells that originate in lymph tissues in which abnormal lymphocytes replace normal structures
Where is the initial tumor formation in lymphomas?
secondary lymphoid tissues
What do lymphomas affect?
lymph nodes, spleen, GI tract, bone marrow, and liver and can spread to other tissues like lungs, kidneys, and skin (or anywhere)
What are 2 types of lymphomas?
hodgkins disease and non-hodgkins lymphomas
What occurs in hodgkins disease?
malignant neoplasm of lymphatic structures that has painless lymphadenopathy
What ages usually get hodgkins disease?
young adults 20-30 and then persons over 60
Who is more likely to get hodgkins disease?
males
What is lymphadenopathy like in hodgkins disease?
painless
What immune system does hodgkins disease affect?
T cells; cell mediated immunity but can lead to depressed humoral in advanced disease
Death in hodgkins disease usually results from?
sepsis
What is cure rate of hodgkins disease with treatment?
85%
When is there a poor prognosis for hodgkins disease?
if complete remission not achieve with treatment; usually after 1st round of chemo
What do cells look like in hodgkins disease?
reed sternberg cells

large binucleated cells that are considered the hallmark for diagnosis of hodgkins disease
What is basis for diagnosis of hodgkins disease?
reed sternberg cells
What is non hodgkins lymphoma?
group of neoplastic disorders of lymhpoid tissue, usually lymph nodes that are not Hodgkins dieases
Which is more common: hodgkins disease or non hodgkins lymphoma?
non hodgkins lymphoma
Where is non hodgkins lymphoma commonly spread?
liver, spleen, and bone marrow
Who has highest rate of non hodgkins lymphoma
men, high SES, and higher age
Which has more bone marrow involvement: hodkings disease or non hodgkins lymphoma?
non hodgkins lymphoma
What are the risk factors for non hodgkins lymphoma?
age over 60
poor performance status
elevated LDH
more than one extra nodal sites
Stage III or IV disease
What is the overall survival for non hodgkins lymphoma?
65% 5 years and 54% 10 years
Who has the lowest cure rate in non hodgkins lymphoma?
those with 4-5 risk factors/ high risk
Where does the transformation of a cell to a reed sternberg occur?
in lymphoid tissue and then extends through lymph channels
What immunity is altered in hodgkins?
mostly cell mediated: T cells
Manifestations of Hogkins disease?
PAINLESS lymphadenopathy (commonly in neck)
intermittent fever
night sweats
weight loss
How many nuclei do cells have in non hodgkins lymphoma?
one
What is the lymphadenopathy like in non hodgkins lymphoma?
painful and may progress to extra nodal involvement
What happens with the enlarged lymph nodes in non hodgkins lymphoma?
they can impinge on other structures
ex: cause cough, chest pain, ascites, jaundice, GU problems (depends on what is pushes on)
What cells does non hodgkins lymphoma affect?
B cells (antibody mediated immunity)
What is multiple myeloma?
plasma cell malignancy of osseous tissue
What is the most common primary malignant bone tumor?
multiple myeloma
What characterizes a multiple myeloma?
proliferation of abnormal plasma cells
What is the prognosis for multiple myeloma without treatment?
less than 2 years survival rate
What is prognosis for multiple myeloma with treatment?
65-95% survival rate
Why is multiple myeloma so dangerous?
it affects B cells which play a role in humoral immunity
What are some causes of multiple myeloma?
genetic, history of chronic infections
What is the patho behind multiple myeloma?
B cells are affected and abnormal and spread throughout the body, deposting into bone as well as other nodes, teh live, spleen, and kidneys
What are some manifestations of multiple myeloma?
bone pain, weakness and fatigue, anemia, weight loss, infections, toxic proteinuria, NO WBC elevation (unless infected)
How do you tell the difference between multiple myeloma and leukemia?
MM does not have WBC elevation like leukemia has (unless a person with MM has an infection)
Why do you get renal failure with multiple myeloma?
toxic proteinuria that damages kidney tubules