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141 Cards in this Set
- Front
- Back
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What is the number one cancer killer
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lung cancer
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Survival rates are based on what mark?
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5 year mark, sometimes 10
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What are the number one cancers diagnosed?
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prostate and breast
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What is an abnormal mass of proliferating cells?
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neoplasm; tumor
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What is a malignant neoplasm?
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cancer
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Describe benign neoplasms
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local, cohesive (close together), centrifugal expansion with a well defined border, can be encapsulated, does not spread, grows leisurely
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Describe malignant neoplasms
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grow more rapidly and relentlessly, cells are not very cohesive, irregular growth, unencapsulated, attached, invade surroundings, and a discontinuous spread from metastasis
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Anaplasia
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all cells generate from stem cells but the cells start to lack differentiation and do not function as normal cells or die on schedule
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What can anaplasia generate?
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ectopic hormones
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What is autonomy in cancer
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uncontrolled cellular reproduction
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What are telomere ends?
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end of the cell division timeline; controls the timeline
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What does cancer do to telomere ends?
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allows their death and allows cell division to continue and so cancer cells rarely die off
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What are the 2 types of malignant tumors
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solid tumors and hematologic tumors
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What are solid tumors
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tend to stay in one place and they shed cells into blood and the lymph transport "seeds" from the site and throughout the body
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What are hematologic tumors?
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immediately associate with blood and lymph and spread from the start
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What does it say if there's cancer in the lymph nodes?
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there is probably metastasis and a worse prognosis
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What can you do first to treat cancer to prevent spreading of seeds?
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radiation and THEN surgery
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Where does renal cancer spread?
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bone adn lung
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What do cancer cells secrete?
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enzymes to break down protein and enter blood vessels
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A tumor is detectable when it has how many cells
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over a billion
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Angiogenesis
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cancer cells can make their own blood supply from large vessels
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What is grading for cancer
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based on cell characteristics
done only by biopsy and microscopic exam Grades 1-4 |
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Staging of cancer
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the extent of cancer spread
done by xray, CT, scans, surgery, or biopsy |
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TNM system
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tumor, nodes, metastasis
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How to stage TNM with T
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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
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How to stage TNM with N
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Nx is unassessed, N0 is no nodes, N1-3 is lymph node metastasis the larger the number, the worse the number of nodes
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How to stage TNM with M
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Mx is unassessed, M0 is no distant metastasis, M1 is distant metastasis
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What are 5 causes of cancer?
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mutation of normal cells, heredity, carcinogens, oncogenic viruses, defective immune systems
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What are indirect carcinogens?
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procarcinogens
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What are the warning signs of cancer
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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
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Affects of cancer on body systems
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bleeding, ulceration, cachexia (wasting), weight loss, pain, anemia, necrosis, obstruction, thrombosis, inappropriate hormones, weakness, bone destruction, effusions, infections
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How often should you have a pap smear of the cervix
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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.
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How often should you have a mammogram
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if you do not have family history, you should have one annually after age 40
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How often should have a clinical breast exam
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every 3 years for women ages 20s to 30s
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How often should you do colon screenings
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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 |
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What is the only definitive diagnosis of cancer
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biopsy
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What are tumor markers?
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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
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What do you do if a patient has a positive tumor marker
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do biopsy
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What is tumor marker HCG?
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either gestational tumor (like hydatiform mole)
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What is tumor marker PSA
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for prostate cancer
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PSA
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prostate specific antigen
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PAP
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prostatic acid phosphatase
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What is tumor marker PAP
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prostate cancer
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What is tumor marker CA 125?
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ovarian cancer
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What is tumor marker CEA?
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colorectal cancer
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What is tumor marker Monoclonal IgG
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multiple myeloma
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What is normal WBC
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4.5-10,000/mm3
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What is a decrease in tumor cell markers
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remission
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Why do you monitor tumor cell markers
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for remission
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What are neutrophils
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fight against bacterial infections by phagocytosis
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What are eosinophils
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weak phagocytes that trigger allergic reactions
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What are basophils
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carry histamine activating factors that can cause some allergies
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What are monocytes
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becomes macrophages which take part in phagocytosis to rid debris
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What are lymphocytes?
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immunity response cells: B and T cells
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What is leukopenia
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decreased total WBC
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What is leukocytosis?
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increased total WBC
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What is neutropenia?
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decreased neutrophils
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What is leukemia?
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malignant disorder of blood and blood forming organs that causes uncontrolled proliferation of dysfunctional WBCs (immature)
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What does leukemia cause
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overproduction of immature blast WBC which decreases production and function of other hematopoietic cells
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What is the most common childhood cancer
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leukemia
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What is the 2nd leading cause of death in children
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leukemia/cancer
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What are the 2 major forms of leukemia?
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acute and chronic
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What is acute leukemia
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undifferentiate immature blast cells with an abrupt onset of disease with a short survival time (if not cured)
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What is chronic leukemia?
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main cell appears mature but does not function normally; gradual onset with a prolonged clinical course and longer survival times
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Leukemia is more frequent in
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adults
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What is ALL?
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very immature leukemia cells that accumulate int eh bone marrow, destroying and replacing cells that produce normal blood cells
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Can you have more than one type of leukemia/myeloma?
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yes
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ALL occurs most often in?
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young children under 15 y/o, white children, and males
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Peak incidence of ALL
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2 and 6 years and over 45 years
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What is cure rate of children with ALL and treatment?
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over 80%
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What is cure rate of ALL in adults with treatment
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30-40%
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What is cure rate of ALL in those over 60 years old with treatment
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10-20%
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What is death rate of ALL without treatment
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3 months
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What are manifestations of ALL?
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decreased RBC, PLT, and changes in WBC
pallor, fatigue, petechiae, purpura, and fever |
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Why do you get pallor and fatigue with ALL
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due to low RBC and anemia
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Why do you get petechiae with ALL
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decreased platelets
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Why do you get fever with ALL
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hypermetabolic state or secondary infection due to immature WBC
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What might the WBC level be in ALL
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over 100,000
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Why can you get renal failure with ALL
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cells breakdown, making high purines which metabolize into uric acid which damages the kidneys
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Why do you get bone pain with ALL
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infiltration of leukemic cells into other organs
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What is a common site of infiltration with ALL
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Central nervous system
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What age does CLL affect?
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over 50, most over age 60, and average age is 70
Does not occur in children |
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Who has highest incidence of CLL
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men
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What is survival rate of CLL
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10-20 years
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What is treatment for CLL
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there is none!!!!!!!
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What is the most common leukemia in adults?
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AML
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What age groups are affected by AML
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all age groups but risk increases with age
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What is survival rate of AML if untreated
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few weeks to 5 months
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What is survival rate of those with AML who are treated with bone marrow transplant
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30-50% at least 5 years
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Who tends to do better with AML treatment?
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younger
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What age does CML occur in?
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over 60, very rare under age 20
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In what is CML most common?
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over age 60, men, Jews of Eastern European descent
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What is the median survival of CML?
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7-10 years (range 3-20 years)
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What is the long term cure after transplantation with CML?
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60-97%
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What occurs in leukemias?
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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
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What is lymphocytic leukemia?
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malignant proliferation of lymphoblasts which interfere with normal hematopoiesis
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What is myelocytic leukemia?
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malignancies of the stem cells
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What are manifestations of leukemias?
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bleeding dyscrasias, fatigue, anorexia, neuro changes, abdominal discomfort, bone pain, fever and symptoms of infection
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What are some neuro changes you might see if the CNS is influenced by leukemia
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headache, visual disturbances, change LOC
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Why do you get infections with leukemia?
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decreased neutrophils due to nonfunctional WBC
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why do you get abdominal discomfort with leukemia?
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lymphadenopathy, hepatomegaly, and splenomegaly
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What are lymphomas?
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malignant neoplasms of cells that originate in lymph tissues in which abnormal lymphocytes replace normal structures
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Where is the initial tumor formation in lymphomas?
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secondary lymphoid tissues
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What do lymphomas affect?
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lymph nodes, spleen, GI tract, bone marrow, and liver and can spread to other tissues like lungs, kidneys, and skin (or anywhere)
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What are 2 types of lymphomas?
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hodgkins disease and non-hodgkins lymphomas
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What occurs in hodgkins disease?
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malignant neoplasm of lymphatic structures that has painless lymphadenopathy
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What ages usually get hodgkins disease?
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young adults 20-30 and then persons over 60
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Who is more likely to get hodgkins disease?
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males
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What is lymphadenopathy like in hodgkins disease?
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painless
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What immune system does hodgkins disease affect?
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T cells; cell mediated immunity but can lead to depressed humoral in advanced disease
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Death in hodgkins disease usually results from?
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sepsis
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What is cure rate of hodgkins disease with treatment?
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85%
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When is there a poor prognosis for hodgkins disease?
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if complete remission not achieve with treatment; usually after 1st round of chemo
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What do cells look like in hodgkins disease?
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reed sternberg cells
large binucleated cells that are considered the hallmark for diagnosis of hodgkins disease |
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What is basis for diagnosis of hodgkins disease?
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reed sternberg cells
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What is non hodgkins lymphoma?
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group of neoplastic disorders of lymhpoid tissue, usually lymph nodes that are not Hodgkins dieases
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Which is more common: hodgkins disease or non hodgkins lymphoma?
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non hodgkins lymphoma
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Where is non hodgkins lymphoma commonly spread?
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liver, spleen, and bone marrow
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Who has highest rate of non hodgkins lymphoma
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men, high SES, and higher age
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Which has more bone marrow involvement: hodkings disease or non hodgkins lymphoma?
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non hodgkins lymphoma
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What are the risk factors for non hodgkins lymphoma?
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age over 60
poor performance status elevated LDH more than one extra nodal sites Stage III or IV disease |
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What is the overall survival for non hodgkins lymphoma?
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65% 5 years and 54% 10 years
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Who has the lowest cure rate in non hodgkins lymphoma?
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those with 4-5 risk factors/ high risk
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Where does the transformation of a cell to a reed sternberg occur?
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in lymphoid tissue and then extends through lymph channels
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What immunity is altered in hodgkins?
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mostly cell mediated: T cells
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Manifestations of Hogkins disease?
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PAINLESS lymphadenopathy (commonly in neck)
intermittent fever night sweats weight loss |
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How many nuclei do cells have in non hodgkins lymphoma?
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one
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What is the lymphadenopathy like in non hodgkins lymphoma?
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painful and may progress to extra nodal involvement
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What happens with the enlarged lymph nodes in non hodgkins lymphoma?
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they can impinge on other structures
ex: cause cough, chest pain, ascites, jaundice, GU problems (depends on what is pushes on) |
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What cells does non hodgkins lymphoma affect?
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B cells (antibody mediated immunity)
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What is multiple myeloma?
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plasma cell malignancy of osseous tissue
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What is the most common primary malignant bone tumor?
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multiple myeloma
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What characterizes a multiple myeloma?
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proliferation of abnormal plasma cells
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What is the prognosis for multiple myeloma without treatment?
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less than 2 years survival rate
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What is prognosis for multiple myeloma with treatment?
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65-95% survival rate
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Why is multiple myeloma so dangerous?
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it affects B cells which play a role in humoral immunity
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What are some causes of multiple myeloma?
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genetic, history of chronic infections
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What is the patho behind multiple myeloma?
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B cells are affected and abnormal and spread throughout the body, deposting into bone as well as other nodes, teh live, spleen, and kidneys
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What are some manifestations of multiple myeloma?
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bone pain, weakness and fatigue, anemia, weight loss, infections, toxic proteinuria, NO WBC elevation (unless infected)
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How do you tell the difference between multiple myeloma and leukemia?
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MM does not have WBC elevation like leukemia has (unless a person with MM has an infection)
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Why do you get renal failure with multiple myeloma?
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toxic proteinuria that damages kidney tubules
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