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41 Cards in this Set

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What are some ways that cancer cells differ from normal cells?
• Invasive capcity
• Induction of angiogenesis
• Loss of contact inhibition in vitro
• Loss of differentiation
• Reduced apoptosis
• Uncontrolled growth
What are general examples of genetic mutations that can lead cancer?
• mutations of proto-oncogenes to oncogenes (ie Philadelphia chromosome) • mutation or deletion of tumor suppressor genes • mutations that lead to an interruption of apoptosis
What are some etiologic factors that cause cancer?
• tobacco • environmental exposure (alcohol, benzene, asbestos, ionizing radiation) • medications • infectious agents • diet
List some infectious agents that predispose to the development of cancer
• H. Pylori » gastric cancer • Epstein-Barr virus » Burkitt's lymphoma • Hepatitis B virus » Hepatocellular carcinoma • HPV 16 & 18 » cervical cancer
Give examples of chemopreventative drugs and the cancer that they prevent (primary prevention)
• Tamoxifen for breast ca • Oral contraceptives for ovarian cancer • Folic acid & NSAIDS for colon cancer • topical sunscreens for melanoma • Lycopene for prostate cancer
What are the 2 major types of lung cancer?
• Non-small cell lung cancer • Small cell lung cancer
What are the different types of non-small cell lung cancer?
• squamous cell • adenocarcinoma • large cell
Which type of lung cancer usually present as a centrally located endobronchial lesion?
Squamous cell carcinoma
Which type of lung cancer is the most common lung cancer and is the type seen most often in non-smokers?
What are characteristic of small cell lung cancer?
• highly linked to cigarette exposure • the most common cancer associated with paraneoplastic syndromes (such as SIADH & Cushing's syndrome) • often presents with a large, central tumor with mediastinal involvement
What are common signs and symptoms of all types of lung cancer?
• cough • chest pain • hemoptysis • radiographic evidence of a mass or pneumonia • weight loss
Describe the staging for non-small cell lung cancer
• Stage I: No lymph node involvement; tumor may be of any size; not closer than 2 cm from carina • Stage II: Tumor may be of any size; peribronchial and/or hilar nodes involved; not closer than 2 cm from carina • Stage IIIA: any size tumor & may invade chest wall, but not thoracic structures; involves ipsilateral nodes • Stage IIIB: any size tumor & may invade any structure; nodes extend to contralateral mediastinum, supraclavicular, or scalene area • Stage IV: presence of metastases
The majority of cancers of the head and neck are what type?
squamous cell carcinoma
What are the 2 types of esophageal cancer and where do they commonly occur?
• Squamous cell cancers most commonly occur in the cervical and thoracic esophagus • Adenocarcinomas commonly occur in the lower esophagus down to the gastroesophageal junction
What are signs and symptoms of esophageal cancer?
• Dysphagia (most common) • Chest pain • weight loss
What are the 2 most common sites of metastasis of esophageal cancer?
chest and liver
What are some signs, symptoms, and physical findings of gastric cancer?
• abdominal pain • anemia • early satiety • hematemesis • weakness • weight loss • physical findings include: gastric mass, umbilical node, left supraclavicular node (Virchow's node)
Describe the staging for colon & rectal cancer
• Stage 0: In situ • Stage 1: Invades mucosa only • Stage 2: May incade muscularis or through serosa • Stage 3: Any size tumor or any level of invasion; nodal involvement • Stage 4: Any size or depth, positive nodes present or absent, metastasis
What is the most common presentation of epithelial pancreatic cancer?
• abdominal pain accompanied by rapid weight loss • pain is located in the periumbilical region and pierces through to the back
What are other symptoms of pancreatic cancer?
• intestinal angina • jaundice due to obstruction of the common bile duct • palpable gallbladder (Courvoisier's sign) • recent onset of diabetes
Name a common paraneoplastic complication of pancreatic adenocarcinoma
migrating thromboplebitis (Trousseau's sign)
What are some risk factors of breast cancer?
• early menarche • exogenous estrogen use • first-term pregnancy after age 25 • genetics (BRCA1 & BRCA2) • late menopause • nulliparity (never carrying a pregnancy) • older age • positive family history
What is the most common type of breast cancer?
ductal adenocarcinoma (70-80%)
What is the most common type of bladder cancer?
• transitional cell carcinoma • squamous cell & adenocarcinoma account for only 10% of tumors in this region
What is the most common presentation of bladder cancer?
gross or microscopic hematuria
What are symptoms of renal cell carcinoma?
• classic triad (hematuria, abdominal mass, and flank pain) occur in 10% of cases • bilateral lower extremity edema (due to occluded inferior vena cava) • paraneoplastic syndromes (fever, polycythemia, and hypercalcemia)
What are the 2 most common cancers of the skin?
basal cell carcinoma & squamous cell carcinoma
Which is more likely to metastasize, basal cell carcinoma or squamous cell carcinoma?
squamous cell carcinoma
What are risk factors for melanoma?
• history of dysplastic nevi • family history of melanoma
What causes Superior Vena Cava (SVC) syndrome?
obstruction of blood flow caused by compression or invasion of the SVC by tumor thrombi
What are symptoms of SVC syndrome?
• arm swelling • chest pain • cough • dysphagia • dyspnea • facial fullness * symptoms begin insiduously and are often worse on bending, stooping, or lying down
What are physical findings of SVC syndrome?
• venous distention of the neck & chest wall • facial & arm edema • cyanosis & plethora (an excess of blood in one area or organ)
What is a paraneoplastic syndrome?
• disease manifestations of tumors through immunologic & metabolic factors that are not the direct result of invasion by neoplastic cells • can be caused by autoantibodies produced in response to the tumor OR ectopic peptide hormone production by the tumor
What is the most common paraneoplastic syndrome and what causes it?
• Humoral hypercalcemia of malignancy is the most common paraneoplastic syndrome • caused by secretion by the tumor of parathyroid hormone-related polypeptide
Describe the TMN staging method
Requires 3 measurements: • T score: size and local invasion of the primary tumor • N score: number, location, or fixation of lymph nodes • M score: presence or absence of metastases
List some hormonal therapy used to treat prostate cancer
• Luteinizing hormone-releasing hormone (LHRH) agonists such as leuprolide and poserelin • Nonsteriodal antiandrogens (such as bicalutamide and flutamide) that inhibit adrenal synthesis of testosterone
What are some hormonal therapies that can be used to treat breast cancer?
• tamoxifen • aromatase inhibitors (AIs) such as anastrozole
What are the 3 pneumonics for chemotherapy agents?
List the ABVD drugs
• Adriamycin
• Bleomycin
• Vincrysteine
• Dacarbazine
List the CHOP drugs
• Cyclophosphamine (Cytoxan)
• Hydroxy-adrianmycin (Doxirubicin)
• Oncavin (Vincrysteine)
• Prednisone
List the MOPP drugs
• Mustagen
• Oncavin
• Procarbazine
• Prednisone