Intro 2

Question 1

Metastatic sites

Answer 1

-Bladder, Thyroid, breast, Melanoma: Bone, Liver, Lung (+brain for breast), (+brain +skin/muscle for Melanoma)
-Kidney, Lung, prostate: adrenal, bone, brain, liver, lung (prostate NOT brain)
-Colorectal, Ovary, pancreas, stomach: liver, lung, peritoneum (colorectal –> + brain)
-Uterus: bone, liver, lung, peritoneum, vagina

Question 2

Survival rates and Cancer - 5 year

Answer 2

75% +: Thyroid, Prostate, testis, melanoma, breast, hodgkin’s lymphoma, uterus, bladder, kidney
50-75%: non-hodgkin’s, anus, Certix, oral cavity, colorectal, leukemia, myeloma
25-50%: Ovarian, Brain, Stomach
<25% - Lung, esophagus, liver, pancreas

Question 3

TNM

Answer 3

used for solid masses; describes primary (T)umor, spread to (L)ymph nodes, and (M)etastasis; most widely used system; includes numbers to indicate increasing levels of each letter

Question 4

Ann Arbor

Answer 4

used for classifying lymphomas and other cancers of the blood and bone marrow

Question 5

FIGO

Answer 5

used for uterus, cervix, ovaries, vagina, and vulva cancers; developed by the International Federation of Gynecology and Obstetrics; uses TNM information

Question 6

COG

Answer 6

Childhood cancers

Question 7

SEER

Answer 7

summary staging for all cancers; includes 5 main categories; registry supported by National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program

Question 8

Nottingham/Elston-Ellis

Answer 8

used for breast cancer; grades tubule formation, nuclear grade, and mitotic rate

Question 9

Gleason score

Answer 9

-prostate - based on slides
-Gleason x = scores of ≤5
-Gleason6 - low-grade cancer
-Gleason 7 - medium grade
Gleason 8+ - high-grade w/ poorly differentiated cells

Question 9

TNM system

Answer 9

Question 10

ECOG performance status

Answer 10

Question 11

0-100 performance score

Answer 11

Question 12

Cancer stages 0-IV

Answer 12

Question 13

Histologic grading

Answer 13

-biopsy slide of cells to determine the aggressiveness of a tumor based on 5 features
-Cellular Atypia
-Mitotic Activity
-Degree of cellularity
-Endothelial proliferation
-Degree of necrosis

Question 14

Histologic grading 5 types and definitions

Answer 14

Question 15

Adjuvant therapy/neoadjuvant therapy

Answer 15

neo - given before the main form of treatment
Adjuvant - treatment to keep cancer from returning. Typically used after primary to decrease risk of recurrence

Question 16

Cell cycle phases

Answer 16

G0 = resting stage
G1 = Gap 1 = beginning of reproducing - RNA + protein synthesis
S = Synthesis of DNA
G2 = gap 2 = RNA/protein synthesis after DNA synthesis but before cell division
M = mitosis = cell division

Question 17

Chemotherapy sensitivity

Answer 17

-Chemos target different parts of cell cycle
-some are cell-cycle specific and so effective only on cells in that phase
-others are active throughout

Question 18

Why administer in cycles of chemo

Answer 18

-to take advantage of the cell cycle of the tumor + condition of patient

Question 19

Why give continuous infusions

Answer 19

-to catch slower dividing cells as they enter cell division

Question 20

what is biotherapy/immunotherapy

Answer 20

-stimulation of patient’s own immune system to fight disease
-also called biologic response modifiers

Question 21

HLAs

Answer 21

-human leukocyte antigens - proteins on surface of blood cells
-need to be matched as closely as possible with donor for BMT

Question 22

Graft vs. host disease

Answer 22

-when T-lymphocytes attack newly introduced cells after BMT

Question 23

3 types of stem cell transplantation

Answer 23

1. Allogenic - from one person to another, can be match-related or unrelated (family or not)
2. Syngeneic - from an identical twin
3. Autologous - from self prior to treatment

Question 24

where do you harvest bone marrow from
-how much do you take

Answer 24

-superior iliac crest
-based on body weight - 10-15 mL/kg requiring 150-200 aspirations

Question 25

what happens after bone marrow harvest

Answer 25

-transplant IV
-cells reestablish normal marrow function 1 to 4 weeks later