ONCOLOGY - risk factors, clinical manifestations, diagnosis & classification

Question 1

what is epigenetics? how is this a risk factor?

Answer 1

person’s genetic makeup that interacts with environmental & lifestyle factors –> changes in gene function & disrupt normal biologic factors for cell proliferation
- reversible
- can not change DNA sequence
- can change how body reads DNA sequence

Question 2

do cancers have early s/s?

Answer 2

cancers do NOT have early s/s

Question 3

what does the C in CAUTION UP mean? what cancers are associated with this?

Answer 3

C = changes in bowel & bladder habits
- bowel: GI cancers - colorectal & stomach
- bladder: prostate & urogenital cancers

Question 4

what does the A mean in CAUTION UP? what cancers are associated with this?

Answer 4

A = a sore that doesn’t heal
- even w treatment
- pain & size gets worse
- skin & oral cancer

Question 5

what does the U stand for in CAUTION UP? what cancers are associated with this?

Answer 5

U = unusual bleeding / discharge @ any part of body
- nipples: breast cancer
- genitalia: gynecological - uterine & cervical cancers

Question 6

what does the T stand for in CAUTION UP? what cancers are associated with this?

Answer 6

T = thickening or lump in breast or somewhere else
- lumps can be common they are PAINLESS
- breast / testicular cancer

Question 7

what does the I stand for in CAUTION UP? what cancers are associated with this?

Answer 7

I = indigestion or difficulty swallowing
- bloating & n/v
- mouth, throat, esophagus, & stomach cancers

Question 8

what does the O stand for in CAUTION UP? what cancers are associated with this?

Answer 8

O = obvious change in warts & moles
- skin cancer – melanoma
- ABCDE rule = asymmetry, border, color, diameter > 6mm, & evolution

Question 9

what does the N stand for in CAUTION UP? what cancers are associated with this?

Answer 9

N = nagging cough or hoarseness
- changes in voice & coughing blood
- lasts for months +
- smoking incr risk
- throat or lung cancer

Question 10

what does the 2ND U stand for in CAUTION UP? what cancers are associated with this? why is this so concerning to adults?

Answer 10

U = unexplained weight loss
- sign of ADVANCED cancer
- fatigue, weak, cant do everyday activities, loss of appetite

concern for adults bc of slow metabolism & have to lose weight with trying

Question 11

what does the P stand for in CAUTION UP? what cancers are associated with this?

Answer 11

P = pernicious anemia
- inflammation & destruction of gastric mucosa –> destruction of intrinsic factor –> incr risk of stomach cancer
- intrinsic factor made by stomach is needed for vit b12 to be absorbed by ileum

Question 12

what is a biopsy?

Answer 12

examining tumor tissue –> DEFINITIVE cancer diagnosis

Question 13

what are the different types of biopsies? what cancers are associated with each biopsy?

Answer 13

• excision = complete removal, margin of normal tissue – mastectomy & partial colectomy
• incisional = part removal – lymph node & muscle mass
• core needle = direct visual/guide of ultrasound or CT scan, tissue & cell are examined – needle prostate & liver mass
• fine needle = cytologic study, cell & small groups – aspiration of thyroid & breast mass
• exfoliative cytology = cells shed from surface thru endoscopic procedures – cervix, lung (sputum), & urine

Question 14

what are the two categories of classifying the ANATOMIC SITE of a tumor?

Answer 14

• solid tumors = associated w organs from where they develop
• hematologic cancers = originate from blood cell forming tissue

Question 15

what is histologic classification? what are the two categories?

Answer 15

histologic classification = grading
- how it LOOKS under a microscope
- appearance of cells = dysplasia
- degree of differentiation = changing in function

Question 16

what are the grades of histologic classification?

Answer 16

• GRADE I = low grade, mild dysplasia & well differentiated
• GRADE II = intermediate grade, moderate dysplasia, moderately differentiated
• GRADE III = high grade, severe dysplasia, poorly differentiated
• GRADE IV = high grade, cells immature, primitive (anaplasia), undifferentiated, cell origin is difficult to determine
• GRADE X = can not be assessed

Question 17

if cancer cells appear to be close to normal tissue of origin =?

Answer 17

better prognosis

Question 18

what is clinical staging?

Answer 18

grading scale of the ANATOMIC EXTENT of cancer, how far it has moved
- helps with diagnosis –> best treatment option

Question 19

what kinds of test can we use to know how much cancer there is?

Answer 19

• BIOPSY
• -oscopy
• x ray
• CT scans
• MRI
• ultra sound
• PET scans

Question 20

what are the stages of clinical staging?

Answer 20

• STAGE 0 = carcinoma in situ
• STAGE I = no metastasis
• STAGE II = local invasion
• STAGE III = spread to regional structures
• STAGE IV = distant metastasis

Question 21

what is the TNM system? what does each letter mean?

Answer 21

most common staging system for cancer
- T = describes the original (primary) TUMOR
- N = whether the cancer has spread to the nearby lymph NODES
- M = tells whether the cancer METASTASIZED

Question 22

what is within the T of TNM?

Answer 22

• T1-T4 = higher the T, high the growth of tumor + near tissues
• TX = tumor cant be measures
• T0 = tumor cant be found

Question 23

what is within the N of TNM?

Answer 23

• N1-N3 = higher N, higher the amount of lymph nodes contain cancer
• NX = cancer in lymph nodes can not be measured
• N0 = no cancer in nearby lymph nodes

Question 24

what is within the M of TNM?

Answer 24

• MX = metastasis cant be measured
• M0 = cancer has NOT SPREAD to other parts of the body
• M1 = METASTASIS, cancer spread to other parts of body