Quiz 1 Flashcards by Courtney W

Abnormal growth of tissue resulting from uncontrolled progressive multiplication of cells that serves no function

Tumor

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Spread of cancer beyond the primary site; tumor moves

Metastases

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Depth at which electronic equilibrium occurs for photon beams; depth of maximum absorbed dose and ionizations for photons from a single treatment field, falls off after
As energy goes up, this goes further down; higher energy = lower

D-max

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Region between the skin surface and the depth of D-max
In this region, dose increases with depth until it reaches a maximum at the depth of D-max
The higher the x-ray energy, the greater this

Build-up region

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Dose delivered at the depth of D-max through a single treatment field; where we can calculate what is given at D-max

Given dose (GD)
Applied dose
D-max dose

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Unit of time; unit of output measure for linacs
Accelerators are calibrated so that 1 delivers 1 cGy for a standard, reference field size at a standard reference depth at a standard source-to-calibration point

Monitor unit (MU)

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1 MU = ? cGy

1 cGy

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Average daily dose

180-280 cGy

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Point of intersection of the three axes of rotation of the treatment unit; gantry, couch and collimator rotate around this point in space, usually tumor

Isocenter

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Central portion of beam emanating from the target, only part of the beam that doesn’t diverge

Central axis (CA)

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Distance from the source to the patient’s skin; disadvantage: have to move patient to make up for difference in thickness of patient

Source-skin distance (SSD) set-up

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Distance from source to the axis of rotation of the treatment unit (isocenter)

Source-axis distance (SAD) set-up

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Unblocked or open field size projected at the reference distance, usually the isocenter (100 cm)

Collimator field size

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Equivalent rectangular field dimension of the open treatment area within the collimated field
Ex: MLCs, aperture block

Blocked (effective) field size

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Small packet of electromagnetic energy (ex: x-rays, gamma rays, etc.)

Photon energy

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Negatively charged subatomic energy that can be accelerated by a variety of machines or emitted from decaying isotopes

Electron energy

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Tool that modifies the isodose distribution of a beam to correct for tissue inhomogeneities by progressively decreasing beam intensity across the field irradiated

Wedge

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Correct for tissue inhomogeneities

Compensating filter

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Used to form/shape treatment field made of 50% bismuth, 26.7% lead, 13.3% tin and 10% cadmium; low melting point but toxic

Cerrobend block

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Distinct part of a linac that allows treatment field shaping and blocking through the use of motorized leaves and the head of the machine

Multi-leaf collimators (MLCs)

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Extended metal structure used to restrict the useful beam to the required size

Electron application (cone)
Extension cone
Cylinder

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Tissue equivalent material placed on the skin to increase skin dose and even out irregular contours on the patient (similar Z to tissue)

Bolus

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Allows part of the beam to pass through while reflecting the other part of the beam; prevents beam from diverging into other part of field

Beamsplit

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Immobilization devices created from styrofoam shell and foaming agents

Alpha cradle

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Immobilization device that consists of a cushion and a vacuum compression pump ("beanbag")

Vac-Lok

Thermoplastic immobilization device; facemask

Aquaplast

Used to help immobilize and position tongue

Bite block

Lasers that project a small red or green beam of light toward the patient to set up the patient for right treatment 5: right, left, ceiling, floor, back

Positioning lasers

Treat patient with one field

Single field

Pair of fields directed along the same axis from opposite sides (ex: AP and PA)

Parallel opposed fields

Two oblique fields which are similar to a breast bridge, skim the field

Tangential field

Distance from midline to side

Breast bridge

Isocentric technique where the beam moves continuously about the patient

Rotation/arc therapy

Treatment at a short distance; uses radioactive material to deliver dose administered directly into the tumor Used in early stage disease or as a boost (ex: prostate seeds)

Brachytherapy

Shows distribution of absorbed dose and points of equal dose

Isodoses

Organs that limit the dose or dose that can be tolerated by critical structures

Critical organ dose

Normal tissue or vital organs whose radiation tolerance limits the deliverable dose

Critical structures

Normal tissues (critical structures) in which sensitivity to radiation damage may influence treatment planning and/or delivery of a prescribed dose of radiation

Organ at rise (OAR)

Distance between the borders of two adjacent fields, usually measured on the patient's skin; used to measure and verify the depth at which two adjacent fields abut

Gap

The use of imaging to compare the position of external set-up marks and internal anatomy to the treatment plan; ex: CT, portal imager (mV and/or kV), etc.

Image guided radiation therapy (IGRT)

Therapy that delivers non-uniform exposure across the beam's eye view (BEV) using a variety of techniques and equipment Changes dose distribution between each field; static field Inversed planned type treatment

Intensity modulated radiation therapy (IMRT)

Visualization perspective that is "end-on" or positioned as if looking at a volume from the source or radiation; made possible from collected CT data, this perspective is essential in three-dimensional planning

Beam's eye views (BEVs)

Type of specialized IMRT where it delivers radiation by rotating the radiation machine through one or more arcs while radiation is continuously delivered

Volumetric modulated arc therapy (VMAT)

Type of radiation therapy in which the radiation is delivered slice by slice; 6x energy Treatment unit where the linac rotates continuously while the treatment couch moves through the gantry bore producing a spiral treatment beam

Tomotherapy

Radiation therapy unit that accelerates electrons and produces x-rays or electron treatments

Linear accelerator (linac)

About 1 in ____ women will develop cancer (____ out of 100)

3; 33

About 1 in ____ men will develop cancer (____ out of 100)

2; 41

Cancer contributes to 1 out of every ____ deaths

Cancer is ________ to heart disease as the most common cause of death

2nd

______ deaths a day from cancer in the US

1650

Preventative treatment (ex: treat brain for small cell lung cancer)

Profolactic

Uncontrollable growth of irregular cells; will grow as long as it can Poor cell differentiation Invades other tissues (altered surface enzymes allow tumor to grow into other tissues) Grow at new sites (lymph, blood, etc.) Avoid immune system (immunotherapy) Autonomy

Cancer cell

Increased growth

-plasia

Abnormal

Dys-

Disorganized growth

Dysplasia

Increased, excessive

Hyper-

Quality or state of being self-governing; self-directing freedom, especially moral independence No limitations of growth

Autonomy

Tumors that often invade and destroy normal surrounding tissue and, if left untreated, can cause the death of the host Have no purpose and immortal

Malignant

Increased cellularity (number of cells increase)

Hyperplasia

After

Meta-

Abnormal appearing of cells, start seeing different cells in an area; not counted as malignant (ex: Barrett's esophagus)

Metaplasia

Pleo-

Variance in size and shape of cells

Pleomorphism

Cell looks the same as the cell it originated from

Well differentiation

Cell looks unlike cell it originated from; more sensitive to radiation

Poor differentiation/anaplastic

2 types of exposure to carcinogens

Incomplete | Complete

Requires same cell to be affected by promoter, can't cause cancer on its own (ex: UV light, hormones, etc.)

Incomplete exposure

Directly causes cancer (ex: chemicals, viruses, environment)

Complete exposure

3 stage theory of carcinogens

Initiation Promotion Progression

4 stages of cell growth

Initiation Promotion Progression Metastasis

Altered DNA cell leads to mutation

Initiation

Promoting agent enhances faulty DNA (preneoplastic to neoplastic)

Promotion

New growth of tumor cell (neoplasm)

Progression

Cell growth, spreads from one point to another

Metastasis

Study of the causes of disease

Etiology

Controls cellular division of normal calls; can become oncogen

Protooncogenes

Gene that regulates the development and growth of cancerous tissues; on/off switch of cancer cells

Oncogene

Gene whose presence and proper function produces normal cellular growth and division; absence or inactivation of such a gene lease to uncontrolled growth Arrest the damaged DNA to give it time to repair itself

Tumor-suppressor gene

New growth

Neoplasia

Provides information about its biological aggressiveness and is based on the degree of cell differentiation

Grade

Cancers grow by reproducing cells; completes cell cycle by loses restriction at ________

G0 (resting phase)

Time it takes for tumor to double in size (can be hours to months)

Doubling time

Earliest cancer can be detected on x-ray

30 doublings will reach 1 cm in size (about size of a marble)

_____ more doublings past 30 can lead to death

Change in ________ can help detect cancer early

WBC count

Greatest risk of developing cancer

Age

Multiple types of cells in tumor volume with a different response to radiation Tumors are not just one type of cell

Tumor heterogeneity

5 ways cancers metastasize

Enter blood and lymph vessels (most common) Invasion of adjacent tissues, continuously growing Invasion/evasion of immune system Reentrance into distant tissue Implantation of malignant cells in new tissue

Implantation of malignant cells in new tissue The spillage of tumor cell clusters and their subsequent growth as malignant implants at a site adjacent to an original tumor Can happen during surgery (tumor removed and part left or falls off somewhere else and grows)

Seeding

Cancer cells break away from tumor and disseminate in blood

Intravasation

Certain cancer cells go to certain sites (ex: prostate to bone)

Homing

Process by which vascular networks (blood supply) are created to sustain malignant tumors

Angiogenesis/neovascularization

Metastasis = stage ?

4 (highest, poor prognosis)

4 common metastatic sites (most to least common) of lung cancer

Liver Adrenal glands Bone Brain

4 common metastatic sites (most to least common) of breast cancer

Lymph Bone Lung Liver

Common metastatic site of stomach cancer

Liver

2 common metastatic sites (most to least common) of anus cancer

Liver | Lungs

3 common metastatic sites (most to least common) of bladder cancer

Lungs Bone Liver

3 common metastatic sites (most to least common) of prostate cancer

Bone Liver Lungs

3 common metastatic sites (most to least common) of uterine cervix cancer

Lungs Bone Liver

Common metastatic site of colon cancer

Liver (direct hepatic drainage)

Common metastatic site of sarcomas

Lungs

3 patterns of cancer occurrence

Sporadic Inherited Familial cancer

Most cancers arise spontaneously (most common pattern of occurrence; no history or exposure to carcinogens Occurs later in life (greater than 50 years)

Sporadic

Family has pattern of cancer, patient inherited faulty repair gene Rare (less than 10% of all cancer) Typically occur at younger age/earlier in life Requires promoter, bilateral Ex: breast cancer about 5%

Inherited

Certain cancers happen enough that it can't be related to chance but is not genetic Families share certain risk factors (ex: smoke, diet) and environment Occurs later in life

Familial cancer

Between ____% to _____% of all cancers are associated with lifestyle (ex: smoking and diet)

60% to 70%

Most preventable cause of cancer

Cigarette smoking

3 patterns of cancer occurance

Sporadic Inherited Familial cancer

Most cancers arise spontaneously, no history or exposure to carcinogens; occurs later in life (greater than 50 years)

Sporadic

Family has pattern of cancer, patient inherited faulty repair gene; two or more generations diagnosed with the same or related forms of cancer Rare, less than 10% of all cancers Typically occurs at younger age/earlier in life Requires promotor Usually bilateral, multifocal, or multiple primary tumors in one or more family members Ex: about 5% of breast cancer

Inherited

Certain cancers happen enough that it can't be related to chance but it's not genetic Families share certain risk factors (ex: smoke, diet) and environment Occurs later in life

Familial cancer

Between ____% to ____% of all cancers are associated with lifestyle (ex: smoking, diet)

60% to 70%

Most preventable cause of cancer; ____% of lung cancer in men, ____% in women

Cigarette smoking; 90%, 70%

Occurance of cancer in the general population

Absolute risk

Statistical estimate that compares the likelihood of development of a cancer in a person who has a specific risk factor with the likelihood in a person who doesn't have the specific risk factor Risk of someone developing disease with a risk factor compared to someone without the risk factor

Relative risk

Number of cases of cancer that could be prevented with the manipulation of known risk factors Amount of disease caused by a specific risk factor and its prevention if changed within the population

Attributable risk

7 cancers smoking is associated with

``` Head and neck Stomach Bladder Kidney Pancreas Liver Cervix ```

___% to ___% of all hereditary cancers diagnosed

5% to 10%

Cancer on both sides of the body (ex: kidneys, breasts)

Bilateral

Cancer in different spots, more aggressive

Multifocal

Noma

Tumor

Leio

Smooth

Myo

Muscle

Sarcoma

Connective tissue

Hemato

Blood

Neuro

Nervous system (brain)

Adeno

Glandular

Carcinoma

Epithelium

Classification of benign and malignant tumors of glandular epithelium

Benign: adenoma Malignant: adenocarcinoma

Classification of benign and malignant tumors of squamous epithelium

Benign: papilloma Malignant: squamous cell carcinoma

The thin tissue forming the outer layer of a body's surface and lining the alimentary canal and other hollow structures

Epithelium

Relating to, consisting of, or denoting a layer of epithelium that consists of very thin flattened cells

Squamous

Classification of benign and malignant tumors of connective tissue smooth muscle

Benign: leiomyoma Malignant: leiomyosarcoma

Classification of malignant tumors of the hematopoietic system

Leukemia (WBC)

Classification of malignant tumors of the lymphoreticular system

Lymphoma

Classification of benign and malignant tumors of the neural system

Benign: neuroma Malignant: blastoma

Most common histology associated with the oral cavity, pharynx, lung, anus, and cervix (tissue comes in direct contact with carcinogen)

Squamous cell carcinoma

Most common histology associated with the breast

Infiltrating ductal carcinoma

Most common histology associated with the colon and rectum, endometrium, and prostate (gland)

Adenocarcinoma

Most common histology associated with the brain

Astrocytoma

3 levels of cancer prevention

Primary Secondary Tertiary

Evading disease by methods such as immunization, avoiding tobacco, and reducing exposure to UV light

Primary cancer prevention

Early detection and treatment of subclinical, asymptomatic, or early disease in persons without signs or symptoms of cancer Screenings should be sensitive (disease present) and specific (no disease) and take into account false positives and negatives

Secondary cancer prevention

Management of an illness to prevent progression, recurrence, or other complications (ex: blood test)

Tertiary cancer prevention

5 dietary recommendations to reduce cancer risk

Avoid overeating, maintain ideal body weight (ex: fat cells produce estrogen associated with breast cancer) Reduce fat intake to less than 30% of total caloric intake Eat fruits and vegetables that provide fiber (5 servings a day); decreases transfer time of fecal material, provides antioxidants Minimize the intake of foods that are salt-cured, smoked (associated with stomach and esophageal cancer), and nitirite-cured (ex: lunch meat, bacon); food preservatives (nitrates and nitrites) associated with increased risk of cancer Limit consumption of alcoholic beverages/don't drink excessively (oral cavity, larynx, esophagus, breast, and liver cancer)

Number of new cases per 100,000 people per year

Incidence rate

Number of deaths per 100,000 people per year

Mortality rate

Proportion of patients alive at some point after their diagnosis

Survival rate

The number of cancers that exist in a defined population at a given point in time Measures proportion of the population who have cancer at a specified point or during an interval of time; how common it is seen in population

Prevalence

Include fatality rates only for those who have the disease

Case-fatality rate

Most common cancer in both men and women

Skin cancer (basal, squamous, malignant melanomas

3 most common cancers in men (account for 41% of all cancers in men)

Prostate Lung and bronchus Colon and rectum

3 incidence rates of cancer in men

Black men have the highest incidence White men are next American Indians/Alaska Natives had the lowest rates

3 most common cancers in women (account for 50% of all cancers in women)

Breast (30%) Lung and bronchus Colon and rectum

How long you can stay in the sun without getting burned x SPF number

Sun protection factor (SPF)

Second leading cause of death in the US

Lung cancer

5 incidence rates of cancer in women

``` White women have the highest rates Blacks Hispanics Asian/Pacific Islander American Indian/Alaska Native women have the lowest rates ```

5 tests recommended for colorectal screenings by the American Cancer Society (ACS) and how often they should be done

Fecal occult blood test (FOBT)- look for blood in feces by getting a stool sample on a test card coated with a plant based substance called guaiac; annual Flexible sigmoidoscopy (flex sig) every 5 years Double contrast BE every 5 years Colonoscopy every 10 years or virtual CT colonoscopy every 5 years (can't biopsy) Combination of FOBT and flex sig every 5 years

When does the ACS recommend people should begin colorectal screenings?

Start around 50 years old or 40-45 if high risk

3 ACS recommendations for breast cancer screenings

Breast self-examinations (BSE) Clinical breast examinations Mammography (40 years and older)

When does the ACS recommend people should do BSEs?

Start at age 20 and perform monthly 5-7 days after period; lead to a lot of false positives so now recommend be familiar with breast

When does the ACS recommend people should get clinical breast exams?

Start at 20 years old every 4 years until annually at 40 years old

When does the ACS recommend people should get mammograms at 40-44 years old, 45-54, and older than 55?

40-44: up to patient 45-54: annually Older than 55: every 2 years

Mammography benefits older women ___ to ___ years old; reduce mortality by ____% to ____% at this age

50-69 years old | 20% to 35%

5 risk factors of breast cancer

``` Mother or sister had premenopausal or bilateral disease Had period before age 12 Reached menopause after age 55 First birth after 30 years old Nulliparity ```

Never given birth

Nulliparity

3 components of BSEs

Visual examination in mirror (scaling or dimpling, change in nipple, discharge) Palpation in the shower Palpation in the supine position on the bed

Blood test, indicators that increase or come about because person has cancer

Serum tumor markers

Cancer protein/molecule immune system recognizes

Cancer antigen (CA)

7 serum tumor markers

``` Alpha-fetoprotein (AFP) Carcinoembryonic antigen (CEA) CA-125 CA-15-3 CA 19-9 Human chorionic gonadotropin Prostate-specific antigen (PSA) ```

4 cancers associated with AFP

Hepatocellular carcinoma Choriocarcinoma (uterus) Teratoma Tumors of testes and ovaries

7 cancers associated with CEA

``` Colon Rectum Pancreas Stomach Lung Breast Ovary ```

3 cancers associated with CA-125

Ovarian Breast Colorectal

Cancer associated with CA-15-3

Breast

4 cancers associated with CA 19-9

Colorectal Pancreas Stomach Liver

4 cancers associated with HCG

Choriocarcinomas Germ cell tumors Testicular disease Hydidiform moles (cysts) - hormonal reproductive system

Structure, shape, etc.

Morphology

Cell type

Histology

Surgical procedure that involves removing all or part of the tissue suspected of being cancerous

Biopsy

4 biopsies from smallest to largest

Needle Incisional Excisional Open

2 types of needle biopsies

Aspiration | Core

Smallest biopsy, cytological sample

Aspiration

Insert needle and remove tumor cells

Core

Act of cutting into tissue to remove part of the tumor so that a diagnosis can be made, larger than needle

Incisional

Removal of the entire tumor by cutting it out so that a diagnosis can be made

Excisional

Under direct vision or by laser remove part or whole tumor, most invasive

Open biopsy

Why is pathology important?

A clinical diagnosis is just a guess without a pathology report

3 things neede to identify the histopathology

Tumor type Classification Grade

Tumor type

Origin

Subtype of malignancy (ex: adenosquamous)

Classification

Provides information about a tumor's biologic aggressiveness and is based on the degree of cell differentiation (what cell looks like)

Grade

Few features of cell tumor originated from = high grade tumor

Poorly undifferentiated

Higher grade tumor = _____ aggressive

More aggressive

5 grades (G) for malignancy

``` X I (1) II (2) III (3) IV (4) ```

Grade cannot be determined, not enough information

Cells are well differentiated, closely resembling the tissue from which they arose; considered a low-grade tumor Mature cells

GI (1)

Cells are moderately differentiated; still resemble normal cells somewhat, but exhibit more malignant characteristics Cells have some immaturity and vary from normal tissue

GII (2)

Cells are poorly differentiated; few normal cellular characteristics are retained, but the tissue of origin may still be established Immature cells, do not look like normal cells

GIII (3)

Cells are undifferentiated, no normal cellular characteristics can be found and determining the origin is very difficult

GIV (4)

3 steps in which cancer is staged

Start with history and physical (H&P) - background (ex: smoker, drinker), family history, when signs and symptoms started if any Order radiographic procedures, diagnostic tests (radiation oncologist = administers RT; medical oncologist = chemotherapy doctor) Order with some labs (easy way to get a lot of information from patient)

Step-by-step process to determine the size and location of a tumor and the degree to which it has spread

Staging

The movement of charged particles in a fluid or gel under the influence of an electric field

Electrophoresis

Staging system from the American Joint Committee on Cancer (AJCC) used on solid tumors (breast, lung, colon, etc.)

Tumor-node-metastasis (TNM) staging

Characteristics of a given tumor (size, depth of invasion, involvement of surrounding structures)

Tumor (T)

Presence or absence of involved nodes and size or number of involved nodes

Node (N)

Presence or absence of metastasis

Metastasis (M)

4 stages of the primary tumor (T)

TX T0 Tis T1, T2, T3, T4

Primary tumor cannot be assesed

No evidence of primary tumor

Carcinoma in situ

Tis

An early form of cancer defined by the absence of invasion

In situ

Increasing size and/or local extent of the primary tumor specific to every disease

T1, T2, T3, T4

3 stages of regional lymph nodes (N)

NX N0 N1, N2, N3

Regional lymph nodes cannot be assessed

No regional lymph node metastasis

Increasing involvement of regional lymph nodes

N1, N2, N3

3 stages of distant metastasis

MX M0 M1

Distant metastasis cannot be assesd

No distant metastasis

Distant metastasis

M1 (automatically stage 4)

3 reasons staging is important

Gives prognosis values Determines treatment based on disease within the patient Data collection gives protocols for type of disease and what treatment works best for it; tumor registry

Database tracking mechanism for cancer incidence, characteristics, management, and results in cancer treatment facilities for patients diagnosed with cancer; carry diagnosis, stage, and treatment Follow patient for life through followup examinations

Tumor registry

4 stages of the Ann Arbor classification of lymphoma staging (Hodgkin's) (spreads in a pattern)

Stage I Stage II Stage III Stage IV

Lymphoma confined to nodal group

Stage I

More than one group of lymphoma on the same side of the diaphragm

Stage II

Lymphoma on both sides of the diagram

Stage III

Disseminated disease, spread of lymphoma

Stage IV

Fevers, night sweats, and weight loss from lymphoma

B-symptoms

Extra lymphatic disease (extra nodal site with disease)

5 stages of leukemia using the Rai system

``` Stage 0 Stage I Stage II Stage III Stage IV ```

The Rai staging system works well with what leukemia?

Chronic lymphocytic leukemia (CLL)

Rai stage of leukemia where patient has more than 10,000 lymphocytes

Stage 0

Rai stage of leukemia where patient has enlarged lymph nodes

Stage I

Rai stage of leukemia where patient has enlarged liver and/or spleen

Stage II

Rai stage of leukemia where patient has anemia

Stage III

Rai stage of leukemia where patient has thrombocytopenia

Stage IV

Decrease in the peripheral red cell count, low RBCs

Anemia

Abnormal decrease in the number of platelets

Thrombocytopenia

About ___% to ___% of all acute lymphoblastic leukemia (ALL) will achieve complete remission and ____% to ____% will be cured; ____% to ____% cure rate for kids

About 80% to 90% of all acute lymphoblastic leukemia (ALL) will achieve complete remission and 30% to 40% will be cured; 60% to 80% cure rate for kids

Most common childhood leukemia

ALL

3 stages of the Binet classification of leukemia

Clinical stage A Clinical stage B Clinical stage C

Binet stage of leukemia where patient has no anemia or thrombocytopenia and less than three areas of lymphoid involvement

Clinical stage A

Binet stage of leukemia where patient has no anemia or thrombocytopenia with greater than or equal to three areas of lymphoid involvement

Clinical stage B

Binet stage of leukemia where patient has anemia and/or thrombocytopenia regardless of the number of lymphoid enlargement

Clinical stage C

4 stages of colon cancer according to Dukes staging system

A B C D

Colon cancer confined to muscular lining of bowel wall

Colon cancer grown beyond muscular layer of bowel wall

Colon cancer spread to involved lymph nodes

Distant metastasis of colon cancer

Staging system for how deeply penetrating a melanoma is

Clark and Breslow

7 other tests for cancer

``` CT: general anatomic information MRI: soft tissue (ex: brains) Nuclear medicine: bone scans, physiological PET: changed lung disease treatment PET/CT Bone marrow biopsy: through iliac crest Multiple gated acquisition (MUGA) scan ```

Scan that determines heart function using a gamma camera; restrictions to who can be around patient (ex: pregnant, kids)

Multiple gated acquisition (MUGA) scan

5 advantages of PET/CT

``` Concise calibration Patient in same position Good for lymphomas Check response to chemotherapy Check for recurrent disease ```

Patients that have mets Tests show no obvious origin (undifferentiated cells) Prognosis around 3-4 months

Unknown primary

Unknown primaries account for what percent of all cancers?

5-10%

Must have _________________ to determine if someone has cancer

Tissue diagnosis

3 steps needed to complete staging

Diagnosis Prognosis Correct treatment

How often should we check a patient's blood?

Once a week

WBCs less than ______ stops treatment, increased risk of infection

2,000

Platelets less than _______ may stop treatment; below ______ to ______ at risk for severe bleed

Platelets less than 100,000 may stop treatment; below 20,000 to 50,000 at risk for severe bleed

Percent of packed RBC

Hematocrit (HCT)

Normal HCT level, in men, and in women

``` Normal = 40-45% Men = 38.8-46.4% Women = 35.4-44.4% ```

What transports oxygen in blood

Iron

Iron level

Hemoglobin (HGB)

Normal HGB level in men, women, and children (g/dL)

``` Men = 13.3-16.2 g/dL Women = 12-15.8 g/dL Children = 11.5-14.5 g/dL ```

Normal erythrocyte (RBC) blood counts per cubic millimeter and percentage for men and women

Men per cubic millimeter = 4.3-5.6 x 10^6; percentage = 100 | Women per cubic millimeter = 4-5.2 x 10^6; percentage = 100

Normal reticulocyte blood count per cubic millimeter and percentage

Per cubic millimeter = 0.8-2.3% red cells | Percentage = 100

Normal total leukocyte (WBC) blood count per cubic millimeter and percentage

Per cubic millimeter = 3,500-9,050 | Percentage = 100

Normal band blood count per cubic millimeter and percentage

Per cubic millimeter = 0-450 | Percentage = 0-5

Normal lymphocyte blood count per cubic millimeter and percentage

Per cubic millimeter = 701-4,530 | Percentage = 20-50

Normal eosinophil blood count per cubic millimeter and percentage

Per cubic millimeter = 0-540 | Percentage = 0-6

Normal basophil blood count per cubic millimeter and percentage

Per cubic millimeter = 0-180 | Percentage = 0-2

Normal monocyte blood count per cubic millimeter and percentage

Per cubic millimeter = 140-720 | Percentage = 4-8

Normal platelet blood count per cubic millimeter

165,000-415,000 per cubic millimeter (severely low less than 20,000)

Clotting factor

Platelets

Bone marrow aspiration/biopsy detects or assesses

Hematologic abnormalities

Blood chemistries and hepatic function studies detects or assesses

Abnormalities of the liver, kidneys, and bone related to cancer or its therapy

Complete blood count detects or assesses

Bone marrow abnormalities or treatment toxicity

Creatinine clearance detects or assesses

Kidney function, especially important prior to administration for nephrotoxic drugs

Hemoccult test detects or assesses

Presence of blood in stool; screening but not specific for cancer

Pap smear detects or assesses

Cervical cancer or premalignant changes

Serum electrophoresis detects or assesses

Serum protein and immunoglobulin levels (multiple myeloma)

Urine catecholamines detects or assesses

Neuroblastoma, pheochromocytoma (released by adrenals)

Quiz 1 Flashcards

(284 cards)