Quiz 3 Flashcards
(69 cards)
What is cancer:
What is differentiation with cancer:
What is Anaplastic / Anaplasia: (how to remember)
What is Atrophy:
What is Hypertrophy:
What is Hyperplasia:
What is Metaplasia:
What is Dysplasia:
What is Neoplasia / Neoplasm:
Tumor:
Benign:
Malignant:
Metastasize:
Situ: (how to remember)
Cancer: A disease in which abnormal cells divide uncontrollably and destroy body tissue.
Differentiation: Normal cells have a distinct size, shape, function, and structure. But when they undergo changes … it is called differentiation. Well-differentiated cancer cells look more like normal cells and tend to grow and spread more slowly than poorly differentiated or undifferentiated cancer cells which look nothing like the normal tissue.
Anaplastic / Anaplacia = UNdifferentiated cells, or cells lose their identity and look nothing like the parent tissue. (ANA LOOKS NOTHING LIKE HER FATHER cause of plastic surgery). CANCEROUS CELLS
Atrophy: Decrease in cell size
Hypertrophy: Increase in cell size
Hyperplasia: Increase in number of cells, resulting in a tissue increasing in mass.
Metaplasia: Substitution of one cell type with another in a tissue. One mature tissue type replaces another tissue type. It is early dysplasia. Ex: columnar epithelial cells change to squamous epithelial cells.
Dysplasia: Cell disorganization or Abnormal changes in cellular shape, size, and/or organization. Basically - abnormal cell growth (precursor to cancer). Dysplasia can reverse itself, or lead to cancer.
Neoplasia / Neoplasm: formation of a new tissue or abnormal growth of an existing tissue.
Tumor: The mass or area of the body that is bulging because of cell proliferation / neoplasm. They are abnormal growth of tissues that serve no purpose and harm tissue and take needed nutrients/blood.
Benign: Non-cancerous, remote or little or not cancerous yet. Can be removed, won’t grow back. But can lead to cancer.
Malignant: Bad and growing. Threat to life.
Metastasize: Spreading to other parts of body.
Situ: “In situ” is in the normal location. An in situ tumor is one that is confined to its site of origin and has not invaded neighboring tissue or gone elsewhere in the body. (remember: SIT - STAY)
1) Explain difference between GRADING and STAGING tumors
(how to remember)
2) Are stages and grades same for each different type of cancer?
3) What is the TNM System
The T =
The N =
The M =
1) GRADING is a way of classifying cancer CELLS. The pathologist gives the cancer a grade based on how different they look from normal cells (differentiation), how quickly they are growing and dividing, and how likely they are to spread. (How aggressive is the cancer?)
STAGING is a way of classifying the TUMOR. It is describing or classifying a cancer based on the extent of cancer in the body. The stage is often based on the size of the TUMOR, whether the cancer has spread (metastasized) from where it started to other parts of the body and where it has spread. Stages are based on specific factors for each type of cancer. Stage 0 = situ, Stage 1 = localized,
Stage 4 = metastasized. (TNM staging system – T = Tumor; N = node involvement and M = metastastic spread)
(Remember alphabetical. G before S, so grading before staging. C before T. Cells before Tumor)
The GRADE of a tumor is looking at microscopic features of the cancer and give a description of the tumor and indication of how quickly it is likely to grow and spread (prognosis). It defines the tumor and how malignant it is. IT IS ALL ABOUT HOW DIFFERENTIATED (4 ways) a cell is compared to parent cell. GX = grading can’t be accessed. G1 is well differentiated, and G4 is undifferentiated or anaplastic (cancerous).
The STAGE of a solid tumor refers to its SIZE or extent and whether or not it has SPREAD to other organs and tissues. Rate and Growth and Size of tumor. Stage 0, I, II, III, IV. Stage 1 is localized, Stage 4 is metastasized.
2) NO. They are specific to each cancer.
3) A system to tell us where in the body the cancer is, cell types, size of tumor, if it has spread to nearby lymph nodes or other parts of body, etc.
T = size and extent of the TUMOR N = Number of near by lymph NODES that have cancer M = Whether the cancer has METASTICIZED
Explain the TNM grading system:
Examples: T1N0MX or T3N1M0
Primary tumor (T)
TX: Main tumor cannot be measured.
T0: Main tumor cannot be found.
T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T’s may be further divided to provide more detail, such as T3a and T3b.
Regional lymph nodes (N)
NX: Cancer in nearby lymph nodes cannot be measured.
N0: There is no cancer in nearby lymph nodes.
N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.
Distant metastasis (M)
MX: Metastasis cannot be measured.
M0: Cancer has not spread to other parts of the body.
M1: Cancer has spread to other parts of the body.
_________________________
T: Primary Tumor
TX, T0, TIS, T1-4
N: Regional Lymph Nodes
NX, N0, N1-3
M: Distant Metastasis
MX, M0, M1
What is the difference between incidence and prevelence
Remember bath tub analogy? What is incidence, what is prevelance in the bath tub?
INCIDENCE IS NUMBER OF NEW CASES OVER A SPECIFIC TIME PERIOD. PREVELANCE IS HOW MANY PEOPLE HAVE IT COMPARED TO TOTAL POPULATION.
The proportion of the population that has a disease at a point in time (prevalence) and the rate of new occurrence of new disease during a period of time (incidence)
Incidence is how many new / how much water added in a time, and prevelance is how much of the poplulation / how much water in the bathtub.
Is cancer higher (generally) among men or women?
Is death rate higher among men or women.
Does incidence of cancer vary among ethnic/race and types of cancer?
Is incidence rate going up or down?
Is survival rate going up or down?
Is incidence to survival rate for cancer going up or down?
Men. Obviously women get more breast and ovarian cancer, but in almost all other categories, men get cancer more.
Men.
Of course
Up (more people are getting cancer)
Up (more people are surviving)
Up (meaning more people who get cancer are LIVING)
What are some common risk factors for getting cancer:
If you have one of these risk factors, does it mean you’ll get cancer?
- Age
- Smoking / Tobacco
- Sun exposure
- Chemical or substance exposure, or alcohol
- Viruses / bacteria
- Sexual behaviors
- Stress / Depression
- Previous cancer
- Genetics or family history
- Occupation
- Diet and exercise (lifestyle)
- Geographic location / enviornment
- Gender
- Ethnicity (genetics)
NO
Is cancer contagious?
How does cancer develop?
No
Cancer is ultimately the result of cells get altered somehow and that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed and planned cell death is called apoptosis (vs. unplanned cell death = necrosis), and when this process breaks down, cancer begins to form. So if smoking, chemical agent, radiation exposure, or just a fluke mutation changes a cell and then the DNA/chromosomes get altered and then replicated wrongfully … it just starts with one cell, and then that cell slowly (or quickly) grows and takes over a tissue with bad cells that don’t perform properly.
So basically when a healthy cell is damaged somehow (from risk factors above) and then copied and replicated over and over and doesn’t perform normal function it is designed to do.
Explain difference between a benign and malignant tumor?
What is metastasize?
How do they related to BEES
A BENIGN tumor is a tumor that does not invade its surrounding tissue or spread around the body. It can be a precursor to cancer, but non-cancerous. Not really growing, spreading, or threatening.
A MALIGNANT tumor is a tumor that may invade its surrounding tissue and rapidly grow (or even metastasize and spread around the body). Its growing and spreading fast, dangerous.
Metastasize: spreading from original tumor site to another site on/in body.
A bee can sting and hurt, but usually it is not aggressive or life threatening and can easily be swatted away = BENIGN. OR, A killer bee that attacks and attacks and is hard to get rid of, and can kill you = MALIGNANT.
What is oncology?
Can dysplasia be reversible?
Early Dysplasia is called:
The suffix “oma” means:
The suffix “ology” means:
Study and treatment of tumors
Yes
Metaplasia
Tumor
Study of
5 major classifications of neoplasm:
(how to remember)
*** Of the 5, which ones can get benign conditions, which ones only have malignant?
Examples of benign and malignant tumors in each of the 5 classifications?
1) Epithilial Tissue (PACA: carcinomas, adenoma)
2) Connective and Muscle Tissue (FO: sarcomas, fibroma)
3) Nerve Tissue (NGR: neuroma fibroma)
4) Lymphoid Tissue (L: lymphomas)
5) Hematopoeitic Tissue (LMM)
(Remember: everyone carries neoplastic lymphoma heredity … E, C, N, L, H)
Benign: First 3
Malignant: All 5 get malignant, but last 2 only get malignant
See power point 3, slide # 3 (and later on there is a flashcard on this).
Define Etiology:
3 Examples of Etiology:
The cause or reasons you got a disease (how you got it).
1) Endogenous (genetic)
2) Exogenous (environmental or external)
- Examples of Carcinogens: viruses, chemical agents, chemotherapeutic drugs, cytotoxic drugs, hormones, alcohol, DIET, EXERCISE, etc. (sometimes controllable)
3) Combination of above factors
(Remember Endo means in, Exo means out)
Define Pathogenesis
What does “occult” mean (how to remember)
So “occult blood” or “occult cancer” means …
What is Tumor Angiogenesis
PATHOGENESIS: The development of a disease (how it developed after you got it).
Occult means “hidden” (Cults stay hidden)
You can’t see the blood in the stool/sample, the cancer was not seen, etc.
Tumors need O2 and nutrients from blood to survive and grow. So they can stimulate nearby normal cells to produce angiogenesis (formation of new blood vessels). The resulting new blood vessels “feed” growing tumors with oxygen and nutrients, allowing the cancer cells to invade nearby tissue, to move throughout the body, and to form new colonies of cancer cells, called metastases
Metastasis =
What is the incidence of Metastases:
What are the 2 mechanisms of Metastases:
Can a metastases metastasize?
A cancer that spreads to a different part of the body from where it started.
Incidence: 30% of newly diagnosed cancers have clinically detected metastases. Another 30-40% have occult metastases.
Mechanism: 1) Tumor angiogenesis. 2) Or Cells break away, travel through body via blood or lymphatic system, become trapped in the capillaries of organs and spread.
Yes, even metastases can metastasize.
What is a Whipple Proceedure
How to remember?
Pancreaticoduodenectomy = Removal of head of pancreas and duodenum to remove cancerous tumor.
“Whip” the duodenum, which a duodenum is somewhat shaped like a whip.
Where are the clinical manifestations (s/s) of Metastases (where do they manifest)?:
Lungs Liver Bone CNS: Brain and Spinal Cord Lymphatic System
Manifestations of cancers can be local or systemic. Explain
If you have a tumor/cancer in just a part of the liver (and that’s it), what type of treatment would you get? If it was all throughout all the bones, what treatment would you get?
Local is a localized cancer in a specific area.
Systemic means it has traveled and effected an entire body system.
Local treatment targets just that area (radiation)
Systemic treats entire body (chemotherapy)
What causes cancer pain?
Different types of cancer pain?
Pain is a major s/s of cancer.
Most cancer pain is caused by the tumor pressing on bones, nerves or other organs in the body. Sometimes pain is due to your cancer treatment (chemo) . For example, some chemotherapy drugs can cause numbness, tingling, fatigue, etc. Or you lose WBC’s and thus get fever or sick easier / more often. Or you lose RBC’s and get anemia and fatigued. Or it eats your bone cells. Or it weakens your muscles. Etc.
TYPES:
Acute pain: short time
Chronic pain: long time
Bone Pain (bone breaks down) Nerve Pain (tumor causes pressure on nerves) Soft Tissue Pain Phantom Pain Referred Pain
What is the role of the PT in cancer treatment?
What are the key considerations in prescribing exercise for a patient with cancer?
Primary prevention: educate patients about importance of good diet, exercise, no alcohol or tobacco use, getting screened, etc.
Restoring physical function, ROM, strength, movement after treatment
Stretches and exercises during chemo to help limit fatigue
Helping to walk or use arm after amputation
What is a carcinogen?
Etiologic agents that change cells to possibly lead to cancer.
Etiologic agents / Carcinogens: viruses, hormones, smoking, alcohol, drugs, radiation, viruses, etc.)
A tumor growing in the brain, for example, will naturally have cancer cells fall off and enter blood stream. Why don’t new metastases form all over the body then?
Once the bad cells enter the blood stream, the body does a great job of sending WBC’s to fight and kill those cancer cells. But, some can slip through the cracks.
What is the role of the PT in treating cancer pain?
- Soft tissue work (massage) … but could rupture tumor
- Estim or ultrasound … but could rupture and lead to further metastacizing
?? Not much research on this.
What is the role of PT’s in helping patients with cancer related fatigue (CRF):
- CRF is when a patient feels very tired / exhausted all the time (especially after chemotherapy), and limits their ADL’s.
- Perhaps if a physician hasn’t diagnosed it, and we see that there is just over all muscle fatigue (after doing MMT), refer to oncologist.
- Stretching, low key exercise, ROM mobilization of joints, soft tissue mobilization, home adaptations, bring in medical equipment for the home.
1) What are paraneoplastic syndromes
3) Incidence of Paraneoplastic syndrome:
4 and 5) Etiology and Pathogenesis of Paraneoplastic syndrome:
6) Clinical manifestations (s/s) of Paraneoplastic syndrome:
7) Medical Management of Paraneoplastic syndrome:
1) Paraneoplastic syndromes are s/s or the effects that are triggered by an altered immune system response to a neoplasm. In other words, the other s/s at a site distant from the tumor but tell you that you may have cancer. These syndromes occur alongside the cancer as a result of the activation of your immune system
3) 10-20% of all cancer clients had paraneoplastic syndromes
4 and 5) An immune reaction as a result of immune system over-working against antigens and cancer cells.
6) Skin changes, neural function loss, anorexia, diarrhea, weight loss, fever, musculoskeletal weakness, fatigue, bad reflexes, hormone levels altered.
7)
How can cancer be prevented?
*** Test question about Primary, secondary and tertiary prevention. Explain each:
Besides genetic and uncontrollable environmental factors, many cancers can be avoided. Stop smoking, don’t drink alcohol, don’t do drugs, eat healthy and exercise, safe sex, etc. etc.
We can do more educating/training patients (population), get better medical facilities, and continued research, reduce businesses who produce unhealthy food options.
Primary: PREVENTION. Teach / educate patients (to not smoke, diet, exercise, etc.)
Secondary: SCREENING
Tertiary: MANAGING SYMPTOMS (medical, surgical, rehab), limiting complications, preventing disability associated with cancer treatment.
