Cancer

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Questions and Answers

What type of cells are specifically associated with Hodgkin's lymphoma?

T-lymphocytes

Reed-Sternberg cells (correct)

B-lymphocytes

Neutrophils

Which of the following is a common manifestation of Hodgkin's lymphoma?

Painless swollen lymph nodes (correct)

Persistent cough

Nausea and vomiting

Severe abdominal pain

What is the most common treatment for thyroid cancer?

Lifelong hormone therapy

Radiation therapy

Chemotherapy

Surgery (correct)

Which type of liver cancer is most prevalent?

Hepatocellular carcinoma Signup and view all the answers

What is one of the major risk factors for developing pancreatic cancer?

Chronic pancreatitis Signup and view all the answers

How is thyroid cancer most commonly diagnosed?

Ultrasound and biopsy Signup and view all the answers

Which of the following is NOT a typical manifestation of liver cancer?

Gradual onset of severe headaches Signup and view all the answers

What is the expected prognosis for pancreatic cancer diagnosed at an advanced stage?

Poor, with low survival rates at 1 year Signup and view all the answers

What complication occurs when edema or hemorrhage limits space for swelling?

Compartment Syndrome Signup and view all the answers

Which of the following conditions is characterized by the uncontrolled production of immature WBCs?

Leukemia Signup and view all the answers

What might be a result of muscle ischemia leading to kidney injury?

Rhabdomyolysis Signup and view all the answers

Which type of leukemia is characterized by the presence of immature white blood cells in the blood?

Myeloid leukemia Signup and view all the answers

Which complication of fractures is characterized by fluid loss leading to decreased blood volume?

Hypovolemia Signup and view all the answers

Which symptom is commonly associated with leukemia due to the ineffective functioning of white blood cells?

Low grade fevers Signup and view all the answers

What is the primary goal of chemotherapy in the management of leukemia?

Achieve remission Signup and view all the answers

At what age does the risk for lymphomas begin to increase significantly?

Age 55 Signup and view all the answers

What is the process called that involves the initiation and promotion of cancer?

Carcinogenesis Signup and view all the answers

Which of the following types of cancer is associated with the highest incidence?

Breast Cancer Signup and view all the answers

What characteristic is most commonly associated with cancer cells compared to normal cells?

Uncontrolled proliferation Signup and view all the answers

What is the significance of detecting cancer early in terms of survival rates?

It correlates with longer survival. Signup and view all the answers

Which term describes the uncontrolled cell proliferation that leads to the formation of tumors?

Neoplasia Signup and view all the answers

What is a critical feature of cancer cells concerning their growth behavior?

Failure to undergo apoptosis Signup and view all the answers

How do cancer cells typically spread within the body?

By cell-to-cell transfer in localized areas Signup and view all the answers

What is the role of carcinogens in cancer development?

They initiate DNA destruction and cellular mutation. Signup and view all the answers

Which of the following cancers is most commonly diagnosed in women in the U.S.?

Uterine cancer Signup and view all the answers

What is a key clinical manifestation of ovarian cancer?

Bloating and pelvic pain Signup and view all the answers

What is the typical risk factor associated with breast cancer related to reproductive history?

Late menarche Signup and view all the answers

Which treatment option is NOT typically recommended for lobular carcinoma in situ?

Surgery Signup and view all the answers

What is a common biochemical marker used in the assessment of ovarian cancer?

CA 125 Signup and view all the answers

Which management strategy is indicated for locally advanced or inoperable breast cancer?

Neoadjuvant chemotherapy Signup and view all the answers

Which of the following factors is believed to provide some protection against ovarian cancer?

Use of oral contraceptives Signup and view all the answers

Which procedure is sometimes performed in cases of small percentage potentially curable metastatic tumors?

Whipple procedure Signup and view all the answers

What is a common clinical manifestation of endometrial cancer?

Vaginal bleeding in postmenopausal women Signup and view all the answers

Which management strategy is essential for the early detection of cervical cancer?

Routine screening with Pap tests Signup and view all the answers

What is the primary goal of surgical management in prostate cancer?

Radical prostatectomy to remove the cancer Signup and view all the answers

What age group has the highest incidence of testicular cancer?

15-35 years old Signup and view all the answers

Which statement accurately describes the pathophysiology of prostate cancer?

It may spread to lymph nodes and other organs. Signup and view all the answers

What is the most common symptom associated with cervical cancer?

Vaginal bleeding Signup and view all the answers

Which of the following cancers has an almost universal association with HPV?

Cervical cancer Signup and view all the answers

For which type of testicular cancer is surgery followed by radiation or chemotherapy recommended?

Seminomas Signup and view all the answers

What is the most common site for metastasis from colorectal cancer?

Liver Signup and view all the answers

Which of the following is NOT a primary risk factor for cancer?

Regular physical activity Signup and view all the answers

What does stage III cancer signify?

Large or locally invasive tumors Signup and view all the answers

In skin cancer, which type is characterized by rapid metastasis and is considered the most dangerous?

Melanoma Signup and view all the answers

Which stage of cancer is defined as having metastasized to other parts of the body?

Stage IV Signup and view all the answers

What is a common early symptom of cancer indicated in the CAUTION acronym?

Thickening or lump in the breast Signup and view all the answers

Which type of skin cancer is known for its potential to arise from precancerous lesions and highly associated with UV exposure?

Squamous cell carcinoma Signup and view all the answers

The TNM staging system for cancer consists of assessment of what components?

Tumor size, number of lymph nodes, presence of metastasis Signup and view all the answers

What characterizes actinic keratosis in skin cancer?

Skin-colored to reddish-brown macules that may exfoliate Signup and view all the answers

Which factor is important for primary cancer prevention?

Modification of risk factors such as diet and exercise Signup and view all the answers

Study Notes

Oncology Concepts

Cancer is the leading cause of death worldwide, although rates are lower in developing countries due to infrastructure limitations in early cancer detection and treatment.
Cancer most frequently affects males and females, with the highest incidence in the prostate, breast, and lung.
The majority of cancer diagnoses are in individuals over 55.
Cancer presentation can range from acute and severe to chronic.
Cancer involves malignant, unregulated cell transformation in a specific body system.

Basic Cancer Information

Cancer affects all ages, with 78% of diagnoses occurring in individuals over 55.
Common types of cancer globally include lung, breast, colorectal, stomach, and prostate cancers.
Carcinogens can cause various patterns of cancer, including internal factors like DNA destruction, and external factors like exposure to environmental substances.
Cancers with slow proliferation and early detection have better survival rates. Cancers without early symptoms may progress to an advanced stage before detection.

Vocabulary

Carcinogenesis: the initiation and promotion of cancer.
Contact inhibition: normal cells stop growing when they touch other cells.
Apoptosis: normal cell cycle ending with programmed cell death.
Anchorage dependence: cells' growth is reliant on typical tissue structures and environments.
Dysplasia: uncontrolled/deranged growth resulting in varying cell size, shape, and organization. This is often a precursor to cancer.

Basic Cancer Continued

The most common cancer risk factor is exposure to carcinogens. Exposure alone is unlikely to directly trigger cancer.
Multiple factors including environmental, hormonal, lifestyle, infectious diseases, medications, immune status, and nutritional factors influence cancer development.
Advanced age and genetic predisposition are also factors in cancer development.

Neoplasia and Anaplasia

Neoplasia: uncontrolled cell proliferation.
Anaplasia: when a cell loses its expected structure and function.
Cancer cells expand locally into malignant tumors and have a propensity to spread (metastasis).
Cancer spread (metastasis) patterns can be predictable, such as in prostate cancer (spread to nearby structures). Colorectal cancer often metastasizes to the liver.

Risk Factors

The most common risk factor for cancer is exposure to carcinogens.
Carcinogens alone are not necessarily direct triggers for cancer.
Environmental, hormonal, lifestyle factors, infectious diseases, medications, immune status and nutrition all influence cancer development.
Advanced age and genetic predisposition also contribute to cancer risk.

Cancer Continued

Primary tumor: the original cancerous site.
Secondary tumor: location of metastasis.

Types and Staging

Solid tumors originate from specific body organs.
Hematological tumors arise from cells in the hematopoietic or secondary immune systems. Examples are leukemia and lymphoma.
Staging uses the TNM system (T = tumor size, N = lymph node involvement, M = presence of metastasis)

CA Staging Continued

Cancer staging progresses through stages I-IV, demonstrating increasing tumor size, spread, and invasion of nearby tissues. Stage IV indicates metastatic spread (to other locations).

Presentation

CAUTION signs can signal possible cancer. (C= changes in bowel or bladder; A= sores; U= unusual bleeding; T= thickened areas; I= indigestion; O= changes in appearance of warts or moles; N= cough).
Constitutional signs could include unusual fatigue, significant weight loss, unexplained fever, or night sweats.
Signs and symptoms specific to certain cancer types may help in diagnosis (location of primary tumor or metastasis).

Prevention

Primary prevention: modifying risk factors, immunizations, and chemoprevention (drugs that slow/prevent cancer).
Secondary prevention: non-invasive screenings to detect cancer early (e.g., colonoscopies, mammograms).
Tertiary prevention: managing cancer-related morbidity and mortality.

Modifying Risk of Cancer

Limiting exposure to carcinogens.
Immunization (targeting viruses that cause some cancers).
Chemoprevention (using certain chemotherapy drugs to prevent cancer in high-risk individuals).
Early detection and treatment (finding cancer early).

Tissues and Bone

Cancer can affect tissues and bones.

Skin Cancer

Skin cancer presents in two main forms (basal and non-squamous).
Skin cancer pathophysiology usually arises from UV-ray damage.
Different types of skin cancer include: actinic keratosis, squamous cell carcinoma, basal cell carcinoma, and melanoma.
Malignant melanoma is the most dangerous type of skin cancer, originating from melanocytes.

Details are more than skin deep

Actinic keratosis can evolve into squamous cell carcinoma (starting as scaly lesions, progressing to crusted/bleeding plaques).
Squamous cell carcinoma involves squamous cells, is associated with prolonged exposure to UV rays and can invade surrounding tissue and frequently metastasize
Basal cell carcinoma starts in the basement membrane and tends to damage tissue around it. These frequently re-occur
Malignant melanoma is the most life-threatening type, but high survival if detected early

ABCDE of melanoma

Characteristic signs for recognizing melanoma:
Asymmetry: Uneven shape
Border irregularity: Jagged/unsmooth edges
Color variation: Different colors within the lesion
Diameter: Larger than 6 mm (1/4 inch)
Evolving: Change in size/color/shape over time

Treatments

Treatment of non-melanomas depends on tumor size and location.
Malignant melanoma treatment includes removal and biopsy, and prognosis is based on the presence or absence of metastasis.
Complications from cancer treatment include cosmetic, financial, and emotional difficulties

Examples of Skin Cancers

Images of different skin cancer types (actinic keratosis, squamous cell carcinoma, basal cell carcinoma).

Bone Cancer and Fractures

Bone cancers can be benign or malignant.
Primary or secondary bone cancers occur in different age groups.
Symptoms of bone cancer include pain, limping, swelling, redness, decreased range of motion, fractures, and elevated calcium levels.

Leukemia

Leukemia is a type of blood cancer characterized by uncontrolled WBC production (leukocytosis)
It can be acute or chronic, originating from either myeloid or lymphoid stem cells.
Tumors are made up of blast cells (immature WBCs) which replace mature cells in bone marrow.

Leukemia continued

Leukemia causes symptoms such as swollen/painful lymph nodes, low-grade fevers, and reduced neutrophils(neutropenia). This condition is characterized by a drop in the levels of neutrophils, the most abundant type of white blood cell involved in the initial phases of the immune response.
Diagnosis is aided with CBC, and bone marrow biopsy.
Treatment includes using systemic chemotherapy/radiation to aim for remission (returning to normal blood cell production).
Cure is often possible with bone marrow/stem cell transplants.

Lymphomas

Lymphomas are cancers of the lymphatic system.
Hodgkin's lymphoma and non-Hodgkin's lymphoma are two main types.
Hodgkin's lymphoma has a better survival rate than non-Hodgkin's lymphoma.
Symptoms include pain-free lymph node swelling (commonly in neck, underarm, groin). Other symptoms may include fever, fatigue, weight loss, and night sweats.
Diagnosis often involves medical history, physical exam, and procedures like CT and PET scans.
Lymphomas are commonly treated with chemotherapy and/or radiation but some cases are surgically treated.

Endocrine System

The endocrine system includes the thyroid glands.
Common types of thyroid cancer include papillary, follicular, medullary, and anaplastic varieties.
Thyroid abnormalities such as nodules can be detected by ultrasound and biopsy.
Treatments for these often include surgery and/or radiation therapy, and in some cases, lifelong hormone replacement.

Gastrointestinal System

Contains cancers associated with the esophageal, stomach and colorectal tracts.
Details vary per system.

Hepatic and Pancreatic System

Liver cancer risk is elevated in individuals with a history of alcohol use, chronic liver disease (e.g., Hepatitis B or C), and/or those whose age has progressed beyond 65.
Liver cancer typically is detected only when the Liver has enlarged.
Symptoms can include pain, swelling, jaundice, and fatigue.
Diagnosis often involves radiological techniques (imaging) and tests.
Treatment can include surgical removal or liver transplant in cases where the cancer has been detected early enough.
Pancreatic cancer diagnosis and treatment are similar, but usually associated with a very low survival rate unless discovered at very early stages (as some studies show a mortality rate approaching 23% within a 1 year period and below 5% after 5 years in patients in remission ).

Reproductive Cancers

Breast Cancer

Epidemiology

Breast cancer risk increases with age, and early menarche/late menopause increases risk
Genetic mutations are linked to some breast cancers (5-10%).
Pathophysiology involves abnormal and uncontrolled cell growth that invade neighboring tissue and spreads through lymphatic systems

Clinical Manifestations

New mass or lump (may feel hard and painless); changes in the shape/appearance of the nipple or breast tissue
Diagnostic tests: mammography, ultrasound, MRI, and biopsy.
Lab tests: CBC (complete blood count), platelets, and liver function tests.

Management

Diagnostic tests: mammography, ultrasound, MRI, and biopsy
Lab tests: CBC, platelets, and liver function tests,
surgery: lumpectomy/mastectomy/preoperative neoadjuvant chemotherapy
Breast conservation therapy (lumpectomy) or total mastectomy (radical)
Treatment for in situ lesions: lobular carcinoma in situ (LCIS)
Treatment for intermediate or advanced: preoperative neoadjuvant chemotherapy,
Treatment for recurrence/metastasis: chemotherapy if not initially operable.

Ovarian Cancer

Epidemiology: common in post-menopausal women and highest incidence is found between ages 55-65. Early diagnosis has a high survival rate in many cases (often above 88%).
Pathophysiology: Cell growth is abnormal and uncontrolled, spreading through lymph and blood systems