Slides 41-48

What is a tumor marker?

A biomarker that may be elevated by the presence of one or more types of cancer

• There are many different tumor markers, each indicative of a particular disease process, and they are used in oncology to help detect the presence of cancer

• A substance that can be found on or inside tumor cells, or in body fluids such as blood, urine, and spinal fluid.

Where can tumor markers be found?

• Tumor cells

• Blood

• Spinal fluid

• Urine

What are the five types of tumor markers we need to know?

➢ Hormones

➢ Enzymes

➢ Genes

➢ Antigens

➢ Antibodies

What can tumor markers help detect?

The presence of cancer

Which tumors secrete alpha fetoprotein into the blood?

Liver and germ cell tumors

What is alpha fetoprotein (AFP)?

A protein secreted into the blood by some liver and germ cell tumors

Which tumors secrete prostate-specific antigen into the blood?

Prostate tumors

What is PSA?

Prostate-specific antigen

What can happen if a tumor marker has biologic activity?

• Symptoms can be expressed

• A paraneoplastic syndrome can occur

How are tumor markers used?

• Screen high-risk individuals

• Diagnose specific tumors

• Follow the clinical course of cancer

When is surgery a definitive treatment for cancer?

When cancer has not spread beyond the limits of surgical excision

What is palliative surgery?

Surgery used for relief of symptoms

How can surgery help prevent cancer in selected high-risk diseases?

Preventive surgery can reduce cancer risk

What can an APC mutation cause?

A very high lifetime risk of colon cancer

What surgery is listed for high-risk APC mutations?

Colectomy

What cancers are associated with BRCA1 and BRCA2 mutations?

Breast and ovarian cancer

What preventive surgeries are listed for BRCA1 and BRCA2 mutations?

• Prophylactic mastectomy

• Bilateral salpingo-oophorectomy

Or Both

What are adequate surgical margins?

Margins showing that surgery has removed the cancer

Why are adequate surgical margins important?

Surgery must remove the cancer

What additional information can surgery provide?

Critical staging information

What is the goal of radiation therapy?

Kill cancer cells while minimizing damage to normal structures

What type of radiation in radiation therapy is used?

Ionizing radiation

How does ionizing radiation damage cells?

• By imparting enough ionizing radiation to cause molecular damage to the DNA.

• 
  

Can radiation cause irreversible damage to normal cells?

Yes

• enough to be a lifetime radiation dose

What is lifetime radiation dose?

The total radiation exposure received over a lifetime

What is brachytherapy?

Radiation therapy in which seeds are implanted

What is the goal of chemotherapy?

Eradicates enough tumor cells to enable the body’s natural defenses to eradicate the remaining cells.

• Can be a single-agent or combination chemotherapy.

What are the three types of chemotherapy needed to know?

• Induction Chemotherapy

• Adjuvant Chemotherapy

• Neoadjuvant Chemotherapy

Can chemotherapy use one drug or multiple drugs?

It can be single-agent or combination chemotherapy

What is induction chemotherapy?

Chemotherapy that causes shrinkage or disappearance of tumors

What is adjuvant chemotherapy?

Chemotherapy after surgery to eliminate micrometastases

What is neoadjuvant chemotherapy?

Chemotherapy given before localized surgical or radiation treatment