Comprehensive Oncology: Cancer Types, Staging, Treatment, and Prognosis, Cancer Biology: Oncogenes, Tumor Growth, and Gompertzian Curve

Cancer

A disease characterized by uncontrolled cell growth.

Humoral Theory

Hippocrates believed there were four humors, or body fluids: Blood, phlegm, yellow bile, black bile; balance was required for good health.

Lymph Theory

Life consists of continuous and appropriate movement of fluids; cancer was a result of fermenting lymph.

Blastema Theory

Cancer was made of cells, not lymph; cancer arose from blastema, or budding elements.

Chronic Irritation Theory

Believed cancer 'spread like a liquid'; showed that cancers metastasize through the spread of malignant cells.

Trauma Theory

Cancer was caused by serious injury; dominant opinion from the late 1800s to 1920s.

Parasite Theory

Resulted in the belief that cancer was contagious; cancer patients were isolated.

Modern Theory

Supported by scientific research; includes known carcinogens such as viruses, chemicals, and radiation.

Oncogenes

Genes that have the potential to cause cancer.

Proto-oncogenes

Normal genes that can become oncogenes due to mutations.

Anti-oncogenes

Genes that protect a cell from one step on the path to cancer.

Gompertzian growth curve

A mathematical model describing tumor growth.

Benign

A tumor that is not cancerous and does not spread.

Malignant

A tumor that is cancerous and can spread to other parts of the body.

Sarcoma

A type of cancer that arises from connective tissues.

Carcinoma

A type of cancer that arises from epithelial cells.

Incidence

Extent or frequency of cancer occurrence.

Cancer Registry

A system for collecting information about cancer cases.

Surgical data

Information related to surgical procedures performed on cancer patients.

Histology

The study of the microscopic structure of tissues.

Grade

A classification of cancer cells based on how abnormal they look under a microscope.

Demographic data

Statistical data relating to the population and particular groups within it.

Follow-up care

Post-treatment care to monitor patient recovery and detect recurrences.

Site

The specific location in the body where cancer is found.

Stage

The extent of cancer in the body, often classified by size and spread.

Lymph node involvement

The presence of cancer cells in the lymph nodes.

Date and location of diagnosis

The specific date and place where a cancer diagnosis was made.

Surgical margins

The edges of the tissue removed during surgery, indicating whether cancer cells are present.

Chemotherapy

A type of cancer treatment using drugs to kill cancer cells.

Insurance information

Details regarding the patient's health insurance coverage.

Type of chemotherapy

The specific class or category of chemotherapy drugs used.

Dosage

The amount of chemotherapy drug administered to the patient.

Dates of treatment

The specific time periods when chemotherapy was administered.

Radiation therapy

A cancer treatment that uses high doses of radiation to kill cancer cells.

Dose

The amount of radiation administered during therapy.

Side effects

Unintended effects of treatment that can occur alongside the intended therapeutic effects.

Hormone therapy

Treatment that adds, blocks, or removes hormones to slow or stop the growth of cancer.

Local data reporting

The process of submitting cancer-related data to local health authorities.

State laws on data reporting

Regulations requiring monthly reporting of cancer data to state health departments.

Federal government reporting

The requirement to report cancer data to federal authorities annually.

Estimated new cancer cases

Projected number of new cancer diagnoses in a given year.

Estimated cancer deaths

Projected number of cancer-related deaths in a given year.

Probability of cancer

Statistical estimates of the likelihood of developing cancer.

Survival rate

Typically reported as 5-year disease-free survival; survival rate for all cancers combined is approximately 60%.

Epidemiology

The study of the incidence of disease in populations.

Etiology

The study of the cause of disease.

Chemical carcinogens

Substances that can lead to cancer, including tobacco, alcohol, and asbestos.

Radiation carcinogens

Types of radiation exposure that can cause cancer, such as medical x-rays and sun exposure.

Drug-induced carcinogens

Medications that can cause cancer, such as chemotherapeutic alkylators and estrogen.

Viral and immunologic carcinogens

Viruses that can lead to cancer, including Epstein-Barr virus, Hepatitis B, and HIV.

Change in bowel or bladder habits

A symptom indicating potential health issues.

A sore that does not heal

A potential sign of underlying health problems.

Unusual bleeding or discharge

An abnormal symptom that may indicate serious conditions.

Thickening of lump in breast or elsewhere

A physical change that may signal the presence of a tumor.

Indigestion or difficulty swallowing

Symptoms that can indicate gastrointestinal issues or cancer.

Obvious change in wart or mole

A noticeable alteration that could suggest skin cancer.

Nagging cough or hoarseness

Persistent symptoms that may indicate respiratory issues or cancer.

Early detection

Identifying cancer at an asymptomatic stage for better outcomes.

Asymptomatic lesions

Lesions that do not present symptoms but may indicate cancer.

Small, localized tumors

Tumors that are confined to a small area, often more treatable.

Smaller, localized lesions are highly curable

Indicates that early-stage lesions have a high success rate for treatment.

Effective screening test

A test that is sensitive, specific, cost-effective, and accurate.

Sensitive

A characteristic of a screening test that correctly identifies those with the disease.

Specific

A characteristic of a screening test that correctly identifies those without the disease.

Cost-effective

A measure of the economic value of a screening test relative to its benefits.

Accurate

The degree to which a screening test correctly identifies the presence or absence of disease.

Purpose of work-up

To determine the general health of the patient and gather tumor information.

Exact procedures are site dependent

The specific methods used in a work-up vary based on the tumor location.

Major purposes of oncologic imaging

To identify the primary tumor and search for distant disease.

Procedures in oncologic imaging

Includes conventional radiographs, CT, MRI, PET, nuclear imaging, and ultrasonography.

Major purpose of biopsy

To determine or exclude the exact diagnosis of a tumor.

Common biopsy methods

Includes fine-needle aspiration, core needle, endoscopic, incisional, and excisional.

TNM

A staging system that classifies tumors based on size, lymph node involvement, and metastasis.

Pierre Denoix

Introduced the TNM staging system between 1943-1952.

G1

Well differentiated grade of cancer.

G2

Moderately well differentiated grade of cancer.

G3

Poorly differentiated grade of cancer.

G4

Very poorly differentiated grade of cancer.

Prevention

The act of reducing or eliminating exposure to known carcinogens.

Tumor boards

A collaborative group of cancer specialists reviewing treatment plans.

Multidisciplinary team

A group including surgeons, radiation oncologists, and medical oncologists.

Basic principle of all therapy

To cure cancer with minimal damage to normal function and structure.

Determining factors in treatment

Include aggressiveness of cancer, predictability, morbidity and mortality rates, and cure rates.

Advantages of radiation oncology

Includes preserving function and achieving good cosmetic results.

Limitations of radiation oncology

Includes localized tumors, proximity to critical structures, and patient medical conditions.

Methods of delivery in radiation oncology

Includes external beam and brachytherapy.

External beam

Radiation source produced outside the patient's body.

Brachytherapy

Radiation source placed next to or directly in the tumor.

Advantages of surgical oncology

Includes instantaneous results and effectiveness for small lesions.

Limitations of surgical oncology

Includes size and extent of tumor, poor cosmetic effect, and patient medical conditions.

Advantages of medical oncology

Includes systemic treatment targeting malignant cells and hormones.

Limitations of medical oncology

Includes large tumors or high tumor burden and patient medical conditions.

Methods of delivery

Various techniques used to administer chemotherapy.

Chemotherapy agents

Medications used to treat cancer by killing or slowing the growth of cancer cells.

Oral administration

Taking medication by mouth.

Alkylating agents

Chemotherapy drugs that work by directly damaging DNA to prevent cancer cells from dividing.

Injections

Administering medication via a syringe into the body.

Antimetabolites

Chemotherapy agents that interfere with DNA and RNA growth by substituting for the normal building blocks of RNA and DNA.

Antibiotics

Medications that are used to treat infections and some types of cancer.

Hormonal agents

Drugs that block or lower the amount of hormones in the body to slow or stop the growth of cancer.