Oncology Test 3

Overall 5 year survival rate for all cancers has increased in recent years to what?

67.9%

What is prevention?

Strategies and measures that stop cancer from developing.

What is early detection?

Examinations and tests intended to find the disease as early as possible before it has spread.

What is screening?

Selecting appropriate tests and studies to check for disease.

What are the two most important and effective strategies for saving lives from cancer?

Prevention and screening

Physical exam

Methodical process of detection that covers the entirety of the anatomic systems.

What is a sign?

An objective finding perceived by an examiner. Ex. Mass, rash, color change in skin.

what is a symptom?

Subjective indication of a disease or a change in condition as perceived by the patient. Ex. Difficulty sleeping, lack of appetite, dysphasia.

Diagnosis

The identification of a disease or condition

Subjective diagnosis

Patient complaints and medical history, preliminary diagnosis with no hard evidence.

Objective diagnosis

Based on current medical procedures and tests (labs and biopsies) and observation by the physician and other medical personnel.

First step to help asses the patient

Physical exam and interview

Seven warning signals of cancer

1. A change in bowel or bladder habits

2. A sore that does not heal

3. Unusual bleeding or discharge

4. Thickening or a lump in the breast or elsewhere

5. Indigestion or difficulty swallowing

6. Obvious change in a wart or mole

7. Nagging cough or hoarseness

Most powerful diagnostic tool for a physician is…

The initial patient interview

Do patients own their medical record?

No but may review then in request and have copies released.

What is the purpose of obtaining patient demographic information?

Certain diseases are found to be more prevalent in some groups according to age, race, gender, and national origin.

What population is prostate cancer more prevalent?

African American males

What population is lung cancer more prevalent in?

Males

What population is thyroid cancer more prevalent in?

Females

What cancer is more prominent in the Bantu of Africa, china, Russia, Japan, Scotland, and Caspian region of Iran.

Esophageal cancer

what is a premalignant condition?

Physiologic characteristics or predisposing factors that may lead to malignancy

What is paraneoplastic syndrome?

A collection of symptoms that results from substances or hormones produced by the tumor, that occur remotely from the tumor. Rare and sometimes occurs with lung cancer.

Mutation

Changes to the base pair to the sequences in DNA and RNA and are passed down.

Can leukemia develop in one or more sibling?

Yes

Are daughters more predisposed to breast cancer if their mothers had it?

Yes, there may be mutations like the BRCA 1 & 2 mutation.

Does colon cancer risk increase in age?

Yes and it also can be connected with genetic mutations and family history.

How much of a role does inherited genes play in cancer?

5-10%

What is edema?

Swelling of the tissue caused by the accumulation of excessive amounts of fluid.

What is palpation?

Use of touch to acquire information about the patient

Lymphadenopathy

Swelling of any lymph nodes

What is percussion?

act of striking or tapping the patient gently

What is auscultation?

Act of listening to sounds within the body

what is the most accurate temperature gauge location?

Rectal

Normal oral temperature

96.8-98.6°F

Normal rectal temperature

99.6°F

Normal axillary temperature

97.6°F

Normal pulse

60-100 bpm

Normal respirations

12-18 breaths

Normal blood pressure

90-140/60-80

What percent of cancers in the United States are caused by a combination of excess body weight, physical activity, excess alcohol consumption, and poor nutrition.

20%

Sensitive test

Ability of a rest to give a true- positive result

Specific test

Ability if a test to obtain a true negative result

When do women start screening for breast cancer?

45, but have the choice to start screening 40-44

How often are women age 45-54 screened for breast cancer?

Annually

At what age do women switch to biannual breast cancer screenings.

55

What is a sentinel lymph node biopsy?

Procedure that focuses on finding lymph nodes that are the first to receive draining fluid from breast tumors and therefor, the first to collect cancer cells.

When does the ACS recommend women get screened with an MRI?

When they have a family history of breast cancer, a history of radiation to the chest 10-30 years; or an estimated risk of approximately 20-25% or greater.

What is the screening method for lung cancer?

Low dose helical CT

Who should be screened for lung cancer?

Current or former smokers, age 55-74, in good health with a 30+ pack-year history

How often do you get screened for lung cancer?

Annually

How much can screening for lung cancer lower chance of dying?

15-20%

What is the leading cause of cancer related death in the United States?

Lung cancer

What are the two most common ways to be screened for prostate cancer?

Digital rectal exam and PSA blood count

How often should a prostate screening be performed?

Annually is PSA level is 2.5 ng/mL or higher

At what age should men who are at average risk for prostate cancer begin to be screened?

50

At what age should men who are at high risk of prostate cancer. This includes African Americans or men with a fist degree relative diagnosed younger then 65 be screened?

45 years

At what age should men who are at a very high risk which includes men with more then one first degree relative diagnosed younger then 65 be screened?

40

How often should you get screened for cervical cancer?

Every 5 years

At what age do you begin getting screened for cervical cancer?

21 (ACS says 25)

When cervical cancer screening methods do you use for 21-29 year olds?

Pap test

What cervical cancer screening method do you use for 30-65 year olds?

Pap test and HPV DNA test

What type of cervical cancer screening do you use for 66+ year olds?

Pap test and HPV DNA test

What type of cervical cancer screening method do you use for women with a total hysterectomy?

No screening If there is no history of cervical cancer or severe diagnosis in 25 years.

Why is screening with a HPV test preferred over a Pap test?

Because it is known to have fewer false negatives, fewer false positives, and has an equivalent long term sensitivity to detect cervical cancer.

The cause of cervical cancer is most associated with what?

Human papilloma virus (HPV). The HPV vaccine protects against types that cause 90% of cancer but it does not protect against all types.

At what age should men and women begin screening for colorectal cancer?

50 (ACS says 45 and continue until 75)

What is the gold standard screening method for colorectal cancer?

Colonoscopy

What is the sensitivity for the guaiac based fecal occult blood screening test?

50% sensitivity. Ran every 10 years?

What is the sensitivity for the fecal immunogenicity test?

50% sensitivity. Ran every 10 years?

How often should a stool DNA test be ran?

Every 3 years

How often should a flexible sigmoidoscopy be done?

Every 5 years

How often should a double contrast BE be done?

Every 5 years

How often should a colonoscopy be done?

Every 10 years

How often should a CT colonoscopy be done?

Every 5 years

What is a fine needle aspiration?

Thin needle to draw fluid and small pieces of tissue.

What is a core needle biopsy?

Removes small cylinder of tissue, 1/16 inch in diameter and ½ inch long.

What is an excisional biopsy?

Removes entire tumor

What is an incisional biopsy?

Removes small part of tumor

What is an endoscopic biopsy?

Thin, flexible lightened tube with camera or viewing lenses.

Laparoscopy

Inside the abdomen

Thoracoscopy

Inside the chest

What is a light microscope?

Beam inflight to view specimens

What is an electron microscope?

Uses beams of electrons, magnifying power one thousand times greater than regular light microscope.

Malignant morphological changes of cytology specimens.

Abnormal size or shape

Nucleus larger or darker

Abnormal function

Misplacement

What is pathology?

Testing process for biopsy specimens

What is cytogenetics?

Looks for abnormalities or chromosomes for certain cancers

Body cavity fluids

Fluid from cavities and spaces can be tested for cancer cells

FNA

Sometimes considered a cytology test

Scrape or brush cytology

Scrape or brush cells from organ or tissue

What is HCG? And what is it a marker for?

Human chorionic gonadotropin. Marker for germ cells

What is CEA? And what is it a marker for?

Carcinoembryonic antigen. Marker for colorectal, breast, and lung.

What is PSA? And what is it a marker for?

Prostate specific antigens. ONLY ONE USED FOR EARLY DETECTION.

What is AFP? And what is it a marker for?

Alpha feroprotein. Used for liver or testicular germ cells.

What is CA 19-9 a marker for?

Colorectal and pancreatic

What is CA 15-3 a marker for?

Breast

What is CA 125 a marker for

Ovarian

Stage 0

Carcinoma in situ

Stage I and II

Indicate the smallness of the tumor. Involvement of early local and regional nodes with no distant metastases or both.

Stage III

Indicates the tumor is more extensive locally and may have reached regional nodes involvment.

Stage IV

Indicated locally advanced tumors with invasion beyond the regional nodes to other areas.