Pathology Chapter 5 Oncology

Remission is defined as

having no clinical signs of a disease

Cancer is the ________ leading cause of death in the United States.

second

What is the most common site for cancer?

skin

What type of cancer causes the largest number of deaths in both genders?

lung

What is a neoplasm?

a cellular growth that no longer responds to normal body controls

Do neoplasms have a useful function?

no, they deprive other cells of needed nutrients

Oncology is the study of

malignant tumors (cancer)

Tumors are named according to their

related body system

The root word in a tumor's name specifies the

cell of origin

The suffix indicates whether the tumor is _______ or __________

malignant, benign

-carcinoma

malignant tumor that occurs in epithelial tissue

-sarcoma

malignant tumor of connective tissue

-oma

benign tumor

Which type of tumor is encapsulated?

benign

Benign tumors consist of__________ cells

differentiated (which reproduce quicker than normal cells)

Benign tumors may damage other tissues due to _____________ of adjacent structures.

compression

Benign tumors are not life-threatening unless they occur in an area where increased pressure may have adverse effects such as the _________ or ___________

brain, spinal cord

What is an angioma?

benign tumor derived from cells of the vascular or lymphatic vessel walls

Malignant tumors consist of ________, ___________ cells

nonfunctioning, undifferentiated

Does leukemia cause the formation of tumors?

no

The risk for cancer ________ with age

increases

Why do tumors proliferate?

growth, inhibition, and cell to cell communications are no longer occurring normally

What is the result of the enlargement of a tumor?

- continued necrosis

- inflammation

- localized infection

Certain tumor cells secrete what?

growth factors (that stimulate angiogenesis and promote tumor development)

The term "in situ" to neoplasms that exist in a _____________ stage.

pre-invasive

Tumors are graded based on

the level of differentiation

The nine warning signs of cancer include

- unusual bleeding or discharge

- changes in bowel or bladder function

- changes in mole appearance

- sores that don't heal

- unexplained weight loss

- anemia or low hemoglobin

- persistent fatigue

- persistent cough

- solid, often painless lump

Localized effects of tumors include

pain, obstruction, tissue necrosis, ulcerations

An infection around a tumor may occur after tissue necrosis or ulceration. This occurs when the normal body flora can become ____________, such as in the __________

opportunistic, oral cavity

Once a malignant tumor has metasized, systemic effects include:

- weight loss

- pain

- cachexia

- anemia

- infections

- bleeding

- paraneoplastic syndromes

What is cachexia?

weight loss and severe tissue wasting

What commonly causes cachexia?

many malignancies

Anemia results from

- anorexia and decreased food intake

- bone marrow depression

- chronic bleeding with iron loss

Anemia _____ the oxygen that is available to cells

decreases

Due to the decrease in oxygen caused by anemia, what occurs?

- poor tissue regeneration

- fatigue

- reduced host resistance

- frequent infections

What type of effects occur due to paraneoplastic syndromes?

hormonal

Substances released by tumor cells affect

clotting or neurological functions

In bronchogenic carcinoma, adrenocorticotropichormone (ACTH) may be produced which causes

Cushing's syndrome

The only 100% accurate test for malignant tumors is

examination of tumor cells

Diagnostic tests for cancer include

- blood tests

- tumor marker tests

- radiographic and imaging tests

- histologic and cytologic tests

What must be diagnosed before someone can be treated for cancer with radiation and/or chemo?

metastasis

What are the three basic mechanisms of the spread of malignancy?

invasion - the localized spread of tumor cells into adjacent tissue

metastasis - the spread of cancer from the primary tumor to distant sites

seeding - the process of cancer spreading via body fluids or membranes

The components of cancer staging are

- size of the primary tumor (T)

- extent of regional lymph node involvement (N)

- invasion or metastasis of the tumor (M)

Breast cancer stage 1

tumor is 2 centimeters or less in diameter, no lymph nodes involved, no metastasis

Breast cancer stage 2

tumor 2-5 cm in diameter, nodes involved, no metastasis

Breast cancer stage 3

tumor larger than 5 cm in diameter, nodes involved, tumor may be fixed, no metastasis

Breast cancer stage 4

tumor any size, but fixed to chest wall or skin, clavicular nodes involved (spread), metastasis present

Etiology of cancer is based on

carcinogenesis, risks and prevention methods, and host defenses

Genes that cause cancer are known as

oncogenes

Changes in cell _____________ are a base cause of malignant transformation

deoxyribonucleic acid (DNA)

When certain components of chromosomes are __________, they may fuse with different genes and form composite genes which allows for uncontrolled cellular growth

translocated

What is carcinogenesis?

process by which normal cells are transformed into cancer cells

What are the three stages of carcinogenesis?

- initiating factors (procarcinogens)

- exposure to "promoters" (including hormones or chemicals)

- continued exposure and DNA changes

Risk factors for cancer include:

- genetic factors (breast cancer, retinoblastoma, leukemia)

- viruses (cervical cancer, Kaposi's sarcoma, hepatic cancer)

- radiation (Leukemia, skin cancer)

- chemicals (bladder cancer, lung cancer, leukemia)

- biologic factors (colon cancer, oral cancer)

- age (many types)

- diet (colon cancer, gastric cancer)

- hormones (endometrial cancer)

Prevention methods for cancer include:

- regular medical and dental examinations

- limiting sun exposure

- changing the diet

- high fiber intake

- regular consumption of fresh fruits and vegetables

- eating foods that contain antioxidants

Cancer risk is increased when the body is

immunodeficient (such as a person with HIV or AIDS)

Common diagnostic procedures used for cancer diagnosis include

- rectal and colon exams

- vaginal exams

- pap smears

- gastrointestinal exams

- various types of X-ray studies

- biopsy

- surgery

- histology

________________ involves use of a very fine needle attached to a syringe that is used to aspirate material from organs or tissues

fine-needle aspiration

Some cancers secrete tumor-associated antigens such as

carcinoembryonic antigen (CEA)

Additional _____________ treatment used when a cancer is known to metastasize early

prophylactic

ex. after a localized breast tumor that has not spread is removed, chemotherapy and radiation are often administered to kill any cancer cells that have broken away and traveled to lymph nodes or tissues

What causes DNA alterations or mutations that kill cancer cells while not harming normal cells?

radiation

Radiation is most effective on what kind of cells?

cells that are undergoing DNA mitosis or synthesis

The most serious negative effect of radiation is

bone marrow depression

*this is also the most serious negative effect of chemotherapy as well

What is the overall effect of radiation on the body?

radiation causes fatigue, lethargy, and mental depression

(long-term effects include inflammation, necrosis, and localized scar tissue)

Classification of chemotherapy include:

- antimetabolites

- antimitotics

- antibiotics

- alkylating agents

Chemotherapy is known to stimulate the__________ in the brain

emetic (vomiting) center

Additional treatments for various cancers include

- hormones (such as prednisone or estrogens)

- hormone-blocking agents

- newer drugs that block the conversion of androgens to estrogens

Cancer is usually pronounced as "cured" when a patient has survived for _____ years without recurrence, after diagnosis and treatment

5

Remission is defined as

having no clinical signs of a disease