xix. cancer medicine

adjuvant chemotherapy

drugs are given after primary therapy (surgery or radiation)

alkylating agents

chemotherapeutic synthetic drugs that cause crosslinks and breaks in DNA to stop cells from dividing

anaplasia

loss of differentiation of cells; reversion to a more primitive cell type

antibiotics

chemotherapeutic drugs found in bacteria and fungi, which cause breaks in DNA strands to inhibit cell division

antimetabolites

chemotherapeutic agents that block the synthesis of DNA components (nucleotides) and prevent cells from dividing

antimitotics

chemotherapeutic chemicals that block the function of a protein necessary for mitosis

apoptosis

programmed cell death; normal cells undergo this when damaged or aging; if cancer cells lose this ability, they survive indefinitely

benign tumor

noncancerous growth (neoplasm); noninvasive and not spreading to other sites

brachytherapy

radiotherapy that uses insertion of sealed containers into body cavities (intracavity therapy) or radioactive seeds directly into the tumor (interstitial therapy)

carcinogens

agents that cause cancer: chemicals and drugs, radiation, and viruses

carcinoma

cancerous tumor made up of cells of epithelial origin; largest group

chemotherapy (chemo)

treatment with drugs (chemicals) that kill tumor cells; standard treatment for many types of cancer

combination chemotherapy

use of several chemotherapeutic agents to treat tumors

dedifferentiation

loss of differentiation of cells; reversion to a more primitive, embryonic cell type; anaplasia or undifferentiation

deoxyribonucleic acid (DNA)

genetic material within the nucleus of a cell; controls cell division and protein synthesis

differentiation

specialization of cells

electron beams

low-energy beams of radiation for treatment of skin or surface tumors

encapsulated

surrounded by a capsule; benign tumors are examples

external beam irradiation (teletherapy)

radiation is applied to a tumor from a source outside the body

fractionation

giving radiation in small, repeated doses; allows larger total doses to be given while causing less damage to normal tissue

genetic screening

patients and family members are tested to determine whether they have inherited a cancer-causing gene

grading of tumors

evaluating the degree of maturity of tumor cells or degree of differentiation; of value in determining the prognosis for certain types

gray (Gy)

unit of absorbed radiation dose

gross description of tumors

visual appearance of tumors to the naked eye: cystic, fungating, inflammatory, medullary, necrotic, polypoid, ulcerating, or verrucous

immunotherapy

cancer treatment using immune cells and antibodies to kill tumor cells; CAR-T cell therapy and checkpoint inhibitors are examples

infiltrative

extending beyond normal tissue boundaries into adjacent tissues

invasive

having the ability to enter and destroy surrounding tissue

irradiation

exposure to any form of radiant energy such as light, heat, or x-rays

linear accelarator

large electronic device that produces high-energy x-ray beams for treatment of deep-seated tumors

malignant tumor

tumor having the characteristics of continuous growth, invasiveness, and metastasis

mesenchymal

embryonic connective tissue; this is the tissue from which connective tissues (bone, muscle, fat, cartilage, and blood cells) arise

metastasis (mets)

spread of a malignant tumor to a secondary site; literally, beyond control

microscopic description of tumors

appearance of tumors when viewed under a microscope: alveolar, carcinoma in situ, diffuse, dysplastic, epidermoid, follicular, papillary, pleomorphic, scirrhous, or undifferentiated

mitosis

replication of cells; a stage in a cell’s life cycle involving the production of two identical cells from a parent cell

mixed-tissue tumors

tumors composed of different types of tissue (epithelial as well as connective tissue)

modality

method of treatment, such as surgery, chemotherapy, or irradiation

molecularl targeted therapy

use of drugs to attack specific targets (mutations) that drive cancer cell growth

monoclonal antibodies (mAB, MAB)

these are antibodies created in a laboratory by special reproductive (cloning) techniques; they are designed to attack specific cancer cells directly or to activate T cells (or other effector cells) to kill the tumor

morbidity

condition of being unwell or deficient in normal function

mucinous

containing mucus (a thick whitish secretion)

mutation

change in the genetic material (DNA) of a cell; may be caused by chemicals, radiation, or viruses or may occur spontaneously

neoadjuvant chemotherapy

drugs are given before primary therapy (surgery or radiation) to reduce the size of a tumor

neoplasm

new growth that arises from normal tissue; benign or malignant tumor

nucleotide

component of DNA (gene) including sugar, phosphate, and a base; their arrangement on a gene is the genetic code

oncogene

region of DNA (gene) in tumor cells that causes cancer; designated by a three-letter name, such as abl, erb, jun, myc, ras, and src

palliative

relieving but no curing symptoms

pedunculated

possessing a stem or stalk (peduncle); characteristic of some polypoid tumors

photon therapy

radiation therapy using energy in the form of x-rays or gamma rays

protocol (prot.)

detailed plan for treatment of an illness

proton therapy

subatomic positively charged particles (protons) produced by a cyclotron deposit a dose of radiation at a tightly focused point in the body

radiation

energy carried by a stream of particles

radiation field

area of the body undergoing irradiation

radiation therapy (RT, XRT)

treatment of tumors using doses of radiation; radiation oncology; radiotherapy

radiocurable tumor

tumor that is completely destroyed by radiation therapy; early Hodgkin lymphoma is an example

radioresistant tumor

tumor that survives large doses of radiation

radiosensitive tumor

tumor for which radiation can cause the death of cells without serious damage to surrounding tissue

radiosensitizers

drugs that increase the sensitivity of tumors to x-rays

radiotherapy

treatment of tumors using doses of radiation; radiation therapy; radiation oncology

relapse

recurrence of tumor after treatment

remission

absence of signs and symptoms of disease (tumor)

ribonucleic acid (RNA)

cellular substance that represents a copy of DNA and directs the formation of new protein inside cells

sarcoma

cancerous tumor derived from connective or flesh tissue

serous

having the appearance of a thin, watery fluid (serum)

sessile

having no stem, from a broad base; characteristic of some polypoid tumors

simulation

study using CT scan or MRI to map the area to receive treatment before radiotherapy is given

solid tumor

tumor composed of a mass of cells

staging of tumors

system of evaluating the extent of spread of tumors; an example is the TNM (tumor-node-metastasis) system

stereostatic radiosurgery (SRS)

technique in which a single large dose of radiation is delivered under precise 3D guidance; the aim is to destroy small tumors, usually at a single site in the body

surgical procedures to treat cancer

methods of removing cancerous tissue: cryosurgery, cauterization, en bloc resection, excisional biopsy, exenteration, fulguration, incisional biopsy

viral oncogenes

pieces of DNA from viruses that, when mutated, cause normal cells to become malignant

virus

infectious agent that reproduces by entering a host cell and using the host’s genetic material to make copies of itself

cancer (CA)

disease caused by abnormal and excessive growth cells in the body; may rise in any tissue, and appear at any time of life (most frequently in older ppl)

carcinogenesis

transformation from a normal to cancerous cell

chromosomes

strands of DNA in a cell nucleus

functions of DNA in a normal cell

1. controls the production of new cells — cell division

2. controls the production of new proteins — protein synthesis

Philadelphia chromosome

new chromosome formed from translocation

heredity

transmission of DNA mutations associated with cancer susceptibility; mutations are found in the DNA of parental egg or sperm cells; passed from generation to generation

retinoblastoma

tumor of the retina of the eye; childhood cancer arising from immature cells in the retina

adenomatous polyposis coli syndrome

premalignant polyps that grow in the colon and rectum

suppressor genes

genes that regulate growth, promote differentiation, and suppress oncogenes from causing cancer; ex. retinoblastoma (Rb) type 1 gene (RB1) and TP53 gene (brain tumors, breast cancer)

gastric adenocarcinoma

cancerous tumor from the glandular cells lining stomach

osteoma

benign tumor of a bone

osteosarcoma

malignant tumor of a bone

cystic

forming large open spaces that are filled with fluid; most common site is the ovaries

serous

containing thin, watery, fluid resembling serum

fungating

mushrooming pattern of growth in which tumor cells are piled one on top of another and project from the tissue surface; often found in the colon

inflammatory

having the features of inflammation (redness, swelling, heat); changes result from a tumor blockage of the lymphatic drainage of the skin; ex. breast cancer

medullary

large, soft fleshy tumors; ex. thyroid, breast

necrotic

containing dead tissue

polypoid

growth that form projections extending outward from a bone

ulcerating

characterized by open, exposed surface resulting from the death of overlying tissue; often in the stomach, breast, colon, and skin

verrucous

resembling a wart-like growth; ex. gingiva (gum)

alveolar

tumor cells form patterns resembling small sacs; ex. muscle, bone, fat, cartilage

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carcinoma in situ

referring to localized tumour cells that have not invaded adjacent structures

diffuse

spreading evenly throughout the affected tissue; ex. malignant lymphomas (lymph nodes)

dysplastic

containing abnormal-appearing cells that are not clearly cancerous; ex. nevi

epidermoid

resembling squamous epithelial cells (thin, plate-like); often on the surface of the skin and the lining of respiratory and digestive tracts

follicular

small, round gland-type clusters; ex. thyroid gland cancers, lymphomas

papillary

forming small, finger-like or nipple-like projections; ex. bladder and thyroid cancers

pleomorphic

composed of variety of types of cells; ex. mixed-cell tumors