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Oncology

Oncology Chapter 21

QuestionAnswer
Neoplasia Development of an abnormal growth of new cells that is unresponsive to normal growth control mechanisms
Neoplasm Any abnormal growth of new tissue that serves no useful purpose Neoplasm = tumor
Differentiation Cells become specialized and differentiated both physically and functionally Cells look and act like the parent cell, or tissue of origin
Anaplasia Loss of cellular differentiation and reversion to a more primitive form Anaplasia = undifferentiated
Malignant Tending to become worse and cause death Malignant tumor = malignant neoplasm
Metastasis Process by which malignant cells spread to other parts of the body
Benign Tumor Usually encapsulated Cells similar in structure to cells from which they originate Well-defined borders Slow growing and limited to one area Possible growth displacement (but not invasion) to adjacent tissue
Malignant Tumor Not encapsulated; not cohesive, and irregular pattern of growth No resemblance to cell of origin No well-defined borders Growth into adjacent cells rather than displacing or pushing them aside Rapid growth through cell division and multiplication
Benign tumor suffix = oma
Malignant tumor suffix = carcinoma or sarcoma
Carcinomas Solid tumors that originate from epithelial tissue Tissue that covers external and internal body surfaces, lining of vessels, body cavities, glands, and organs
Sarcomas Originate from supportive and connective tissue Bone, fat, muscle, and cartilage
Grading of Neoplasms Measures extent to which tumor cells differ from their parent tissue
Grade 1 of Neoplasms well-differentiated cells, function most like the parent tissue Least malignant
Grade 4 of Neoplasms least-differentiated cells, not like the parent tissue Most rapidly increasing in number
Staging of Neoplasms Extent of disease and relative size of tumor
TNM staging classification system Internationally recognized system used for staging neoplasms T: (0-4) = tumor size (primary) N: (0-3) = degree of regional lymph node involvement M: (0-3) = presence or absence of distant metastases
Risk Factors of Neoplasms Lifestyle and environmental risk factors Tobacco Alcohol Diet Sunlight Radiation Industrial agents and chemicals Hormones
Lifetime risk Probability that an individual, over the course of his or her lifetime, will develop cancer or will die from cancer
Relative risk Measures the strength of the relationship between risk factors and particular types of cancer
Intracranial Tumors Tumors occurring in any structural region of the brain May be malignant or benign Classified as primary or secondary Named according to tissue from which they originate
Metastatic Intracranial Tumors (Secondary) Tumors occurring as a result of metastasis from a primary site such as the lung or breast
Primary Intracranial Tumors Tumors that arise from gliomas and meninges Gliomas = malignant glial cells that are a support for nerve tissue
Glioblastoma multiforme Most rapidly growing of the gliomas’ most common and most malignant glial tumor Also known as Grade IV astrocytomas
Astrocytomas Low-grade (I and II) astrocytomas usually nonmalignant Grade III (anaplastic) and Grade IV are malignant and most likely to invade surrounding structures
Ependymomas Occur more commonly in children and adolescents Usually encapsulated and benign
Primary Intracranial Tumor -Oligodendrogliomas Usually slow growing
Primary Intracranial Tumor - Medulloblastomas Occur most frequently in children between 5 and 9 years of age Rapid growing; poor prognosis
Primary Intracranial Tumor - Meningiomas Occur most often in adults Slow growing
Lipoma Benign tumor of fatty/adipose tissue Most common benign soft tissue tumor Can occur anywhere in the body Idiopathic, but with inherited tendency
Liposarcoma A malig. tumor of fatty/adipose tissue Most common soft tissue sarcoma in adults Chromosomal abnormalities lead to dysfunctional fusion proteins Most common locations: deep soft tissues of limbs and retroperitoneum
Papilloma a small solid growth on the skin or on a mucous membrane, with a clear-cut border that projects above the surrounding tissue classic fingerlike or cauliflowerlike appearance Derived from epidermis and usually benign E.g., a raised wart
Papilloma Can be benign or malignant and can be found in numerous anatomical locations
Squamous Cell Carcinoma Malignancy of the squamous cells of the epithelial tissue of the skin. Much faster growing than basal cell carcinoma Greater potential for metastasis if not treated
Squamous Cell Carcinoma Risk Factors UVR exposure Immunosuppression Exposure to ionizing radiation or chemical carcinogens Human papillomavirus (HPV) infection
Basal Cell Carcinoma Most common malig. epithelial tumor; begins as a slightly elevated nodule w/a depression or ulceration in the ctr that becomes more obvious as the tumor grows; tissue breaks down, crusts, and bleeds Occurs most often on skin exposed to the sun
Carcinoma of the Breast: Breast Cancer Malignant tumor of the breast tissue Most common type, ductal carcinoma, originates in the mammary ducts
Bronchogenic Carcinoma Malignant lung tumor that originates in bronchi Lung cancer
Cervical Carcinoma Malignant tumor of the cervix One of the most common malignancies of female reproductive tract
Colorectal Cancer Presence of a malignant neoplasm in large intestine Most are adenocarcinomas At least 50% originate in the rectum, causing bleeding and pain 3rd. most common type of cancer in both men and women
Endometrial Carcinoma Malignant tumor of inner lining of uterus Aka adenocarcinoma of uterus Classic symptom is abnormal uterine bleeding Most common cancer of female reproductive tract after menopause
Lymphoma Lymphoid tissue neoplasm that is typically malignant Painless enlarged lymph node(s) Progressing to anemia, weakness, fever, and weight loss
Kaposi’s Sarcoma Rare malignant lesions that begin as soft purple-brown nodules or plaques on feet and gradually spread throughout the skin Most often associated with AIDS
Malignant Melanoma Malignant skin tumor originating from melanocytes in preexisting nevi, freckles, or skin with pigment Darkly pigmented tumor with irregular surfaces and borders Variable colors
ABCDs of Malignant Melanomas Asymmetry Borders Color Diameter
Neuroblastoma Highly malignant tumor of the sympathetic nervous system
Oral Leukoplakia Precancerous lesion occurring anywhere in the mouth Elevated gray-white or yellow-white leathery surfaced lesions have clearly defined borders
Ovarian Carcinoma Malignant tumor of the ovaries Most commonly occurring in women in their 50s Rarely detected in early stage
Pancreatic Cancer Life-threatening primary malignant neoplasm typically found in head of pancreas
Carcinoma of the Prostate Malignant growth within the prostate gland, creating pressure on upper part of urethra Most frequently diagnosed cancer in men
Carcinoma of the Prostate Symptoms Urinary frequency, especially at night Difficulty starting or stopping urine flow Inability to urinate Weak or interrupted flow of urine when urinating Pain or burning urination Pain or stiffness in lower back, hips, or thighs Painful ejaculation
Renal Cell Carcinoma Malignant tumor of the kidney, occurring in adulthood Patient is asymptomatic until latter stages of the disease
Carcinoma of the Testes Malignant tumor of the testicle that appears as a painless lump Also called testicular cancer Rare type of tumor Usually occurs in men under the age of 40
Cancer, Thyroid Gland Malignant tumor of the thyroid gland Leads to dysfunction of the gland and thus inadequate or excessive secretion of the thyroid hormone
Wilms’ Tumor Malignant tumor of the kidney occurring predominately in childhood Most frequent finding is palpable mass in the abdomen
Chemotherapy Use of cytotoxic drugs and chemicals to achieve a cure, decrease tumor size, provide relief of pain, or slow metastasis
Radiation therapy Delivery of ionizing radiation to accomplish: Destruction of tumor cells Reduction of tumor size Decrease in pain Relief of obstruction To slow or stop spread of cancer cells
Radiation therapy Destroys rapidly multiplying cells regardless of whether they are cancerous Goal is to reach maximum tumor control with no, or minimum, normal tissue damage May be delivered by teletherapy (external) or brachytherapy (internal)
Tumor Surgery Tumor removal through surgery In more than 90 percent of all cancers, surgery is used for diagnosing and staging In more than 60 percent of all cancers, surgery is the primary treatment When feasible, the primary tumor is excised in its entirety
Incisional biopsies Used to remove a piece of a tumor for examination and diagnosing
Excisional biopsies Used to remove the tumor and a portion of normal tissue
En bloc resection Removal of a tumor and a large area of surrounding tissue that contains lymph nodes
Cryosurgery Destruction of tissue by freezing the malignant tissue
Exenteration Wide resection that removes the organ or origin and surrounding tissue
Immunotherapy Agents capable of changing the relationship between a tumor and the host are known as biological response modifiers (BRMs) Agents are used to strengthen individual’s immune responses
Mohs surgery Surgical procedure, tumor is removed in stages Tissue is examined for evidence of cancer Additional tissue is removed until negative boundaries are confirmed Most often used to treat basal cell carcinoma and squamous cell carcinoma
Fulguration Destruction of tissue with electric sparks
Electrocauterization Destruction of tissue by burning
Created by: wallace263