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Study Guide Quiz 1

by: Adriana Zuniga

Study Guide Quiz 1 SCI 108- HYB2

Adriana Zuniga
Suffolk University

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About this Document

This study guide outlines what will be on the first quiz!
Intro to Cancer Care
Jessica Mak
Study Guide
50 ?




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This 11 page Study Guide was uploaded by Adriana Zuniga on Friday September 23, 2016. The Study Guide belongs to SCI 108- HYB2 at Suffolk University taught by Jessica Mak in Fall 2016. Since its upload, it has received 47 views. For similar materials see Intro to Cancer Care in RADI - Radiology at Suffolk University.

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Date Created: 09/23/16
Study Guide #1  SKIN CANCER IS THE TOP CANCER!!!! Top 3 Cancers (Incidence) MALES Prostate  Lung Colorectal  FEMALES  Breat Lung Colorectal  Top 3 Cancers (Mortality)  MALES  Lung  Prostate  Colorectal  FEMALES Lung  Breast  Colorectal TERMS TO KNOW  Carcinogen: Cancer causing agent Carcinogenesis: Development or production of cancer  Oncogene: Cancer gene, promotes cancer growth  ● Mutation/damaged DNA or activation of gene that promotes growth (cell division) Neoplasm: New abnormal growth (benign or malignant)  Tumor: Lump, mass, swelling, lesion (can be benign or malignant)   Benign: Tumor that doesn’t grow into other tissue or spread to other areas of the body  (non­cancerous)  ● Usually more favorable outcome   ● Grow slower   ● Encapsulated  ●  Do not invade through surrounding tissues or structures  ●  Do not Metastasize Malignant: Cancerous tumor  ● Less favorable outcome  ●  Grow faster   ● Not encapsulated  ●  Do invade through surrounding tissues and structures  ●  Do Metastasize Incidence: The occurrence of a particular disease over a period of time in relationship to an entire population Examples of populations…   ● People of US   ● People living in New England   ● Men/women  Age 20­30   ● Age >65  ●  Race: Asians, Caucasians, etc. U.K = LUNG CHINA= LIVER AUSTRALIA= SKIN JAPAN= STOMACH U.S= COLON CANADA= LEUKEMIA BRAZIL= CERVICAL CANCER Epidemiology: The study of cancer incidence  Etiology: The study of what causes cancer Tumor suppressor gene: Helps stop cell growth Defective tumor suppressor gene: Mutation of gene that restrains growth RISK FACTORS DIET 30­35% TOBACCO 30­32% ADDITIVES 1% SUNLIGHT 1% RADIATION (ENVIRONMENT, MEDICAL & DIAGNOSTIC) 1% ENVIRONMENTAL POLLUTION 2% HEREDITY 2% INDUSTRIAL OCCUPATIONS 4% ALCOHOL 3­4% UNKNOWN 5+% SEXUAL FACTORS 7% VIRUSES AND INFECTION 10% Direct Extension: Growing into neighboring tissues or structures  Metastasis:  ● Blood (hematogenous spread)   ● Lymph system  ●  Lymph vessels – drain infectious & foreign material from body   ● Lymph nodes – trap material Carcinoma: (tumor classification)  ● Epithelial cells  ●  Skin Tissue that secretes something  ●  Ex: Lung tissue – mucus  ●  Ex: Breast – milk Sarcoma: (tumor classification)  ● Connective  ●   Ex: muscle, nerves, bone, adipose (fat) Lymphomas  ●  Cancer of lymph glands   Leukemias   ● Cancer of white blood cell (WBC)   Plasma cell myeloma (aka multiple myeloma)   ● Cancer of plasma cells SARCOMA CLASSIFICATION BENIGN ­ OMA Lipoma   CANCEROUS ­ SARCOMA  Liposarcoma Biopsy: Examining tumor cells under microscope/ measure growth rate Well­differentiated: ●  Look similar to original cell type  ●  Grows slowly   ● Less aggressive Moderately differentiated  ●  Middle range Undifferentiated: ●   Don’t look very similar cell of origin   ● May appear as an “immature” cell   ● Ex: Cancerous pancreatic cell no longer strongly resembles a pancreatic cell   ● Most commonly…  ●  More aggressive/grow faster   ● Metastasize (spread) earlier High Grade: ↑ ● Immature   ● Poorly differentiated   ● Fast growing ●   Aggressive  Low Grade: ↓ ● Often mature   ● Well differentiated   ● Slow growing   ● Less aggressive  Cancer stages:  ● Focuses on extent of tumor…   ● Size   ● Degree of growth   ● Degree of spread TNM System:  T ­ Tumor N­ Nodal Involvement M­ Metastases  ● is = in situ  ●  0 = no evidence of   ● 1= small or low #  In a patient’s medical record:  T2N1M0 Tumor Classifications  1. Cell differentiation  2. Grade 3.  Stage CANCER WARNING SIGNS⭕ ● Change in bowel or bladder habits   ● A sore that won’t heal   ● Unusual bleeding or discharge   ● Thickening or lump somewhere  I ● Indigestion or difficulty swallowing   ● Obvious change in wart or mole   ● Nagging cough or hoarseness DIAGNOSTIC WORKUPS/TESTING  Laboratory Work­up  ●  Blood  ●  Fluid  ●  Stool  ●  Cells (cytology) Blood tests:  Non­specific  ● Indicates abnormality, but not exactly what is wrong   ● Ex: low red blood cell (RBC) count   ● Specific Tumor marker blood tests – testing for a specific cancer   ● Ex: PSA (prostate specific antigen) Specific  Tumor  ● marker blood tests – testing for a specific cancer   ● Ex: PSA (prostate specific antigen) Fluid tests:  ● Urinalysis (urine test)   ● Protein = kidney problems   ● Sugar = diabetes   ● WBC’s (white blood cells) =infection   ● Fluids from other body cavities can identify an infection, inflammation, or cancer  ● Pleura (lung)  ●  Abdominal cavity   ● Lumbar punctures  Fluids from other body cavities can identify an infection, inflammation, or cancer   EX: Pleura (lung)  Abdominal cavity  Lumbar punctures  Stool Tests:  ● Occult (hidden) blood in fecal matter   ● Sign of problems in the digestive tract   ● Hemorrhoids   ● Polyps (precursor to cancer)   ● Cancer Cytology  ● The study of cells in the body   ● Phlegm   ● Pap smears (cervix)   ● Scraping the surface of organs Biopsy  ●  Excision: complete removal of tumor  ● Incision: partial removal of the tumor   ● Fine needle aspiration   ● Core  RADIOLOGY ● X­ray/plain films ­ 2D views, x­ray  ●  Fluoroscopy – 2D x­ray video, with contrast  ( EX: Barium swallow (UGI)  Barium  enema (LGI)  Angiography  Intravenous pyelogram (IVP) ● Interventional radiology – fluoroscopy + biopsy, catheter placement, or pump placement ● Endoscopy – camera/scope EX: Camera pill ●  CT – 3D view, cross­sectional views, uses a scanner to emit x­rays  (Head, Chest,  Abdomen, Spine) ● MRI – 3D view, magnets (Electromagnetic energy)  ● Ultrasound – sound waves (Aka­ sonogram or echogram  Uses high frequency,  inaudible sound waves  As sound waves bounce back from body tissues ­ they are  recorded  Information regarding anatomy & organ function can be obtained)  EX: OB/GYN, Breast,  Pelvic,  Heart ● Nuclear medicine – radioisotopes (radioactive decay)  Uses radioisotopes ­ gamma camera/scanner synthesize information into images BASIC CANCER PREVENTION Change habits…  ● Food  ↓ Fats ↑ Fiber ↑ Fresh fruits & vegetables ●  Beverages   ↓ Alcohol ↑ Water ● Tobacco  No smoking cigarettes   No chewing tobacco Smoking + alcohol is worse than just one or the other ● Air quality Air pollution ↓ Exposure ● Disease safety Safe sex, prevent STD’s  Get tested  Positive for STD – get treated Viruses Linked to Cancer: HPV  H&N ca  Cervical, vulvar, vaginal, anal, penile ca  HIV   Kaposi’s sarcoma  Non­Hodgkin lymphoma  EBV (mono)  Non­Hodgkin lymphoma   Nasopharyngeal ca ● Doctor’s visits   Annual primary care physician (PCP) app  Lump or other change in body or function =  visit PCP  Specialist if applicable  Gynecologist  Dermatologist  Dentist  ● Exercise   More fat tissue, ↑ in certain hormones Overweight…more difficult to: Detect tumor Be a candidate for surgery Recover from surgery Receive RT (radiation therapy) Tolerate RT (increased side effects) Healthy lifestyle = ↓ cancer risk ● Skin protection  Limit sun exposure  Sunscreen (SPF 30)  No tanning booths 3 BRANCHES OF ONCOLOGY ● Medical oncology (chemotherapy, immunotherapy, bone marrow transplants)   ● Surgical oncology  ●  Radiation oncology TREATMENTS ● Chemotherapy ●  Surgery   ● Radiation ONCOLOGY HEALTHCARE TEAM Med. onc.   ● Oncologist  ●  Nurse   Surgical onc.   ● Oncologist   ● Nurse   Rad. onc.  ●  Oncologist   ● Nurse Oncologists(MD)  Nurse practitioner (NP)   Physician’s assistant (PA)   Nurse (RN)   Nutritionist   Social Worker   Other professional staff (rad onc – radiation therapists, medical dosimetrists, medical physicists)  Treatment capabilities: ○ Chemotherapy ­ is considered a "systemic" treatment affecting the entire body (most  commonly), because in the majority of treatments the cancer drugs travel throughout  the entire body via the bloodstream (whether injected intravenously or ingested, which  are the most common types of chemo administration) ○ Surgery ­ is a "site specific" treatment, because it is affecting only the area of the body  being removed. ○ Radiation ­ is also a "site specific" treatment, because the radiation is only aimed at  and targeting a certain area of the body in most cases (ex: if the radiation is aimed at  the brain, it will only be treating the brain; the abdomen for example would not be  receiving the radiation) Definitive surgery:  ●  Removal of entire tumor (i.e. excision)   ● Sample surrounding tissue – ensure “clean margins” or “clear margins” Preventive surgery  ●  i.e. Prophylactic tx   ● ↑ Risk patients ● Precancerous conditions   ● Pros vs. cons Reconstruction  ● ↑ Appearance, function, & quality of life Palliative ● ↓ Pain, bleeding, obstruction ● ↓ Mobility Types of Surgery Cont.  Supportive Care   ● Helps with other tx’s  ●  Deliver chemo, nutrition, blood, etc…   ● Catheters   ● Ports   ● Pumps   ● Gastrointestinal tube (i.e. g­tube)   Radiation therapy (RT)   ● Intraoperative radiation therapy (IORT)  Surgery 1ST!!!  Followed by radiation    ● Radioactive seed implants (brachytherapy) ● Teletherapy: Radiation therapy administered with the source at a distance from the  body.  CHEMO & OTHER DRUGS ●  Immunotherapy   ● Hormonal therapy   ● Targeted therapy   ● Differentiating agents  ADMINISTER CHEMO Neoadjuvant: Before surgery or RT   Adjuvant:  After surgery or RT   Concurrent: Same time as RT  PO : Pill or liquid (by mouth)  IV: Intravenous  (veins) IM : Intramuscular (like a flu shot)    Intracavitary  ● Intraperitoneal   ● Intrapleural   ● Intraarterial   Topical   ● Cream   Spine (CNS)   ● Directly into spinal fluid Intraarterial CANCER PHASES Complete remission: tumor seems to have disappeared   Cure: Lack of cancer signs for at least 5 yrs.   Partial remission: Tumor ↓ to ½ Stabilization: No change in size   Progression: Tumor growing  (Tx may need to be adjusted) PBST/BMT Bone Marrow aspiration (taken from patient) Graft vs. Tumor (GVT)  Graft (donor cells) attack cancer cells  Only works for allogeneic transplants   Graft vs. Host Disease (GVHD)  Graft (donor cells) attack healthy cells  Rejection of  organ  Only occurs with allogeneic transplants TERMS Autologous: Donate your own bone marrow Syngeneic : Donor = identical twin Allogeneic :Donor & pt not related TBI: Total body radiation (SURGERY FIRST, THEN RADIATION )  COMPLICATIONS & RISKS ● Illness   ● Depleted immune system   ● Chemotherapy side effects  ●  Radiation side effects   ● GVHD


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