Chapter 16: Oncology

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Oncology, oncologist
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__ is the study of tumors, both benign (noncancerous) and malignant (cancerous). An __ is a specialist in the diagnosis, treatment, and prevention of tumors.
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Cancer registrars
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__ (also called tumor registrars) are specialists in cancer data management. Their primary responsibility is to report and track patients with cancer who are diagnosed and/or treated at the staff’s healthcare facility.
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cancer
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__ has shared characteristics that are uncontrollable cell growth and a spread of altered cells.
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Carcinogenesis
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__ is the development of cancer.
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Mutation
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Once a __ takes place, a process of uncontrolled cell growth may begin.
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Reproduce
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The only mission of cancer cells is to __.
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Apoptosis
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__ is the body’s normal restraining function to keep cell growth in check.
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Hyperplasia, dysplasia
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The progression from normally functioning skin tissue goes to __, to __, and finally to carcinoma in situ (CIS)
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Continuum
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Cancer is a __-from tissue made up of normally functioning cells fulfilling their role to keep the body healthy, to tissue replaced by cancerous elks that no longer perform the work of the tissue and now perform only the function of reproducing themselves.
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Primary site, Metastasis
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Cancers are capable of destroying not only the tissue in which they originate (the __), but also other tissues, through the process of __, the spread of cancer.
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Metastasis
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__ can occur by direct extension to contiguous organs and tissues or to distant sites through blood or lymphatic involvement.
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Neoplasms
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All cancers are __ (new growths), but not all (these) are cancerous.
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Malignant, benign
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Cancerous tumors are termed __, wheras noncancerous tumors at termed __.
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Ectoderm, endodermal, carcinoma
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Approximately 80% to 90% of malignant tumors are derived from the outer (__) and inner (__) layers of the embryo that develop into epithelial tissues that either covers or lines the surfaces of the body. What type of cancer is derived from these two layers?
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Adenocarcinoma, squamous cell carcinoma
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Carcinoma cancers are divided into two main types. What are they?
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Adenocarcinoma
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If the carcinoma is derived from an organ or gland, it is an __.
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Squamous cell carcinoma
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If the carcinoma is derived from squamous epithelium, it is __.
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Sarcomas
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__ are derived from the middle (mesodermal) layers, which becomes connective tissue (bones, muscle, cartilage, blood vessels, and fat).
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Lymphomas
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__ develop in lymphatic tissue (vessels, nodes, and organs, including the spleen, tonsils, and thymus gland)
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Extranodal lymphomas
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Lymphomas are solid cancers and may also appear outside of the sites of lymphatic organs in the stomach, breast, or brain; these are called __.
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Hodgkin lymphoma, non-Hodgkin lymphoma
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All lymphomas may be divided into two categories: __ and __.
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Leukemia
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__ is cancer of the bone marrow.
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Myelomas
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__ arise from the plasma cells in the bone marrow.
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Mixed tumors
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__ are a combination of cells from within one category or between two categories; ex: teratocarcinoma and carcinosarcoma
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Grading, anaplasia
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__ is the first means of affixing a value to a clinical opinion of the degree of dedifferentiation (__) of cancer cells, or how much the cells appear different from their origin form.
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Well, poor
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Healthy cells are __ differentiated. Cancer cells are __ differentiated.
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I, IV
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The pathologist determines the dedifferentiation and assigns a grade ranging from _ to _. The higher the grade, the more cancerous, or differentiated, is the tissue sample.
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Severity
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Grading is a measure of the cancer’s __.
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Staging
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Another means of determining the size and the spread of the cancer from its original site, which is called __.
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Clinical staging
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If staging is determined by various diagnostic techniques, it is referred to as __.
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Pathological staging
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If staging is determined by the pathologist’s report, it is called __.
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Tumor, nodes, metastasis
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An example of pathological staging is TNM staging. In this system, T stands for the size of the __, N stands for the number of lymph __ positive for cancer, and M stands for the presence of distant __.
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Carcinoma in situ (CIS)
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If the cancer cells appear only at the original site and have not invaded the organ of origin, it is called __.
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Primary tumor
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Cancer that brings in an organ is referred to as a __.
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Metastatic
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When a cancer spreads to another site in the body from that primary tumor, the new tumor is referred to as secondary, or __.
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Metastatic tumor
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The cells in the __ are composed of the same tissue as the anger at the original site.
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Tumor marker tests
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__ measure the levels of a variety of biochemical substances detected in the blood, urine, or body tissues that often appear in higher than normal amounts of individuals with certain neoplasms.
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AFP
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Increased levels may indicate liver or testicular cancer
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B2M (beta-2 microglobulin)
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Levels are elevated in multiple myeloma and chronic lymphocytic leukemia
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BTA (bladder tumor antigen)
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Present in the urine of patients with bladder cancer and
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CA125
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Used for ovarian cancer detection and management
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CA15-3
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Levels are measured to determine the stage of breast cancer
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CA19-9
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Levels are elevated in stomach, colorectal, and pancreatic cancers
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CA27-29
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Used to monitor breast cancer; especially useful in testing for recurrences
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CEA
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Monitors colorectal cancer when the disease has spread or after treatment to measure the patient’s response
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hCG
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Used as a screen for choriocarcinoma and testicular and ovarian cancers
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NSE
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Used to measure the stage and/or patient’s response to treatment of small cell cancer and neuroblastoma
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PSA
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Increased levels may be due to BPH or prostate cancer
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TA-90
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Used to detect the spread of malignant melanoma
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Computed tomography (CT) scans
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__ provide information about a tumor’s shape, size, and location, along with the source of its blood supply. They are useful in detecting, evaluating, and monitoring cancer, especially liver, pancreatic, bone, lung, and adrenal gland cancers. They are also useful in staging cancer and guiding needles for aspiration therapy.
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Magnetic resonance imaging (MRI)
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Areas of the body that are often difficult to image are possible to see with __ because of its 3D capabilities. It is useful in detecting cancer in the CNS and the musculoskeletal system. It is also used to stage breast endometrial cancer before surgery and to detect metastatic spread of cancer to the liver.
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Nuclear scans
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__ are useful in locating and staging cancer of the thyroid and bone.
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Positron emission tomography (PET) scan
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A __ provides information about the metabolism of an intern structure, along with its size and shape. It is primarily used for images of the brain, neck, colon, rectum, ovary, and lung. It may also help identify more aggressive tumors.
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Single-photon emission computed tomography (SPECT)
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__ used a rotating camera to create 3D images with the use of radioactive substances. It is useful in identifying metastasis to the bone.
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Monoclonal antibodies
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__ are used to evaluate cancer of the prostate, colon, breast, and ovaries, and melanoma.
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Gray
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Because tumors are usually more sense than the tissue surrounding them, they may appear as a lighter shade of __ (blocking more radiation).
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Abdominal x-Rays, chest x-rays
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__ may reveal tumors of the stomach, livers, kidneys, and so on, wheras __ are useful in detecting lung cancer.
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Contrast medium
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If a __bis used, as in an upper or lower gastrointestinal (GI) series or intravenous urogram (IVU), tumors of the esophagus, rectum, colon, or kidneys may be detected.
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Mammogram
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A special type of x-Ray is a __, which is useful in the early detection of breast cancer.
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Stereotactic (3D) mammography
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__ may be used for an image-guided biopsy.
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Self-detection
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__ remains the most important method of discovering cancer.
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CAUTION
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What is the reminder that the American Cancer Society came up with for general detection of cancer?
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ABCDE
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What is the reminder that the American Cancer Society came up with for discovering skin cancer?
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Removal of the tumor
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The primary treatment for cancer has always been and remains __.
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Surgery
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When the tumor is relatively small and is present only in the organ that is removed, __ is most effective.
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En bloc resection
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Removal of the cancerous tumor and the lymph nodes
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Lumpectomy
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Removal of the tumor only
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Lymph node dissection
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The removal of clinically involved lymph nodes
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Lymph node mapping
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__ determines a pattern of spread from the primary tumor site through the lymph nodes.
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Sentinel node
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The __ is the first node in which lymphatic drainage occurs in a particular area. If this node is negative for cancer upon dissection, then the lymph system is free of cancer, and no other nodes need to be excised.
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Radical mastectomy
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Removal of the breast contains the cancer, along with the lymph nodes and the muscle under the breast
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Margins
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When the surgical report of the radical mastectomy discusses __, it refers to the borders of normal tissue surrounding the cancer.
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Wide margin resection
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A __ means that the cancer is removed with a significant amount of tissue around the tumor to ensure that all cancer cells are removed.
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Negative
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If the margins of a radical mastectomy are reported as __, no cancer cells are seen. If positive, cancer cells have been detected by the pathologist.
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Simple mastectomy
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Removal of the breast containing the cancer
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Radiation therapy
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The goal of __ is to destroy the nucleus of the cancer cells, thereby destroying their ability to reproduce and spread.
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3D conformal radiation therapy (3DCRT)
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Targeted radiation therapy that used digital diagnostic imaging and specialized software to treat tumors without damaging surround tissue
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Brachytherapy
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The use of radiation placed directly on or within the cancer through the use of needles or beads containing radioactive gold, cobalt, or radium
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Gamma knife surgery
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A noninvasive type of surgery that uses gamma radiation to destroy a brain tumor
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Intensity-modulated radiation therapy (IMRT)
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High-dosage radiation delivered via beam that changes its dosage and shape
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Bone marrow transplant (BMT)
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Patients ho are incapable of producing healthy blood cells are given bone marrow from a matching donor to stimulate normal blood cell growth
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Leukemia
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Patients with specific types of __ may receive bone marrow transplants after chemotherapy has effectively destroyed the functioning of their own bone marrow.
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Chemotherapy
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__ is the circulation of cancer-destroying medicine throughout the body. It may also be used as an adjuvant (aid) to other forms of treatment to relieve symptoms or slow down the spread of cancer.
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Combination chemotherapy
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__ is the use of two or more anticancer drugs at one time.
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Complementary and alternative medicine (CAM) techniques
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Prayer, massage, diet, exercise, and mind-body techniques constitute the majority of (these) methods used in cancer treatment
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National Center for Complementary and Alternative Medicine
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The U.S. Government has established the __, which reports on results of research studies on the use of CAM techniques for various disorders.
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Immunotherapy
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__ is the use of the body’s own defense system to attack cancer cells. (Interleukins)
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Two
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How many vaccines are there to prevent specific cancers?
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Hepatitis B vaccine
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The __ prevents hepatitis B with its sequels of liver cancer and cirrhosis.
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Cervical cancer vaccine
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The __ protects women against strains of 16 and 18 of the human papilloma virus (HPV)
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Chemotherapy
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__ works by disrupting the cycle of cell replication.
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Protocol
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It should be noted that two or more chemotherapeutic agents usually are used together to effectively attack the cancer at various stages. This is referred to as a drug __ or plan.
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Alkylating agents
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Interfere with DNA replication to lead to cancer cell death or dysfunction
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Antimetabolics
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Replace compounds that cancer cells need to grown and/or replicate
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Antineoplastic antibiotics
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Prevent or delay cell replication
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Antineoplastic hormones
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Interfere with receptors for growth-stimulating proteins
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Interleukins
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Stimulate cells of the immune system to boost attack a in cancer cells
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Mitotic inhibitors
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Prevent cell division
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Vinca alkaloids
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Prevent formation of chromosome spindles necessary for cell duplication
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3D conformal radiotherapy
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3DCRT stands for
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American cancer society
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ACS stands for
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Alpha-fetoprotein test
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AFP stands for
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Beta-2 microglobulin
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B2M stands for
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Bone marrow transplant
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BMT stands for
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Breast self-examination
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BSD stands for
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Bladder tumor antigen
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BTA stands for
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Biopsy
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bx stands for
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Canver
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CA stands for
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CA 125
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Tumor marker primarily for ovarian cancer
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CA 15-3
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Tumor marker to monitor breast cancer
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CA 19-9
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Tumor marker for pancreatic, stomach, and bile duct cancer
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CA 27-29
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Tumor marker to check for recurrence of breast cancer
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Complementary and alternative medicine
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CAM stands for
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Carcinoembryotic antigen (used to monitor colorectal cancer)
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CEA stands for
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Carcinoma in situ
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CIS stands for
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Central nervous system
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CNS stands for
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Computed tomography
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CT stands for
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Certified tumor registrar
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CTR stands for
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Fecal occult blood test grade
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Grade
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G stands for
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Gastrointestinal
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GI stands for
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Human chorionic gonadotropin
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hCG stands for
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Intensity-modulated radiation therapy
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IMRT stands for
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Intravenous urogram
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IVU stands for
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Metastases
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mets stands for
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Musculoskeletal
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MS stands for
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NSE
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Neuron-specific enolase (used to detect neuroblastoma, small cell cancer)
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Papanicolaou test for cervical/vaginal cancer
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Positron emission tomography
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PET stands for
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Prostate-specific antigen
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PSA stands for
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Single-photon emission computed tomography
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SPECT stands for
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TA-90
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Tumor marker for spread of malignant melanoma
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Tumor-nodes-metastases
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TNM stands for
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Testicular self-examination
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TSE stands for

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