question

Oncology

answer

the study (-logy) of diagnosis and treatment of tumors (onc/o)

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tumor, or neoplasm

answer

a mass or growth that arises from normal tissue

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benign tumor

answer

not cancerous. It grows slowly and does not spread to other sites.

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malignant

answer

cancerous, tumor is characterized by continuous and often fast growth. Malignant tumors are invasive, able to enter and destroy surrounding tissue.

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When tumors become infiltrative

answer

they extend into adjacent healthy tissue.

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metastasis (mets) (-stasis = control; meta- = beyond, change.)

answer

the process by which tumor cells spread from one part or organ to another not directly connected with it Metastasis may also be used as a noun to name the tumor that develops distant to the site of origin.

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The cells that make up benign tumors

answer

are composed of differentiated, or specialized, cells that form in an organized manner, similar to normal cells.

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Malignant cells undergo dedifferentiation

answer

means that they revert to a more primitive, embryonic form that lacks differentiation, or specialization. Another name for dedifferentiation is anaplasia (ana- means backward)

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benign tumors are often encapsulated

answer

they are surrounded by a fibrous capsule. This is the reason they are not invasive.

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morbidity

answer

state of being unwell or diseased

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histogenesis

answer

the formation (-genesis) and differentiation of tissue (hist/o) from undifferentiated cells.

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carcinomas (carcin/o = cancer, cancerous).

answer

solid tumor is one composed of a mass of cells. Carcinomas begin in the epithelial tissue that lines external and internal body surfaces, including the skin and glands, as well as the digestive, urinary, and reproductive organs. Carcinomas comprise about 90% of all malignancies.

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Benign tumors that arise from epithelial cells are called

answer

adenomas

question

gastric adenoma

answer

a benign tumor of the glandular (aden/o) epithelial cells that line the stomach (gastr/o)

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adenocarcinoma

answer

a cancerous (carcin/o) tumor (-oma) of an epithelium that originates in glandular tissue

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gastric adenocarcinoma

answer

Stomach (gastr/o) cancer

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sarcomas

answer

Much less common than carcinomas cancers that originate in connective tissues such as bone, fat, muscle, cartilage, bone marrow, and lymphatic tissue. Sarc/o = flesh, connective tissue. Sarcomas commonly arise in the mesenchymal tissue

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mesenchymal tissue

answer

embryonic connective tissue

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osteosarcoma

answer

a tumor (-oma) of bone (oste/o) and connective tissue (sarc/o)

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lymphoma.

answer

arcomas can also occur in the lymphatic system, which is the site of origin of lymphoma

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leukemia

answer

sarcoma in bone marrow a disease of blood-forming organs (-emia) in which bone marrow is replaced by proliferating leukocytes and their precursors (leuk/o)

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glioma

answer

Cancer in the connective tissue in the brain

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neuroblastoma

answer

a childhood cancer arising from immature tissues in the autonomic nervous system or the adrenal medulla (-blastoma = immature tumor). a cancerous tumor derived from embryonic (immature) nerve tissue

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retinoblastoma

answer

Another childhood cancer is retinoblastoma, which arises from immature cells in the retina, the light-sensitive surface at the back of the interior of the eye. known to be inherited

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mixed-tissue tumors

answer

derived from several different types of cells capable of differentiating into both epithelial and connective tissue. Sites for the development of these tumors are the kidneys, ovaries, and testes.

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The defining characteristic of any cancer

answer

the unrestrained growth of abnormal cells that creates the tumor, or mass. This process of unrestrained growth is called hyperplasia. Unchecked, malignant tumors will compress, invade, and eventually destroy surrounding tissue.

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carcinogenesis

answer

The development of cancer caused by a mutation of genetic material in normal cells that leads to uncontrolled cell division. Only certain mutations can lead to cancer and more than one mutation is necessary for carcinogenesis. Only mutations in the genes that play a vital role in cell division, apoptosis, and DNA repair will cause a cell to lose control of the process of its proliferation.

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nucleotides

answer

Each gene is made up of units called nucleotides.

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When the processes of mitosis and protein synthesis are disturbed, a cell becomes _________.

answer

malignant

question

Malignant cells are ___________-, which, as we learned earlier, means that the cell has reverted to its embryonic type in which it is no longer capable of differentiation, or specialization.

answer

anaplastic

question

Mutations that stimulate cell growth or block DNA repair lead to

answer

the formation of malignant tumors. Some cancer cells are no longer capable of apoptosis and can live indefinitely.

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virus

answer

an infectious agent that uses the host's genetic material to make copies of itself, and some viruses are carcinogenic.

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the human T cell leukemia virus (HTLV)

answer

causes a form of leukemia in adults.

question

Kaposi sarcoma

answer

s caused by herpesvirus type 8

question

Papillomavirus

answer

can cause cervical cancer

question

the Epstein-Barr virus

answer

causes Burkitt lymphoma.

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oncogenic viruses

answer

Tumor-producing viruses RNA viruses (called retroviruses) and DNA viruses

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oncogene

answer

a piece of DNA whose activation is associated with the conversion of normal cells into cancerous cells oncogenes can cause normal cells to become malignant if they are activated by mutations or dislocation

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hydrocarbons

answer

A common group of carcinogens are toxic chemicals associated with all forms of smoking and exhaust, chemicals found in insecticides, dyes, and insulation, as well as other industrial chemicals

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hormone called diethylstilbestrol (DES)

answer

a chemical carcinogen. DES is a synthetic estrogen that was given to pregnant women who had had previous miscarriages or premature deliveries and was shown to cause carcinoma in the children who were exposed to it in utero

question

mesothelioma

answer

asbestos was found to be one of the most deadly carcinogens, causing a rare form of lung cancer called mesothelioma

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stool guaiac test, also called the guaiac fecal occult blood test (gFOBT)

answer

detects the presence of blood in feces. (Occult means hidden, not visible.) The term guaiac comes from the name of the paper surface used in the test, which contains a chemical compound that is extracted from the resin of Guaiacum trees. The presence of fecal occult blood (FOB) can indicate colorectal cancer as well as a number of other non-cancerous conditions like peptic ulcers and inflammatory bowel disease.

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the concentration of estrogen receptors (ERs) in tumor cells of breast cancer patients

answer

used more to guide treatment choices than to diagnose.

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estrogen (estradiol) receptor assay

answer

pinpoints the tumor's receptivity to estrogen. If this is positive, the patient is likely to respond to antiestrogen hormone therapy.

question

protein marker tests

answer

used specifically for cancer assays measure tumor-generated proteins, or protein markers, which are present in the bloodstream CA-125 test and the CEA test, which detects carcinoembryonic antigen (CEA), associated with colorectal and other GI tumors

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Acid phosphatase test and the prostate-specific antigen (PSA) test (for prostate cancer)

answer

protein marker test

question

Alpha-fetoprotein test

answer

(testicular and liver cancers)

question

Cytogenetic analysis

answer

examines chromosomes for breaks, translocations, or deletions of DNA, which is used for leukemia and other cancers

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Immunohistochemistry (IHC)

answer

localizes antigens or proteins in tissues using marked antibodies to assess presence and amount of specific molecules in both normal and tumor cells

question

genetic screening

answer

tests family members to determine whether they have inherited a cancer-causing gene.

question

pleural effusion

answer

fluid accumulating between the lining of his lungs and his chest cavity

question

needle biopsy with fine needle aspiration

answer

To relieve the shortness of breath To aspirate means to withdraw fluid or air from a cavity. A needle biopsy may be performed in two ways: either by removing a thin core of tissue from an organ or mass using a large-bore needle (core needle biopsy) or by extracting, or aspirating, free cells from a fluid-filled cavity or from inside a solid tumor mass using a fine needle; this second procedure is called fine needle aspiration (FNA) biopsy.

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thoracocentesis thoracentesis

answer

when the cause of excessive fluid can accumulate in the pleural space is unknown This procedure consists of a surgical puncture by insertion of a needle or catheter into the pleural space (thorac/o) to obtain pleural fluid for analysis (-centesis means surgical puncture to remove fluid).

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Bone marrow biopsy

answer

the removal of bone marrow, usually from the sternum or ilium (as shown here) by needle puncture for examination to diagnose certain blood cell diseases, such as anemia and leukemia.

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Exfoliative cytology

answer

the microscopic examination of scraped (exfoliated) cells

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Papanicolaou (Pap smear)

answer

one of the most common forms of this test. The Pap smear collects cervical cells and is a screening test for cancer or precancerous conditions. A Pap smear may also be ordered when a woman is pregnant or has abnormal vaginal bleeding, pain, discharge, or itching.

question

fiberoptic colonoscopy

answer

a noninvasive procedure that uses a fiberoptic instrument to perform a visual examination (-scopy) of the colon (colon/o).

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laparoscopy, or peritoneoscopy

answer

A slightly more invasive procedure A small incision is made in the abdominal wall (lapar/o) for insertion of a laparoscope (or peritoneoscope) to inspect the abdominal cavity for tumors.

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staging laparotomy

answer

a much wider incision (-tomy) is made in the abdomen so that the surgeon can explore the abdominal cavity to determine, more specifically, the extent of the spread of a malignant disease.

question

PET scan

answer

learn the stage, or extent, of the disease

question

positron emission tomography (PET) scan

answer

uses the injection of a radionuclide into a body part to be scanned. Recording the distribution of radioactivity through emission of positrons creates a cross-section image. What distinguishes this procedure from a CT scan is the fact that radioisotopes are used instead of a contrast material and x-rays.

question

mammography

answer

An imaging technique specifically for early cancer detection of the breast

question

Nuclear medicine

answer

offers further advances in diagnostic imaging

question

radionuclide scans

answer

radioactive substances, injected intravenously, can detect tumors and metastases

question

nuclear bone scan

answer

obtained by injecting a radioactive phosphate substance, called a radionuclide, into the area under examination and then measuring the substance's uptake with a special scanning device. Excessive uptake in an area can help pinpoint the location of tumors, infection, inflammation, stress fracture, or other damage. It is normal to see activity in the brain and in the kidneys or bladder as the tracer is excreted into the urinary system

question

thallium-201

answer

When the radioactive substance thallium-201 is used to detect head and neck tumors, brain abnormalities appear as an increased accumulation of radioactivity This is because the blood-brain barrier prevents normal brain tissue from taking up radioactivity.

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beta hcg test

answer

detects human chorionic gonadotropin in serum of patients with testicular cancer

question

prostate-specific antigen (PSA) and acid phosphatase

answer

protein marker tests for prostate cancer

question

asthenia

answer

muscle weakness

question

cachexia

answer

weight loss, exhaustion, anemia, muscle weakness, or asthenia, as well as his reported taste alterations the most severe (cac/o means bad; -hexia means state or condition) form of malnutrition associated with cancer and other chronic, severe diseases. It leads to wasting, emaciation, and decreased quality of life

question

gross description of tumors

answer

their visual appearance to the naked eye. Gross means large Tumor types based on gross description include cystic, fungating, inflammatory, medullary, necrotic, polypoid, ulcerating, and verrucous.

question

microscopic description of tumors

answer

what the tumor cells look like under a microscope. Micro- = small

question

fungating tumors

answer

Tumors in the colon are often fungating tumors with a mushrooming pattern of growth (fung/i = fungus, mushroom),

question

cystic tumors

answer

characterized by large open spaces filled with fluid (cyst/o = sac of fluid). Cystic tumors are frequently found in the ovaries

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mucinous tumor

answer

it is filled with thick, sticky mucus

question

serous tumor

answer

it is filled with a watery fluid resembling serum. Serous means having the appearance of a thin, watery fluid, or serum.

question

medullary tumor

answer

frequently encountered in the breast or thyroid gland. These tumors are large, soft, and fleshy (medull/o = soft, inner part)

question

verrucous tumor

answer

shows a definite wartlike pattern (verruc/o = wart); these are most frequently seen in the gingiva or cheek.

question

polypoid

answer

they have projection-like growths that extend outward from a base. They resemble (-oid) a polyp (polyp/o), which is a small tumorlike growth projecting from the surface of any mucous membrane. Polyps can be malignant or benign but are usually benign. They are often found in the colon and, even when benign, should be removed because they may become malignant over time.

question

sessile polypoid tumor

answer

extends from a broad base (the term sessile means having no stem).

question

pedunculated polypoid tumor

answer

extends from a stalk or stem (pedunculated means having a stem or stalk).

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inflammatory tumor

answer

gets its name from the characteristic features of inflammation—redness, swelling, and heat. Inflammatory changes occur when the tumor blocks the skin's lymphatic drainage.

question

necrotic tumor

answer

contains dead tissue (necr/o = death); tumors can sometimes outgrow their blood supply and die.

question

ulcerating tumor

answer

exhibits an exposed surface from the death of overlying tissue.

question

dysplasia

answer

an abnormality in cellular development (plas/o; -plasia = formation).

question

Undifferentiated cells

answer

help us detect malignancies. Undifferentiated cells lack microscopic structures typical of normal mature cells

question

dysplastic cells

answer

adult cells that are abnormal (dys-) in size, shape, and organization—certainly exhibit highly abnormal cell formation, but they are not yet clearly cancerous in appearance. Moles or nevi on the skin are good examples of dysplastic cell growth.

question

metaplasia

answer

adult differentiated cells transform to differentiated tissue of another kind (meta- = beyond; change). What makes this fascinating is the fact that it is reversible. For instance, a habitual cigarette smoker may experience a change in the shape and structure of the pulmonary epithelial cells. If he or she stops smoking, this abnormal cellular change can reverse itself.

question

carcinoma in situ

answer

These localized tumor cells are cancerous but have not yet invaded adjacent structures; the cancer remains in place (in situ) for the moment. What makes cervical cancer curable if caught in time is that it most often begins as carcinoma in situ.

question

diffuse tumor growth

answer

his cancer is spreading evenly throughout the affected tissue. This level of involvement is characteristic of malignant lymphomas as they spread through the lymph nodes.

question

Alveolar tumor cells

answer

form patterns that resemble small, microscopic sacs (alveol/o). These are commonly found in tumors of muscle, bone, fat, and cartilage.

question

epidermoid cells

answer

frequently encountered in the respiratory tract resembling squamous epithelial cells

question

follicular tumor cells

answer

common in thyroid gland cancer and can form glandular sacs of their own (follicul/o = small glandular sacs).

question

Nodular cells

answer

often seen in malignant lymphomas when there is extended lymph node involvement; contrast their tightly packed clusters with the lightly populated areas in between.

question

Papillary cells

answer

characterized by fingerlike or nipplelike (papill/o) projections. Papillary cells are frequently seen in bladder cancer.

question

pleomorphic

answer

-ic = pertaining to; ple/o means many or more; morph/o means shape or form. mixed-cell tumors

question

scirrhous tumor

answer

densely packed and overgrown with fibrous tissue (scirrh/o = hard). These cell types are common in breast or stomach cancers.

question

Grading

answer

based on the microscopic appearance of the tumor cells. What the pathologist looks for specifically is the degree of maturation or differentiation. For example, the grade I tumor is well differentiated, closely resembling the normal tissue of origin. The more advanced grade IV cells are anaplastic, or undifferentiated, so that it is difficult to recognize what might be original tissue (-tic = pertaining to; ana- = backward; plas/o = development).

question

Staging

answer

relies on careful evaluation of the size and spread of a tumor using CT, PET/CT, and MRI scan as well as radionuclide bone scans. One of the most common staging systems is referred to as TNM

question

TNM

answer

stands for tumor, nodes, metastases. For example, a tumor with a label of T1N2M0 would be described as follows: The T refers to the size and extent of the tumor itself; thus, a T1 suggests a small tumor. The letter N in this same code represents the number of regional lymph nodes involved. Finally, the letter M refers to the spread to distant sites—in other words, the number of metastases, which in this case is zero. Once the T, N, and M categories have been assigned, this information is combined to give an overall stage grouping of I, II, III, or IV.

question

Duke Staging System

answer

used specifically for staging colon cancer, including hereditary non-polyposis colon cancer (HNPCC).

question

excisional biopsy

answer

the removal of the tumor, along with a margin of normal tissue Used for diagnosis, this removal also often cures small, noninvasive tumors

question

incisional biopsy

answer

involves removal of a piece of the tumor for diagnosis and may be followed by additional treatment to remove the bulk of the tumor.

question

A wide resection

answer

involving removal not just of the tumor but its original site, along with surrounding tissue in the body space, is called exenteration

question

Pelvic exenteration

answer

the removal of all the organs and adjacent structures of the pelvis, including with the uterus, ovaries, bladder, and segments of the large bowel. This radical surgery usually is performed to stop cancer involving the urinary bladder, uterine cervix, and rectum

question

En bloc resection

answer

involves removal of the tumor along with a large area of the surrounding tissue and usually lymph node removal as well. Classic examples of en bloc resection (-ectomy) include the modified radical mastectomy, colectomy, and gastrectomy.

question

cryosurgery,

answer

subfreezing temperature is used to destroy the malignant tumor (cry/o = cold)

question

cauterization

answer

destroys the tumor by burning it (cauter/o = burn, heat)

question

fulguration

answer

another way to destroy abnormal tissue is with the use of electric sparks generated by a high-frequency current

question

debulking procedure

answer

may be used if the tumor is attached to a vital organ and cannot be completely removed; instead, as much of the tumor as possible is removed and adjuvant radiation or chemotherapy is given.

question

bone marrow transplant (BMT)

answer

procedural intervention that is an alternative to traditional excision or resection

question

autologous bone marrow transplant

answer

stored marrow from the patient's own body is reinfused when needed; auto- = self

question

allogeneic marrow transplant

answer

someone else donates the marrow; allo- means other, different.

question

peripheral (blood) stem cell transplant (PSCT)

answer

the patient receives a reinfusion of stem cells selected and harvested from his or her own peripheral blood, or from someone else's, to repopulate the bone marrow with blood cells.

question

ionizing radiation therapy (RT), or radiotherapy

answer

can be used to destroy tumor cells (radi/o = rays) by delivering a maximum dose of ionizing radiation to tumor tissue. This treatment modality is also called radiation oncology. Radiation therapy can target abnormal tissue while minimizing the morbidity, or damage to the DNA and cells, of normal tissue. Radiation therapy may be used alone or in conjunction with other forms of treatment, such as chemotherapy. It can also be used before or after a surgical procedure as well as intraoperatively—referred to as intraoperative radiation therapy (IORT)

question

fibrosis

answer

an increase in connective tissue (fibr/o = fibers) in normal tissue, along with loss of surface lining cells and blood vessel damage

question

Irradiation

answer

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

question

Exposure is limited through both carefully defined target fields as well as through tight control of the administration of unit doses of radiation, measured as

answer

gray (Gy) (absorbed radiation dose)

question

An older term for the unit dose of radiation is

answer

rad, which stands for radiation absorbed dose

question

Fibrosis

answer

Abnormal increase in connective tissue (fibr/o) within normal tissues

question

Pneumonitis

answer

Inflammation (-itis) in the lungs (pneumon/o)

question

Myelosuppression

answer

Bone marrow (myel/o) depression (-suppression = to stop)

question

Anemia

answer

-emia = blood condition; an- = no or without

question

Thrombocytopenia

answer

A deficiency of platelets or thrombocytes: -penia = deficiency; thromb/o = clot; cyt/o = cell

question

Mucositis

answer

Inflammation and ulceration of mucous membranes (mucos/o)

question

Xerostomia

answer

Dryness of the mouth: -ia = condition; xer/o = dry; stom/o = mouth

question

Alopecia

answer

Partial or complete hair loss

question

Infertility

answer

Inability to contribute to conception

question

Secondary tumors

answer

New types of tumors originating at a site separate from the primary tumor, including sarcomas, carcinomas, or leukemias that may arise from damaged tissue

question

fractionation

answer

Another method of limiting damage to normal tissue is through the technique of fractionation, in which radiation is delivered in small, repeated doses rather than in fewer large doses. Despite lessened damage to normal tissues, this technique actually enables larger total dosages.

question

brachytherapy

answer

in treatment of prostatic and brain tumors, brachytherapy limits exposure by implanting seeds of radioactive material directly into a tumor (interstitial therapy) or into the cavity of a tumor (intercavitary therapy). The short distance (brachy-) in drug delivery to its target site gives this treatment its name of brachytherapy.

question

external beam radiation (teletherapy)

answer

applied to the tumor from a distant (tele-) source outside the body—namely, a linear accelerator. Because of the precision with which the beams can be directed, the treatment can be very localized, that is, restricted to the cancerous site.

question

Electron beam radiation

answer

produces low-energy rays to treat skin cancer and surface tumors

question

Proton therapy

answer

tightly focuses positive subatomic particles (protons) to a finite target point using a cyclotron

question

proton stereotactic radiosurgery, or PSRS (also called stereotaxic radiosurgery)

answer

a single large dose of radiation is delivered from several different angles under highly precise (stereotactic) guidance to treat small intracranial or arteriovenous abnormalities. This is also called gamma knife surgery.

question

Radiocurable tumors are usually

answer

localized

question

Lymphomas, Hodgkin disease, and seminomas of the testes

answer

radiocurable

question

Radiosensitive tumors

answer

tumors in which radiation can cause the death of cells without serious damage to surrounding tissue.

question

radiosensitive tumors

answer

irradiation can cause cell death at fairly low doses of radiation without serious damage to the surrounding tissue, such as the leukemic cells

question

Radioresistant tumors

answer

require large doses of radiation to produce cell death. Pancreatic tumors, melanoma, and renal carcinoma fall into this category. These radioresistant tumors may benefit more from chemotherapy, particularly from the use of radiosensitizers, drugs that increase the tumor's sensitivity to x-rays—drugs such as 5-fluorouracil (5-FU) and cisplatin.

question

Chemotherapy (chemo)

answer

the use of drugs or chemicals (chem/o) to damage the DNA of cancer cells and is the standard treatment for a number of types of cancer. Such a drug can be used alone, as an adjuvant, or enhancement, to surgery, or it can involve the use of more than one agent in combination chemotherapy.

question

The goal of chemotherapy research

answer

to develop drugs that kill large numbers of tumor cells without harming normal cells

question

Scientists in the field of pharmacokinetics

answer

measure how quickly drugs disappear from the bloodstream and tissues and investigate drug routes (oral, intravenous) and schedules to determine how best to achieve the goal of tumor destruction with the least harm to normal cells.

question

protocol (prot.)

answer

or treatment plan, that details the route, schuedule, and frequency of doses administered.

question

remission

answer

a partial or complete disappearance of signs of the disease

question

complete response (CR)

answer

the patient's tumor has disappeared,

question

partial response (PR)

answer

indicates that the tumor is now one-half its original size

question

NED in a treatment report

answer

means "no evidence of disease.

question

Relapse

answer

describes a recurrence of the tumor after treatment

question

Progressive disease (PD)

answer

the tumor has increased in size

question

stable disease (SD)

answer

the tumor neither shrinks nor grows

question

Alkylating agents

answer

Attack DNA molecules, causing strand breaks

question

Antibiotics

answer

Promote breakage of the DNA strands, preventing their replication

question

Antimetabolites

answer

Inhibit synthesis of DNA components or block DNA replication

question

Antimitotics

answer

Block mitosis (division or replication) in cells

question

Steroids

answer

Can modulate cancer cell apoptosis

question

Differentiating agents

answer

Promote tumor cells to differentiate, stop growing, and die

question

Molecularly targeted drugs

answer

Block the function of growth factors, their receptors, and signaling pathways in tumor cells

question

Antiangiogenic drugs

answer

Interfere with angiogenesis (creation of new blood vessels) needed for tumor cell growth

question

hormonal agents

answer

A final chemotherapeutic class is the hormonal agents made by the body's endocrine system, such as estrogens and androgens. Hormones attach to receptor proteins in target tissues and can have growth-inhibiting effects on certain types of cancer, such as leukemia and breast cancer. The key to using hormonal agents for cancer is knowledge of which receptors are associated with different cancers.

question

biological therapy

answer

attempts to use the body's own defense mechanisms to fight tumor cells.

question

Biologic response modifiers

answer

substances produced by normal cells that either directly block tumor growth or stimulate the immune system to fight cancer.

question

interferons (IFN), monoclonal antibodies (MoAb) and colony-stimulating factors (CSFs)

answer

can combat the side effects of chemotherapy,

question

interleukins

answer

stimulate the immune system to destroy tumors

question

Phase I trials

answer

Experimental drug or treatment is tested, usually just for safety, dosage, and schedule of administration, in a small group of people (20 to 80).

question

Phase II trials

answer

Experimental treatment is tested for risks to a specific population and disease among a larger group of people (200 to 300)

question

Phase III trials

answer

Experimental treatment is tested in a more definitive trial for risks vs. benefits in a larger group of people (hundreds or thousands).

question

Phase IV trials:

answer

Large studies are conducted after FDA approval of the drug for marketing. These are designed to monitor safety and identify new indications, if possible

question

pedunculated

answer

extend from a stem

Chapter 19: Cancer Medicine – Flashcards

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