NR201.StudyGuide.Oncology Complete

NR 201- Fall
Oncology Study Guide

 Cancer types
o Carcinoma – Skin, Sarcoma – bone, Leukemia – Blood, Lymphoma/myeloma – immune,
CNS – brain/spinal
 Cell Division
o Hyperplasia -  # of cells
o Dysplasia – abnormal cells
o in Situ – abnormal cells ‘in place’, haven’t spread
 Modifiable and non-modifiable risk factors for cancer
o Modifiable- smoking, alcohol, obesity, diet, sun exposure
o Non-Modifiable- race, heredity, age
 Most common cancers in:
o Men - Prostate
o Women - Breast
o Children- Leukemia
o Highest mortality rate for men and women - Lung and bronchus
 Cancers with highest mortality rates – ones that there are screening guidelines for
o Lung, breast, prostate, colon, cervical, uterine
 Screening guidelines for breast, ovarian, colon and prostate cancer – Lecture #1 slides 60-65
o Immediate family member with cancer you should start screenings 10-15 yrs earlier
o Breast
 Over 30 with immediate family member screen now
 40-44 begin mammograms
 54 yearly mammograms
 55+ every 2 years or yearly
o Cervical
 21 begin screening
 21-29 PAP / 3yrs, HPV test only after abnormal PAP
 30-65 PAP+HPV / 5yrs or PAP /3yrs
 65+ with regular screening can stop
 Cancer hx should screen for +20 yrs
 Prevention: Gardasil – 2x 11-12yrs, 3x 15-26yrs
o Colorectal cancer screening
 45 begin screening, high risk start sooner
 76-85 screening based on preference and Hx
 85+ end screening
 Fecal immunochemical test (FIT) /1yr
 Guaiac-based fecal occult blood test (gFOBT) /1yr
 Stool DNA test/3yrs
 Digital rectal exam
 Colonoscopy / 10yrs
 Polyps + cancer - CT colonoscopy, flex sigmoidoscopy, contrast barium /5yrs
o Prostate cancer screening
 50 begin screening, 45 for AA with relative, 40 high risk and relative
 PSA blood test with or without a rectal exam, biopsy to confirm
 Staging cancer TNM
o The higher the number the more involvement
o T = Size and involvement of the local neoplasm

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, NR 201- Fall
Oncology Study Guide

 T Subclass – T=Primary Tumor
 Tx - tumor cannot be assessed
 T0 - no evidence of primary tumor
 TIS - carcinoma in situ
 T1 - T4 – progressive increase in tumor size and involvement
o N= Regional Lymph node
 Nx-regional lymph nodes cannot be clinically assessed
 N0-regional lymph nodes demonstrably normal
 N1 - N4-Increasing degrees of abnormalities of regional lymph nodes
o M= Distant Metastasis
 Mx-not assessed
 M0-no (known) distant metastasis
 M1- M4 -distant metastasis present, specify site(s)
 Grading cancer
o The higher the number the more involvement
o Grade-classification of tumor cells based on cellular differentiation, or resemblance to
normal cells in structure, function, and maturity.
o Grade I - Well Differentiated: cancer cells that closely resemble the tissue of origin.
o Grade II - Moderately well differentiated; some immaturity present
o Grade III - Poorly differentiated; little resemblance to normal parent tissue
o Grade IV - Undifferentiated: bizarre tumor cells, no similarity to the tissue or origin.
o Grade X - unable to be assessed
 Means to diagnose cancer
o Tumor marker, MRI, CT, Fluoroscopy, U/S, Endo, Nuclear Imaging, PET Scan,
o Must confirm with biopsy
o Tumor markers
 PSA, BRCA1 and BRCA2,
 Common warning signs and symptoms of breast, lung, colon and prostate cancer
o C -change in bowel or bladder habits
o A- a sore that does not heal
o U- unusual bleeding or discharge
o T- thickening or lump in the breast tissue
o I- indigestion or difficulty swallowing
o O- obvious changes in wart or mole
o N- nagging cough or hoarseness
 Benign vs malignant
o Benign – encapsulated, noninvasive, well differentiated, slow grow, local, no anaplasia,
no metastases
o Malignant- invasive, poor differentiation, rapid grow, anaplasia, metastases
Treatment
 Hormonal therapy
o Change in environment where tumor grows
o Effective for hormone dependent tumors: breast, ovary, prostate, testicular
o Side effects: changes in wt, mood, skin, cardiac, BP, nausea, hirsutism, baldness. Hot
flashes, fluid retention, liver toxicity, gynecomastia
o Leuprolide – used as treatment for hormonal cancers


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