The Language Of Medicine th 11 edition DaviEllen

Chapter 19 Cancer Medicine (Oncology) Copyright © 2017, 2014, 2011, 2007 by Saunders, an

Chapter Goals • Identify medical terms that describe the growth and spread of tumors.

Chapter Goals (cont’d) • Describe x-ray studies, laboratory tests, and other procedures used by

Chapter 19 Lesson 19. 1 Copyright © 2017, 2014, 2011, 2007 by Saunders, an

Introduction Cancer: characterized by unrestrained and excessive growth of cells Malignant tumors: compress, invade,

Cancer • Cancer is responsible for 20% of all deaths in the United States.

QUICK QUIZ: 1. Which cancers are the most common causes of cancer death for

QUICK QUIZ: (cont’d) 2. Which cancers are the most common causes of cancer death

Characteristics of Tumors Neoplasms (tumors): growths that arise from normal tissue Copyright © 2017,

Characteristics of Tumors (cont’d) Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint

What Causes Cancer? • Carcinogenesis: transformation of a normal cell to a cancerous one

Carcinogenesis • Environmental agents ØChemical carcinogens ØRadiation ØViruses (RNA and DNA) ØOncogenes (ras/colon cancer,

Genes Implicated in Hereditary Cancers Copyright © 2017, 2014, 2011, 2007 by Saunders, an

Classification of Cancerous Tumors Carcinomas: epithelial cell origin, 90% of all malignancies are carcinomas

Carcinomas and the Epithelial Tissues from Which They Derive Copyright © 2017, 2014, 2011,

Classification of Cancerous Tumors (cont’d) Sarcomas: connective tissue origin, 5% of all malignancies Copyright

Sarcomas and the Connective Tissues from Which They Derive Copyright © 2017, 2014, 2011,

Classification of Cancerous Tumors (cont’d) Mixed tissue tumors: tissues capable of differentiating into epithelial

Chapter 19 Lesson 19. 2 Copyright © 2017, 2014, 2011, 2007 by Saunders, an

Pathological Descriptions Gross • • Cystic Fungating Inflammatory Medullary • • Necrotic Polypoid Ulcerating

Pathological Descriptions Microscopic • • • Alveolar Carcinoma in situ Diffuse Dysplastic Epidermoid Follicular

Grading and Staging of Tumors Grade: degree of maturity or differentiation under the microscope

International TNM Staging System for Lung Cancer (cont’d) Copyright © 2017, 2014, 2011, 2007

Chapter 19 Lesson 19. 3 Copyright © 2017, 2014, 2011, 2007 by Saunders, an

Cancer Treatment: Surgery • Debulking procedure: may be used to remove as much of

Cancer Treatment: Surgery (cont’d) • • Cauterization Core needle biopsy Cryosurgery En bloc resection

Cancer Treatment: Radiation Therapy (Radiation Oncology) • Brachytherapy • Electron beams • External beam

Radiation Therapy Side Effects • Alopecia (baldness) • Fibrosis (increase in connective tissue) •

Chapter 19 Lesson 19. 4 Copyright © 2017, 2014, 2011, 2007 by Saunders, an

Chemotherapy, Biological Therapy, and Differentiating Agents • • • Alkylating agents Antibiotics Antimetabolites Antimitotics

Cancer Chemotherapeutic Agents and the Cancers They Treat Copyright © 2017, 2014, 2011, 2007

Cancer Chemotherapeutic Agents and the Cancers They Treat (cont’d) Copyright © 2017, 2014, 2011,

Vocabulary • adjuvant chemotherapy • alkylating agents • anaplasia • angiogenesis Copyright © 2017,

Vocabulary (cont’d) • adjuvant chemotherapy Assisting primary treatment • alkylating agents Synthetic chemicals containing

Vocabulary (cont’d) • antibiotics • antimetabolites • antimitotics • apoptosis Copyright © 2017, 2014,

Vocabulary (cont’d) • antibiotics Chemicals produced by bacteria or primitive plants; inhibit growth of

Vocabulary (cont’d) • benign tumor • biological response modifiers • biological therapy • brachytherapy

Vocabulary (cont’d) • benign tumor Noncancerous growth (neoplasm) • biological response modifiers Produced by

Vocabulary (cont’d) • carcinogens • carcinoma • cellular oncogenes • chemotherapy Copyright © 2017,

Vocabulary (cont’d) • carcinogens Agents that cause cancer • carcinoma Cancerous tumor made up

Vocabulary (cont’d) • combination chemotherapy • dedifferentiation • deoxyribonucleic acid (DNA) • differentiating agents

Vocabulary (cont’d) • combination chemotherapy Use of several chemotherapeutic agents together in treatment of

Vocabulary (cont’d) • differentiation • electron beams • encapsulated • external beam irradiation Copyright

Vocabulary (cont’d) • differentiation Specialization of cells • electron beams Low-energy beams of radiation

$Vocabulary (cont’d) • fields Dimensions of body areas undergoing irradiation • fractionation Giving radiation$

Vocabulary (cont’d) • gray (gy) • gross description of tumors • infiltrative • invasive

Vocabulary (cont’d) • gray (gy) Unit of absorbed radiation dose • gross description of

Vocabulary (cont’d) • irradiation • linear accelerator • malignant tumor • mesenchymal Copyright ©

Vocabulary (cont’d) • irradiation Exposure to any form of radiant energy such as light,

Vocabulary (cont’d) • metastasis • microscopic description of tumors • mitosis • mixed-tissue tumors

Vocabulary (cont’d) • metastasis Spread of a malignant tumor to a secondary site •

Vocabulary (cont’d) • modality • molecularly targeted therapy • morbidity • mucinous Copyright ©

Vocabulary (cont’d) • modality Method of treatment, such as surgery, chemotherapy, or irradiation •

Vocabulary (cont’d) • mutation • neoplasm • nucleotide • oncogene Copyright © 2017, 2014,

Vocabulary (cont’d) • mutation Change in DNA; may be spontaneous or caused by chemicals,

Vocabulary (cont’d) • palliative • pedunculated • photon therapy • protocol Copyright © 2017,

Vocabulary (cont’d) • palliative Relieving, but not curing symptoms • pedunculated Possessing a stem

Vocabulary (cont’d) • proton therapy • radiation • radiocurable tumor • radioresistant tumor Copyright

Vocabulary (cont’d) • proton therapy Use of protons produced by a cyclotron to deposit

Vocabulary (cont’d) • radiosensitive tumor • radiosensitizers • radiotherapy • relapse Copyright © 2017,

Vocabulary (cont’d) • radiosensitive tumor Tumor in which radiation cause the death of cells

Vocabulary (cont’d) • remission • ribonucleis acid (RNA) • sarcoma • serous • sessile

Vocabulary (cont’d) • remission Partial or complete disappearance of symptoms of disease • ribonucleis

Vocabulary (cont’d) • simulation • solid tumor • staging of tumors • stereotactic radiosurgery

Vocabulary (cont’d) • simulation Study using CT scan or MRI to map treatment before

Vocabulary (cont’d) • steroids • surgical procedures to treat cancer • viral oncogenes •

Vocabulary (cont’d) • steroids Complex, naturally occurring chemicals derived from cholesterol • surgical procedures

Combining Forms COMBINING FORMS alveol/o cac/o carcin/o cauter/o chem/o cry/o cyst/o fibr/o follicul/o fung/i

Suffixes and Prefixes Suffixes -blastoma -genesis -oma -plasia -plasm -suppression -therapy Prefixes anaapobrachyepimetaneotele- Copyright

Clinical Procedures to Detect or Treat Malignancies • Bone marrow biopsy • Bone marrow

Abbreviations • • • • AFP ATRA BMT BRC bx CA CEA c. Gy

Abbreviations (cont’d) • • • • AFP ATRA BMT BRC bx CA CEA c.

Abbreviations (cont’d) • • • EGFR ER EPO FNA 5 -FU Ga GIST Gy

Abbreviations (cont’d) • • • IGRT IHC IMRT IORT Mets Mo. Ab NED NF

Abbreviations (cont’d) • • • PR prot PSA PSCT PSRS RNA RT SD TNM

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Chapter Goals • Identify medical terms that describe the growth and spread of tumors. • Recognize terms related to the causes, diagnosis, and treatment of cancer. • Review how tumors are classified and described by pathologists. Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 3

Chapter Goals (cont’d) • Describe x-ray studies, laboratory tests, and other procedures used by physicians for determining the presence and extent of spread (staging) of tumors. • Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records. Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 4

Introduction Cancer: characterized by unrestrained and excessive growth of cells Malignant tumors: compress, invade, and destroy surrounding tissues Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 6

Cancer • Cancer is responsible for 20% of all deaths in the United States. • More than half of people who develop cancer are cured. Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 7

QUICK QUIZ: 1. Which cancers are the most common causes of cancer death for women? A. Lung, breast, colorectal B. Lung, colorectal, breast C. Breast, lung, colorectal D. Colorectal, breast, lung Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 8

QUICK QUIZ: (cont’d) 2. Which cancers are the most common causes of cancer death for men? A. Lung, prostate, colorectal B. Lung, colorectal, prostate C. Prostate, lung, colorectal D. Colorectal, prostate, lung Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 9

What Causes Cancer? • Carcinogenesis: transformation of a normal cell to a cancerous one • Damage to genetic material • DNA function • Mitosis • Protein synthesis • • Genes Nucleotides Mutation Apoptosis Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 12

Carcinogenesis • Environmental agents ØChemical carcinogens ØRadiation ØViruses (RNA and DNA) ØOncogenes (ras/colon cancer, myc/lymphoma, and bcr-abl/chronic myelogenous leukemia) • Heredity ØRetinoblastoma, polyposis coli Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 13

Classification of Cancerous Tumors (cont’d) Mixed tissue tumors: tissues capable of differentiating into epithelial and connective tissue Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 19

Pathological Descriptions Microscopic • • • Alveolar Carcinoma in situ Diffuse Dysplastic Epidermoid Follicular • • • Nodular Papillary Pleomorphic Scirrhous Undifferentiated Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 22

Grading and Staging of Tumors Grade: degree of maturity or differentiation under the microscope Stage: extent of spread in the body Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 23

Cancer Treatment: Surgery • Debulking procedure: may be used to remove as much of primary tumor mass as possible • Adjuvant (assisting) radiation therapy and/or chemotherapy: after removal of primary tumor to prevent recurrence at distant sites Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 26

Cancer Treatment: Surgery (cont’d) • • Cauterization Core needle biopsy Cryosurgery En bloc resection • • • Excisional biopsy Exenteration Fine needle aspiration biopsy Fulguration Incisional biopsy Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 27

Cancer Treatment: Radiation Therapy (Radiation Oncology) • Brachytherapy • Electron beams • External beam radiation (teletherapy) • Fields • Fractionation • Gray (Gy) • Linear accelerator • • Photon therapy Proton therapy Radiocurable tumor Radioresistant tumor Radiosensitive tumor Radiosensitizers Simulation Stereotactic radiosurgery Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 28

Radiation Therapy Side Effects • Alopecia (baldness) • Fibrosis (increase in connective tissue) • Infertility (inability to contribute to conception of a child) • Mucositis (inflammation and ulceration of mucous membranes) • Myelosuppression (bone marrow depression) • Nausea and vomiting • Pneumonitis • Secondary tumors (new types of tumors) • Xerostomia (dryness of mouth) Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 29

Chemotherapy, Biological Therapy, and Differentiating Agents • • • Alkylating agents Antibiotics Antimetabolites Antimitotics Hormonal agents Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 31

Vocabulary (cont’d) • adjuvant chemotherapy Assisting primary treatment • alkylating agents Synthetic chemicals containing alkyl groups that attack DNA • anaplasia Loss of differentiation of cells • angiogenesis Process of forming new blood vessels Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 35

Vocabulary (cont’d) • antibiotics Chemicals produced by bacteria or primitive plants; inhibit growth of cells • antimetabolites Chemicals that prevent cell division; inhibit formation of substances needed to make DNA • antimitotics Drugs that block cell division • apoptosis Programmed cell death Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 37

Vocabulary (cont’d) • benign tumor Noncancerous growth (neoplasm) • biological response modifiers Produced by normal cells; directly block tumor growth or stimulate immune system to fight cancer • biological therapy Use of the body’s own defenses to destroy tumor cells • brachytherapy Use of radiation placed directly on or within the cancer Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 39

Vocabulary (cont’d) • carcinogens Agents that cause cancer • carcinoma Cancerous tumor made up of cells of epithelial origin • cellular oncogenes Pieces of DNA, activated by mutations or dislocation, that can cause a normal cell to become malignant • chemotherapy Treatment with drugs Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 41

Vocabulary (cont’d) • combination chemotherapy Use of several chemotherapeutic agents together in treatment of tumors • dedifferentiation Loss of differentiation of cells • deoxyribonucleic acid (DNA) Genetic material within the nucleus of a cell; controls cell division and protein synthesis • differentiating agents Drugs that promote tumor cells to differentiate, stop growing, and die Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 43

Vocabulary (cont’d) • differentiation Specialization of cells • electron beams Low-energy beams of radiation for treatment of skin or surface tumors • encapsulated Surrounded by a capsule; benign tumors are encapsulated • external beam irradiation Applying radiation to a tumor from a source outside the body Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 45

$Vocabulary (cont’d) • fields Dimensions of body areas undergoing irradiation • fractionation Giving radiation$

Vocabulary (cont’d) • fields Dimensions of body areas undergoing irradiation • fractionation Giving radiation in small, repeated doses • genetic screening Testing family members to determine if they have inherited a cancer-causing gene • grading tumors Evaluating the degree of maturity of tumor cells Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 47

Vocabulary (cont’d) • gray (gy) Unit of absorbed radiation dose • gross description of tumors Visual appearance of tumors to the naked eye • infiltrative Extending beyond normal tissue boundaries into adjacent tissues • invasive Having the ability to enter and destroy surrounding tissue Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 49

Vocabulary (cont’d) • irradiation Exposure to any form of radiant energy such as light, heat, or x-rays • linear accelerator Large electronic device that produces highenergy x-ray beams for treatment of deepseated tumors • malignant tumor Tumor having the characteristics of continuous growth, invasiveness, and metastasis • mesenchymal Embryonic connective tissue Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 51

Vocabulary (cont’d) • metastasis Spread of a malignant tumor to a secondary site • microscopic description of tumors Appearance of tumors when viewed under a microscope • mitosis Replication of cells • mixed-tissue tumors Tumors composed of different types of tissue Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 53

Vocabulary (cont’d) • modality Method of treatment, such as surgery, chemotherapy, or irradiation • molecularly Anticancer drugs designed to block the targeted therapy function of growth factors, their receptors, and signaling pathways in specific tumor cells • morbidity • mucinous Condition of being unwell; deficient in normal function Containing mucus Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 55

Vocabulary (cont’d) • mutation Change in DNA; may be spontaneous or caused by chemicals, radiation, or viruses • neoplasm New growth; benign or malignant tumors • nucleotide Unit of DNA composed of a sugar, phosphate, and a base • oncogene Region of DNA in tumor cells or in viruses that causes cancer Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 57

Vocabulary (cont’d) • palliative Relieving, but not curing symptoms • pedunculated Possessing a stem or stalk • photon therapy Radiation therapy using energy in the form of x-rays or gamma rays • protocol Detailed plan for treatment of an illness Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 59

Vocabulary (cont’d) • proton therapy Use of protons produced by a cyclotron to deposit a dose of radiation at a tightly focused point in the body • radiation Energy carried by a stream of particles • radiocurable tumor Tumor that is destroyed by radiation therapy • radioresistant tumor Tumor that requires large doses of radiation to be destroyed Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 61

Vocabulary (cont’d) • radiosensitive tumor Tumor in which radiation cause the death of cells without serious damage to surrounding tissue • radiosensitizers Drugs that increase the sensitivity of tumors to x-rays • radiotherapy Treatment of tumors using doses or radiation • relapse Recurrence of tumor after treatment Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 63

Vocabulary (cont’d) • remission Partial or complete disappearance of symptoms of disease • ribonucleis acid (RNA) Cellular substance that represents a copy of DNA; directs formation of new protein inside cells • sarcoma Cancerous tumor derived from connective or flesh tissue • serous Having the appearance of a thin, watery fluid • sessile Having no stem Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 65

Vocabulary (cont’d) • simulation Study using CT scan or MRI to map treatment before RT is given • solid tumor Tumor composed of a mass of cells • staging of tumors System of evaluating the extent of spread of tumors • stereotactic radiosurgery Delivery of dose of radiation under stereotactic guidance Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 67

Vocabulary (cont’d) • steroids Complex, naturally occurring chemicals derived from cholesterol • surgical procedures to treat cancer Methods of removing cancerous tissue • viral oncogenes Pieces of DNA from viruses that infect a normal cell and cause it to become malignant • virus Infectious agent that reproduces by entering a host cell and using the host’s genetic material to copy itself Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 69

Combining Forms COMBINING FORMS alveol/o cac/o carcin/o cauter/o chem/o cry/o cyst/o fibr/o follicul/o fung/i medull/o mucos/o mut/a mutagen/o onc/o papill/o pharmac/o plas/o ple/o polyp/o prot/o radi/o sarc/o scirrh/o xer/o Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 70

Suffixes and Prefixes Suffixes -blastoma -genesis -oma -plasia -plasm -suppression -therapy Prefixes anaapobrachyepimetaneotele- Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 71

Clinical Procedures to Detect or Treat Malignancies • Bone marrow biopsy • Bone marrow or stem cell transplant • CT scans • Fiberoptic colonoscopy • Exfoliative cytology • • Laparoscopy Mammography MRI Needle biopsy Radionuclide scans Ultrasound X-rays Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 72

Abbreviations (cont’d) • • • • AFP ATRA BMT BRC bx CA CEA c. Gy chemo CR CSF DES DNA Alpha-fetoprotein All-transretinoic acid Bone marrow transplantation breakpoint cluster region Biopsy Cancer Carcinoembryonic antigen Centigray (one hundredth of a gray) or rad Chemotherapy Complete response – disappearance of all tumor Colony-stimulating factor Diethylstilbestrol Deoxyribonucleic acid Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 74

Abbreviations (cont’d) • • • EGFR ER EPO FNA 5 -FU Ga GIST Gy H&E HER 2 -neu • HNPCC Epidermal growth factor receptor Estrogen receptor Erythropoietin Fine needle aspiration 5 -fluorouracil Gallium Gastrointestinal stromal tumor Gray Hematoxylin and eosin Growth factor gene highly activated on certain types of breast cancer Hereditary non-polyposis Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 76

Abbreviations (cont’d) • • • IGRT IHC IMRT IORT Mets Mo. Ab NED NF NHL NSCLC Pap smear PD Intensity-modulated gated radiation therapy Immunohistochemistry Intensity-modulated radiation therapy Intraoperative radiation therapy Metastases Monoclonal antibody No evidence of disease Neurofirbromatosis Non–Hodgkin lymphoma Non-small cell lung cancer Papanicolaou smear Progressive disease – tumor increases in size Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 78

Abbreviations (cont’d) • • • PR prot PSA PSCT PSRS RNA RT SD TNM VEGF XRT, RT Partial response – tumor one half its original size Protocol Prostate-specific antigen Peripheral stem cell transplantation Proton stereotactic radiosurgery Ribonucleic acid Radiation therapy Stable disease – tumor does not shrink or grow Tumor, nodes, metastases Vascular endothelial growth factor Radiation therapy Copyright © 2017, 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc. 80