Only $2.99/month

Medical Terminology Chapter 19

Terms in this set (243)

a Latin word meaning crab, was first identified around 400 BC during the time of Hippocrates; early reports on cancer compared the disease to a crab because of its tendency to stretch out and spread like the crab;s four pairs of legs; today, cancer refers to any malignant tumor; the incidence of cancer is now five times than it was 100 years ago; cancer will strike one of every three Americans, according to recent statistics from the American Cancer Society; however there is hope for those afflicted; cancer has become one of the more treatable of the major diseases in the US; highly advanced surgical techniques are being used to remove cancerous tissue, and it is usually possible to excise all the cancer cells when the malignancy is discovered in its earliest stages; chemotherapy (chemo) and radiation therapy are the other two principal means of treatment for patients with cancer; these treatments employ agents to kill cancerous cells that remain after surgery or in malignancies deemed inoperable; immunotherapy and photodynamic therapy are two newer methods employed in the treatment of cancer; although the exact cause or causes remain unknown research has shown that some cancers can be prevented especially those associated with environmental factors; oncologists searching for the causes of cancer have identified numerous factors; oncologists searching for the cause of cancer have identified numerous factors that play a role in the development of cancer; these factors are generally grouped under three main classifications: environmental, hereditary and biological; the American cancer society recommends various safeguards against cancer, which encourages individuals to take specific steps to safeguard their health and aid in the early detection of cancer
normal cells reproduce themselves through mitosis, an orderly process that ensures growth, tissue repair, and cell reproduction; normal cells have a distinct appearance and a specialized function; in normal cell development, immature cells undergo normal changes as they mature and assume their specialized functions; this process is called differentiation; knowledge of cell differentiation allows a pathologist or histologist to identify the body area from which the tissue was removed by looking at a sample of tissue through a microscope; in cancer an abnormal process in which a cells or group of cells undergoes changes and no longer carries on normal cell functions occur; this failure of immature cells to develop specialized functions is called dedifferentiation; it is believed that this process involves a disturbance in the DNA of the affected cells; malignant cells usually multiply rapidly, forming a mass of abnormal cells that enlarges, ulcerates, and sheds malignant cells that invade surrounding tissues; this process destroys the normal cells, and malignant cells take their places; microscopic analysis of a malignant cell reveals a loss of differentiation, anaplasia, nuclei of various sizes that are hyperchromatic, and cells in the process of rapid and disorderly division; based on microscopic analysis, malignant tumors are further classified as grades 1, 2, 3, or 4; the following describes each of the four grades of tumors in this system: grade 1: the most differentiated and the least malignant tumors, only a few cells are undergoing mitosis; however some abnormally does exist; grade 2: moderately undifferentiated; more cells are undergoing mitosis and the pattern is fairly irregular; grade 3: many undifferentiated cells; tissue origin can be difficult to recognize; many cells are undergoing mitosis; grade 4: the least differentiated and high degrees of malignancy; this system of grading tumors is used to report the prognosis of the disease and to determine whether the tumor is likely to respond to radiation therapy or chemotherapy as well as the prognosis for surgery
can be the treatment of choice when the tumor is small and localized and the surrounding tissue us accessible for removal; the aim of surgery is to remove all cancerous tissue plus some of the surrounding normal tissue; surgery is also used to alleviate some of the complications of cancer, such as the obstruction of an area caused by the enlargement of a tumor; a type of microscopically controlled surgery, Mohs, created by a general surgeon, Dr. Frederic E. Mohs, can be used to remove the two most common forms of skin cancer, basal cell carcinoma and squamous cell carcinoma; the Mohs procedure is essentially a pathology sectioning method that allows for the complete examination of the surgical margin, while the patient is still present in the office; it is different from the standard technique of sectioning in which random samples of the surgical margin are examined, sent to a lab for analysis and then the patient is notified of the results and if indicated must schedule another visit for further treatment; the Mohs surgery is performed in four steps during one visit: surgical removal of tissue, mapping the piece of tissue, freezing and cutting the tissue between 5 and 10 micrometers using a cryostat (device for maintaining very low [cold' temperatures) and staining with hematoxylin and eosin, a popular stain used in medical diagnosis, interpretation of microscope slides for the presence of cancerous cells, reconstruction of the surgical site as needed; the procedure is usually performed in a physician;s office using a local anesthetic; a small scalpel is utilized to cut around the visible tumor; a very small surgeon margin is utilized usually with 1 to 1.5 mm of free margin or uninvolved skin; the amount of free margin removed is much less than the usual 4 to 6 mm required for the standard excision of skin cancers; after each surgical removal of tissue, the specimen is processed, cut on the cryostat and placed on slides, stained with H&E and then read by the Mohs surgeon/pathologist who examines the sections for cancerous cells; if cancer is found its location is marked on the map (drawing of the tissue) and the surgeon removes the indicated cancerous tissue from the patient; this procedure is repeated until no further cancer is found
use of ionizing radiation; in all cases, this treatment seeks to deliver a precise calculated dose of radiation to a tumor, while causing the least possible damage to surrounding normal tissue; can be defined as the process whereby, energy is beamed from its source to a selected target tissue; substances that emit radiation are said to be radioactive; malignant cells are more sensitive to radiation because these cells divide frequently making the DNA replication more vulnerable to destruction; radiation is frequently used as either a curative or a palliative mode of therapy; certain types of cancer cells can be destroyed by radiation therapy this preventing the unrestrained growth of such tumors; in other cancers, radiation has only a palliative effect, preventing cell growth, reducing pain, pressure and bleeding but not providing complete tumor destruction; important factors that must be considered when determining the use of radiotherapy for the cancer patient include the following: the tumor must be surrounded by normal tissue that can tolerate the radiation and then repair itself; the tumor must not be widespread, if the tumor has metastasized, radiation can be used as a palliative form of treatment; the tumor must be moderately sensitive to radiation (a radiosensitive tumor); radiotherapy is often the treatment of choice for cancers of the skin, uterus, cervix or larynx or those located within the oral cavity; with other types of cancer, radiotherapy is frequently used in combination with other forms of treatment, including surgery and chemotherapy
the most common cancer among women; the majority of cases are sporadic, meaning there is not a family history of breast cancer, as opposed to genetic, in which genes predispose a person to the disease; men can also develop breast cancer, but it accounts for less than 1% of breast cancer cases; early detection of breast cancer is extremely important; the five year survival rate for women wit localized and properly treated breast cancer is about 97%; for all stages of breast cancer, it is about 87%; if cancer is not detected and treated early it will continue to grow, invade, and destroy adjacent tissue and spread into surrounding lymph nodes; it can be carried by the lymph and blood to other areas of the body and once this process, known as metastasis, has occurred, the cancer is usually advanced and/or disseminated and the five year survival rate is low; approximately 50% of malignant tumors of the breast appear in the upper outer quadrant and extend into the armpit; eighteen percent of breast cancers occur in the nipple area, 11% in the lower outer quadrant and 6% in the inner quadrant; sign and symptoms of breast cancer are generally insidious and may include: unusual secretions from the nipple, changes int he nipple's appearance, nontender movable lump, well localized discomfort that may be described as burning, stinging or aching sensation, dimpling or peau d'orange (orange peel appearance) may be present over the area of cancer of the breast, asymmetry and an elevation of the affected breast, nipple retraction, pain in the later stages; stages of breast cancer indicate the size of a tumor and how far the cancer has spread within the breast, to nearby tissues and to other organs; specific treatment is most often determined by the following stages of the disease: carcinoma in situ--cancer is confined to the lobules (milk producing glands) or ducts (passages connecting milk producing glands to the nipple) and has not invaded nearby breast tissue; also referred to as ductal carcinoma in situ; stage 1: tumor is smaller then or equal to 2 cm in diameter and axillary (underarm) lymph nodes test negative for cancer; stage 2: tumor is between 2 and 5 cm in diameter with or without positive lymph nodes, or tumor is greater than 5 cm without positive lymph nodes; stage 3: this stage is divided into substage known as IIIA and IIIB--IIIA=tumor is larger than 5 centimeters with positive movable lymph nodes, or tumor is any size with lymph nodes that adhere to one another or surrounding tissue and IIIB=tumor of any size has spread to the skin, chest wall, or internal mammary lymph nodes (located beneath the breast and inside the chest); stage 4: tumor regardless of size has metastasized (spread) to distance sites such as bones, lungs or lymph nodes not near the breast; recurrent breast cancer--the disease has returned in spite of initial treatment; in 2012 a study funded by the national cancer institute and the national human genome research institute, both part of the national institutes of health revealed genomic similarities between breast cancer and ovarian cancer; it was found that one subtype of breast cancer shared many genetic features with high grade serous ovarian cancer; the findings suggest that the two cancers are of similar molecular origin, which may facilitate the comparison of therapeutic data for subtypes of breast an ovarian cancers; analysis of genomic data have confirmed that there are four primary subtypes of breast cancer, each with its own biology and survival outlooks; the four groups are called intrinsic subtypes of breast cancer: HER2-enriched (HER2E), luminal A (LumA), Luminal B (LumB) and basal like; more than 90% of all breast lumps are discovered by women themselves; the majority of these lumps are benign but for those that are not early detection and treatment are essential; a woman should examine her breasts every month; check for appearance, size, shape, symmetry, tenderness, thickening, and texture changes
cancers that begin in the lungs are divided into two major types, non-small cell lung cancer and small cell lung cancer, depending on how the cells look under a microscope; each type of lung cancer grows and spreads in different ways and is treated differently; there are three main types of non-small cell lung cancer; they are named for the type of cells in which the cancer develops: squamous cell carcinoma (also called epidermoid carcinoma), adenocarcinoma, and large cell carcinoma; small cell lung cancer, sometimes called oat cell cancer, is less common than non-small cell lung cancer; this types of lung cancer grows more quickly and is more likely to spread to other organs in the body; to diagnose lung cancer, the doctor evaluates a person's medical history, smoking history, exposure to environmental and occupational substances and family history of cancer; the doctor also performs a physical exam and may order a chest x-ray and other tests; if lung cancer is suspected, sputum cytology (the microscopic examination of cells obtained from a deep cough sample of mucus in the lungs) is a simple test that may be useful in detecting lung cancer; to confirm the presence of lung cancer the doctor must perform a biopsy and examine tissue from the lung; treat depends on a number of factors, including the type of lung cancer (non-small or small cell lung cancer); the size, location, and extent of the tumor; and the general health of the patient; many different treatments and combinations of treatments may be used for lung cancer such as surgery, chemotherapy, radiation therapy, or photodynamic therapy
a disease in which malignant cells form in the tissues of one or both testicles; it is the most common cancer in men age 20 to 35; in a given year about 7500 American men are diagnosed with this type of cancer; most testicular tumors are discovered by patients themselves, either by accident or while performing a testicular self examination; it is most important that testicular cancer be diagnosed early so young men should be taught how to examine their testicles; the most common presenting sign of testicular cancer is of an enlarges, painless lump or swelling in either testicle; the lump typically is pea-sized but sometimes it might be as big as a marble or even an egg; occasionally there may be pain; with early detection, the survival rates for testicular cancer are approximately 95% at five years for seminomas and nonseminomas localized to the testis; nearly all testicular tumors stem from germ cells, the special sperm forming cells within the testicles; these tumors fall into one of two types, seminomas or nonseminomas; other forms of testicular cancer, such as sarcomas or lymphomas are extremely rare; testicular cancer is diagnosed by a medical history and physical examination, ultrasound, serum tumor marker test and a radical inguinal orchidectomy including a tissue biopsy; a seminoma, a cancerous tumor of the testis, is diagnosed by biopsy; imaging tests such as chest x-ray, computed tomography are often utilized to assess the spread of the disease and the staging of the cancer; staging allows the doctor to plan the most appropriate treatment for each patient; stages of testicular cancer are as follows: stage 1: cancer confined to the testicle; stage 2: disease spread to retroperitoneal lymph nodes, located in the rear of the body below the diaphragm; stage 3: cancer spread beyond the lymph nodes to remote sites in the body, such as the lungs and/or liver; recurrent: recurrent disease means that the cancer has come back after it has been treated; it may come back in the same place or in another part of the body; no one treatment works for all testicular cancers; because certain treatments can cause infertility, the patient who wishes to have children should consider sperm banking before beginning treatment