CANCER STAGING AND TUMOR TYPES

Question 1

What is staging?

Answer 1

Process of finding out how much cancer is in a person’s body and where it is located

Staging helps with treatment plans and predict a person’s prognosis

Question 2

CANCER STAGING

The stage is based on four main factors?

Answer 2

1. Location of the primary tumor
2. Tumor size and extent of tumors
3. Lymph node involvement
4. Presence or absence of distant metastasis

Question 3

CANCER STAGING
1. Why is staging needed? 3

2. What is looked at when staging cancer? 5
3. How are cancers staged? 5

Answer 3

1. • Amount of cancer
   • Where in the body
   • Best treatment

For example, the treatment for an early-stage cancer may be surgery or radiation, while a more advanced-stage cancer may need to be treated with chemotherapy.

2. • Tumor size
   • Location
   • Extent of growth
   • Lymph nodes
   • Spread to distant areas
3. • Physical exam
   • Imaging studies
   • Laboratory test
   • Pathology reports
   • Surgical reports

Question 4

What are the types of staging?

4

Answer 4

1. Clinical staging
   - Estimate of the extent of cancer based on results
2. Pathologic staging
   - Surgical stage
3. Post-Therapy/Post-Neoadjuvant -Therapy Staging
4. Restaging

Question 5

Cancer staging: The TNM system?

Answer 5

T stands for the primary tumor

N stands for nodes

M stands for metastasis

Question 6

T category gives info about primary tumor: Such as?

Answer 6

1. Size
2. How deep it has grown into the organ it started
3. If it has grown into nearby tissues

Question 7

CANCER STAGING: Describe what the followng mean:

TX?

T0?

Tis?

Numbers after the T (T1-T4)?
3

Answer 7

TX: Means tumor can’t be measured

T0: Means there is no evidence of a primary tumor

Tis: Means that cancer cells are only growing into most superficial layers, without growing into deeper tissues

T (T1-T4):

• Describe the tumor size
• Amount of spread into nearby tissues
• Higher the T number, the larger the tumor and spread to nearby tissue

Question 8

1. N category describes what?
2. NX?
3. N0?
4. Numbers after the N? (1-3)

Answer 8

1. N category describes whether the cancer has spread into the lymph nodes
2. NX: Means the nearby lymph nodes can’t be evaluated
3. N0: Means nearby lymph nodes do not contain cancer
4. Numbers after the N (N1-N3)

Question 9

1. M category describes what?
2. M0?
3. M1?

Answer 9

1. M category tell whether cancer has spread (metastasized) to distant body parts
2. M0: Means that no cancer spread was found
3. M1: Means cancer has spread to distant organs or tissues

Question 10

Stage grouping
Once TNM has been determined, cancer is staged in what?

Describe each stage:

1. I?
2. IV?
3. Stage 0?

Answer 10

Roman numerals I-IV

1. I is least advanced
2. IV is most advanced
   - Some will be subdivided with A & B (IIA, IIIB)
3. Stage 0 is carcinoma in situ for most cancers

Question 11

Describe severity of Stage I, Stage II, and Stage III?

Answer 11

Higher numbers indicate more extensive disease: Larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or tissues or organs adjacent to the location of the primary tumor

Question 12

Describe severity of stage IV?

Other staging terms? 5

Answer 12

The cancer has spread to distant tissues or organs

Other staging terms:

1. In situ
2. Localized
3. Regional
4. Distant
5. Unknown

Question 13

1. The stage of the cancer is determined only when what?
2. How does the stage change over time?
3. Survival statistics and info on treatment by stage refers to the stage when the cancer was what?
4. “Restaging” is what?
5. A ____ is written before the new stage

Answer 13

1. the cancer is first diagnosed
2. The stage does not change over time
3. first diagnosed
4. Term used to describe doing test to find the extent of the cancer after treatment
5. “r”

Question 14

TUMOR TYPES

8

Answer 14

1. Carcinoma
2. Sarcoma
3. Leukemia
4. Lymphoma
5. Multiple Myeloma
6. Melanoma
7. Brain and Spinal Cord Tumors
8. Other Types

Question 15

What is the most common type of cancer?

Answer 15

Carcinoma

Question 16

Carcinoma
1. Formed by what?

2. What are the two types?

Answer 16

1. epithelial cell
   - Cells that cover the inside and outside surfaces of the body
2. • Adenocarcinoma
   • Basal Cell
   • Squamous cell
   • Transitional cell

Question 17

What are the following types of carcinomas:

1. Adenocarcinoma
2. Basal Cell
3. Squamous cell
4. Transitional cell

Answer 17

1. Cancer that produce fluids or mucus
2. Cancer that begins in base layer of epidermis
3. Are epithelial cells that lie just beneath the outer surface of the skin
   - Also line the stomach, intestines, lungs, bladder and kidneys
4. Are epithelial cells called transitional epithelium or urothelium
   - Tissue made of many layers of epithelial cells that get bigger and smaller

Question 18

What is a sarcoma?

Answer 18

Cancers that form in bone and soft tissue

Question 19

1. What is the most common cancer of the bone?

2. Most common soft tissue cancer? 3

Answer 19

1. Osteosarcoma
2. • Leiomyosarcoma
   • Kaposi sarcoma
   • Malignant fibrous histiocytoma

Question 20

What is leukemia?

4 common types?

Answer 20

Cancers that begin in the blood-forming tissue of the bone marrow

4 common types

1. Acute lymphoblastic
2. Acute myeloid
3. Chronic lymphoblastic
4. Chronic myeloid

Question 21

1. What is lymphoma?

2. 2 main types?

Answer 21

Lymphoma
1. Cancer that begins in lymphocytes (T cells or B cells)

2. 2 main types
   - Hodgkin lymphoma
   - Non-Hodgkin lymphoma

Question 22

Where does multiple myloma originate?

Answer 22

Multiple Myeloma

Cancer that begins in plasma cells

Question 23

Brain and Spinal Cord Tumors
1. What are these tumors named after?

2. What tumor types are in the other category? 3

Answer 23

1. Named based on type of cell they formed and where tumor first formed in the CNS
2. Other Types
   - Germ cell tumors
   - Neuroendocrine tumors
   - Carcinoid tumors

Question 24

DISCRIPTION AND LOCATION
What is an adenocarcinoma?

Name the most common types of adenocarcinomas?
5

Answer 24

Cancer that forms in mucus-secreting glands throughout the body

1. Lung cancer
   -Non-small cell lung cancer
   80% of lung cancers
2. Prostate cancer
   - 99% of all prostate cancers
3. Pancreatic cancer
   - Exocrine pancreatic cancer forms in pancreas ducts
4. Esophageal cancer
   - Cancer in the glandular cells
   - Most common type of esophageal cancer
5. Colorectal cancer
   -Cancer in intestinal gland cells that line inside of colon or rectum
   95% of colon and rectal cancers

Question 25

DISCRIPTION AND LOCATION 1. What are the two types of small lung cell cancers? 2. What are the main types of non-small cell lung cancers? 3

Answer 25

``` 1. Small Cell Lung Cancer 2 types -Oat cell -Combined small cell (uncommon) 10-15% of all lung cancers ``` ``` 2. Non-Small Cell Lung Cancer 85-90% of lung cancer 3 main sub-types -Squamous cell carcinoma -Large cell carcinoma -Adenocarcinoma ```

Question 26

DISCRIPTION AND LOCATION Carcinoid Tumors 2 types?

Answer 26

1. Lung 10% of all carcinoid tumors 1-6% of all lung tumors 2. Gastrointestinal

Question 27

Carcinoid Tumors- Lungs: Two types? Carcinoid Tumors- GI: Form in where? 4

Answer 27

1. 2 types - Typical - Atypical 2. Form in the - stomach, - small intestine, - rectum - appendix

Question 28

1. Describe what squamous cell carconomas look like? | 2. Found where? 3

Answer 28

1. Thin flat cells that look like fish scales 2. Found in - tissue that forms the surface of the skin, - lining of hollow organs, - lining of the respiratory tract and digestive tracts

Question 29

1. Clear cell tumors look like what? | 2. Found where? 4

Answer 29

1. Cells are clear or pale in color 2. Found in the - breast, - on the skin, - lower urinary tract and organs of female reproductive system - Also found in Renal Cell Carcinoma

Question 30

DISCRIPTION AND LOCATION 1. What is a germ cell carcinoma? 2. Tumors arise in where? 2 3. Extragonadal sites? 5

Answer 30

1. Germ Cell Carcinoma Cells that develop in the embryo and become the cells that make up the reproductive system 2. Tumors arise in the ovaries and testes 3. Extragonadal sites: - Head - Chest - Abdomen - Pelvis - Lower back

Question 31

Germ Cell Carcinoma types? | 5

Answer 31

1. Teratomas 2. Germinomas 3. Endodermal sinus tumor/yolk sac tumor 4. Choriocarcinoma 5. Embryonal carcinoma

Question 32

1. What is a myxoma? | 2. Its the most primary tumor of the what?

Answer 32

1. Myxoid tumor of primitive connective tissue | 2. Most common primary tumor of the heart in adults

Question 33

What is a path report?

Answer 33

A document that contains the diagnosis determined by examining cells and tissue under a microscope The report contains a gross description from the pathologist

Question 34

What kind of tissue biopsies could you get for the path report? 4

Answer 34

1. Fine needle 2. Open biopsy - Punch - Excisional 3. Surgical excision 4. Cytology

Question 35

Describe the following types of tissue processing: 1. Permanent section? 3 steps 2. Frozen section? 2 steps

Answer 35

Permanent section 1. Tissues are placed in fixative (formalin) 2. Then processed into additional solutions and final is paraffin wax 3. Then tissues are cut into thin slices, placed on slides and stained Frozen section 1. Freezing and slicing tissue sample 2. Takes about 15-20 minutes

Question 36

What information is on the Path report? | 8

Answer 36

1. Patient information 2. Gross description 3. Microscopic description 4. Diagnosis 5. Tumor size 6. Tumor margins 7. Other information 8. Pathologist’s signature

Question 37

Diagnostic terms on the Path report?

Answer 37

1. Abscess 2. Atypical 3. Carcinoma 4. Dysplasia 5. Granuloma 6. Hyperplasia 7. Metaplasia 8. Well-differentiated 9. Poorly differentiated 10. Mitotic rate

Question 38

What do the following diagnostic terms mean on the Path report: 1. Atypical? 2. Carcinoma? 3. Dysplasia? 4. Granuloma? 5. Hyperplasia? 6. Metaplasia? 7. Well differentiated? 8. Poorly differentiated? 9. Mitotic rate?

Answer 38

1. A vague warning but not worried enough to call it cancer 2. Neoplasm derived from epithelium 3. An atypical proliferation of cells 4. Type of inflammation characterized by accumulations of macrophages which combine into “giant cells” 5. Proliferation of cells which is not neoplastic 6. One type of cell is replace with another type of cell 7. How much or how little tumor tissue looks like normal tissue it came from 8. Lack the structure and function of normal cells and grow uncontrollable 9. A measure of how fast cancer cells are dividing and growing