Define Staging
Process of finding out how much cancer is in a person’s body & where it is located
What does staging help with?
Treatment plans
Predict person’s prognosis
Main Factors in Staging
Location of primary tumor
Tumor size & extent of tumors
Lymph node involvement
Presence or absence of distant metastasis
How are cancers staged?
Imaging
Lab tests
PE
Pathology reports
Types of Staging
Clinical staging
Pathologic staging
Define Clinical Staging
Estimate of the extent of cancer based on results
Most Common Staging System
TNM
What does TNM stand for?
T: primary tumor
N: nodes
M: metastasis
What information about the primary tumor is given with the T number?
Size
How deep it has grown into the organ
If it has grown into nearby tissues
Define TX
Tumor can’t be measured
Define T0
No evidence of primary tumor
DefineTis
Cancer cells are only growing into most superficial layers
Define N in the TNM Staging
Describes whether the cancer has spread into the lymph nodes
Define NX
Nearby lymph nodes can’t be evaluated
Define N0
Nearby lymph nodes do not contain cancer
Meaning of Numbers After N
Size
Location
# of nodes
Define M in the TNM Staging
Tell whether cancer has spread to a distant body part
Define M0
No cancer spread was found
Define M1
Cancer has spread to distant organs or tissues
Stage 0
Carcinoma in situ
Stage I, II, III
Higher numbers indicate more extensive disease
Stage IV
Cancer has spread to distant tissues or organs
Other Staging Terms
In situ Localized Regional Distant Unknown
Define Localized
Limited to place where it started
No spread
Define Regional
Nearby lymph nodes
Define Distant
Distant part of the body
Ex: brain, liver, bones
Tumor Types
Carcinoma Sarcoma Leukemia Lymphoma Multiple Myeloma Melanoma Brain & Spinal Cord Tumors Others
Define Carcinoma
Cancer formed by epithelial cells
Ex: adenocarcinoma, BCC, SCC, transitional cell carcinoma
Define Adenocarcinoma
Cancer that produces fluids or mucus
Define Basal Cell Carcinoma
Cancer that begins in the base layer of epidermis
Define Squamous Cell Carcinoma
Cancer in the epithelial cells that lie just beneath the outer surface of the skin, stomach, intestines, lungs, bladder, & kidneys
Define Transitional Cell Carcinoma
Cancer in the epithelial cells called transitional epithelium or urothelium
Define Sarcoma
Cancers that form in bone & soft tissue
Most Common Cancer of the Bone
Osteosarcoma
Most Common Soft Tissue Cancers
Leiomyosarcoma
Kaposi sarcoma
Malignant fibrous histiocytoma
Define Leukemia
Cancers that begin in the blood-forming tissue of the bone marrow
4 Common Types of Leukemia
Acute Lymphoblastic (ALL) Acute Myeloid (AML) Chronic Lymphoblastic (CML) Chronic Myeloid (CML)
Define Lymphoma
Cancer that begins in the lymphocytes (T or B cells)
2 Main Types of Lymphoma
Hodgkin’s
Non-Hodgkin’s
Define Multiple Myeloma
Cancer that begins in the plasma cells
Define Brain & Spinal Cord Tumors
Named based on type of cell they formed & where tumor first formed in the CNS
Other Types of Tumors
Germ Cell tumors
Neuroendocrine tumors
Carcinoid tumors
Define Neuroendocrine Tumors
Release hormones into the blood
Define Carcinoid Tumors
Serotonin release
Define Adenocarcinoma
Cancer that forms in mucus-secreting glands throughout the body
Types of Adenocarcinomas
Lung CA Prostate CA Pancreatic CA Esophageal CA Colorectal CA
Where do the pancreatic adenocarcinomas form?
Pancreatic ducts
Where is the cancer found in esophageal adenocarcinoma?
Glandular cells
Where is the cancer found in colorectal adenocarcinoma?
Intestinal gland cells that line inside of colon or rectum
2 Types of Small Cell Lung Cancer
Oat cell
Combined small cell
3 Sub-types of Non-Small Cell Lung Cancer
SCC
Large cell carcinoma
Aenocarcinoma
2 Types of Carcinoid Tumors
Lung
Gastrointestinal
2 Types of Lung Carcinoid Tumors
Typical
Atypical
Where do gastrointestinal carcinoid tumors form?
Stomach
Small intestine
Rectum
Appendix
Where are squamous cells found?
Tissue that forms the surface of the skin, lining of hollow organs, lining of the respiratory tract & digestive tracts
Where are clear cells found?
Breast, on the skin, lower urinary tract, & organs of female reproductive system
Renal cell carcinoma
Define Germ Cell Carcinoma
Cells that develop in the embryo & become the cells that make up the reproductive system
Where do germ cell carcinomas arise?
Ovaries/Testes (most common) Head Chest Abdomen Pelvis Lower back
Different Types of Germ Cell Carcinomas
Teratomas Germinomas Endodermal sinus tumor/yolk sac tumor Choriocarcinoma Embryonal carcinoma
Define Myxoma
Myxoid tumor of primitive connective tissue
Most Common Primary Tumor of the Heart in Adults
Myxoma
What does a pathology report entail?
Diagnosis determined by examining cells & tissue under a microscope
Gross description form pathologist
Types of Tissue Biopsy
Fine needle
Open (punch, excision)
Surgical excision
Cytology (from fluid)
Tissue Processing
Permanent section
Frozen section
Information Within a Pathology Report
Patient information Gross description Microscopic description Diagnosis Tumor size Tumor margins Other information Pathologist's signature
Diagnostic Terms Used on a Pathology Report
Abscess Atypical Carcinoma Dysplasia Granuloma Hyperplasia Metaplasia Well differentiated Poorly differentiated Mitotic rate/index
Define Atypical on a Pathology Report
Vague warning but not worried enough to call it cancer
Define Carcinoma on a Pathology Report
Neoplasm derived from epithelium
Define Dysplasia on a Pathology Report
Atypical proliferation of cells
Define Granuloma on a Pathology Report
Type of inflammation characterized by accumulations of macrophages which combine into “giant cells”
Define Hyperplasia on a Pathology Report
Proliferation of cells which is not neoplastic
Define Metaplasia on a Pathology Report
One type of cell is replaced with another type of cell
Define Well Differentiated on a Pathology Report
How much or how little tumor tissue looks like normal tissue it came from
Define Poorly Differentiated on a Pathology Report
Lack the structure & function of normal cells & grow uncontrollable
Define Mitotic Rate
Measure of how fast cancer cells are dividing & growing