View stunning SlideShares in full-screen with the new iOS app!Introducing SlideShare for AndroidExplore all your favorite topics in the SlideShare appGet the SlideShare app to Save for Later — even offline
View stunning SlideShares in full-screen with the new Android app!View stunning SlideShares in full-screen with the new iOS app!
Grading : based on the degree of malignancy , how alike the cells are to the parent tissue or “differentiated”
Grade 1 – most differentiated
Grade 4 least differentiated, most malignant
Staging : general extent of cancer and spread of disease rather than cell appearance
Stage 1 – No invasion of other tissues, localized
Stage IV – Metastasized to distant parts
Grading and Staging of Tumors M0 = no evidence metastasis M1 – distant metastasis present (specify site/s) N0 - indicates no abnormal lymph nodes detected N1 – minimal involvement N2,N3,N4 progressively more involvement more involvement T0 - no evidence of metastasis Tis – tumor is in epithelial tumor is in epithelial T1 T1 –minimal size and extension T2, T3, T4 – progressively larger and extensive larger and extensive M = distant metastases N=lymph node involvement T=Primary Tumor Size
Benign – obstruct lumen of tubular structure such as ureters, trachea, or intestinal tract
Intraspinal or intracranial – pressure within the close space
Destroy or infiltrate surrounding tissues
Systemic Effects Metastastic implant in abdomen in pleural cavity Ascitis, pleural effusion General disorders Malabsorption, chronic blood loss, impaired digestion Weakness, fatigue, weight loss GI Degenerative changes as in central nervous system and respiratory Cachexia, weakness, cerebellar disease, pneumonia Neuromuscular Blood vessel erosion by tumor Hemorrhage Vascular Cause Problems
PSA prostate specific antigen (0.4ng/ml) increases
CEA – carcino embryonic antigen
Most commonly ordered when a patient has a cancer of the GI system-colon, rectum, stomach, esophagus, liver, or pancreas
Once treatment for the cancer has begun, CEA tests have a valuable role in monitoring the patient's progress. A decreasing CEA level means therapy is effective in fighting the cancer. A stable or increasing CEA level may mean the treatment is not working, and/or that the tumor is growing.
AFP – Alpha-fetoprotein
Used to detect tumors that mark cancers of the liver, testes, ovaries
The higher the AFP level in patients with cancer, the bigger the tumor. AFP decreases when your body responds to anti-cancer therapy. If AFP does not return to normal within about one month after cancer therapy, some of the tumor may still be present.
This refers to the removal of part of the tumor from the larger tumor mass. An incisional biopsy is employed for tumors located deep within the body and after an initial needle biopsy has failed to supply enough tissue for diagnosis.
(2) Excisional Biopsy
Also known as surgical biopsy, the excisional biopsy entails the surgical removal of the entire tumor mass and is a diagnostic technique that simultaneously serves as a treatment
(3)Needle Aspiration Biopsy
Removal of a sample of fluid and cells through a needle.
(4)Cytology Biopsy- deals with the formation, structure, and function of cells The removal and examination of a sample of tissue for diagnostic purposes
A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected and travels through the bloodstream. It collects in the bones, especially in abnormal areas of the bones, and is detected by special instrument called a scanner. The image of the bones is recorded on a special film for permanent viewing.
Direct Imaging Tests
Fiberoptic endoscopy - use of a very flexible tube with a lens or camera (and a light on the end), which is connected to a computer screen, allowing the physician to see inside the body cavities, such as the uterus or upper GI, to examine the area in question for any abnormality Biopsy samples can be taken through the tube.
Computed tomography (CT or CAT scan) - a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray. The CT scan may indicate enlarged lymph nodes - a possible sign of a spreading cancer or of an infection.
Radionuclide scan - an imaging scan in which a small amount of radioactive substance is injected into the vein. A machine measures levels of radioactivity in certain organs, thereby detecting any abnormal areas or tumors.
Ultrasound – non-invasive - an imaging technique that uses sound waves to produce an image on a monitor of the abdominal organs, such as the uterus, liver, and kidneys. A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram or ultrasonogram
Magnetic resonance imaging (MRI) - a non-invasive procedure that produces a two-dimensional view of an internal organ or structure, especially the brain and spinal cord. The MRI may show abnormal nodules in bones or lymph nodes - a sign that cancer may be spreading.
Mammogram – non invasive - A low voltage X-ray photograph of the breast. It allows early detection of malignant or benign tumors and other microcalcification-containing lesions
( a) Upper GI - X-rays of the esophagus, stomach, and duodenum (the first section of the small intestine). The patient swallows barium first. Barium makes the organs show up on x-rays. The upper GI series can show a blockage, abnormal growth, ulcer, or a problem with the way an organ is working.
(b) Lower GI -X-rays of the rectum, colon, and lower part of the small intestine. A barium enema is given first. Barium coats the organs so they will show up on the x-ray.
Barium enema is used to check for tumors of the colon and rectum. It also can check for polyps (abnormal growths attached to the intestinal lining by a stalk), diverticulosis or other problems.
Tumor markers are measurable biochemicals that are associated with a malignancy. They are either produced by tumor cells (tumor-derived) or by the body in response to tumor cells (tumor-associated). They are typically substances that are released into the circulation and thus measured in the blood
CEA (carcinoembryonic antigen) is a protein found in many types of cells but associated with tumors
PSA - Prostate-specific antigen. A substance produced by the prostate that may be found in an increased amount in the blood of men who have prostate cancer, benign prostatic hyperplasia, or infection or inflammation of the prostate
Acid Phosphatase - an enzyme found throughout the body, but primarily in the prostate gland. Acid phosphatase testing is done to diagnose whether prostate cancer has metastasized and to check the effectiveness of treatment.
CBC A complete blood count (CBC) provides important information about the RBC red blood cells , WBC white blood cells , and platelets.
A CBC evaluate symptoms (such as weakness, fatigue, or bruising) and diagnose conditions (such as anemia, infection, and many other disorders) and diagnose diseases of the blood, such as leukemia.
The number of white blood cells is sometimes used to identify an infection or monitor the body's response to cancer treatment.
Monitor the response to some types of drug or radiation treatment.
Hemetest- detects blood in stool
CA-125 -A protein that can be made by abnormal ovary cells. It can be a tumor marker. If it is present in high levels in the blood or in other body fluids or tissues, it may be a sign of ovarian cancer
laboratory tests to examine any/all of the following:
biopsy to remove a sample of the suspicious tissue for examination in a laboratory by a pathologist
Thinprep - A Pap Test Alternative Approved by the US Food and Drug Administration (FDA), Thinprep is a liquid-based procedure in which cells from the cervix are put into a vial of liquid instead of being "smeared" onto a slide. The liquid is then filtered and only the cervical cells are placed onto a slide for examination.