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2. Symptoms:
Breast Cancer:
•Early Stages: A painless lump in the breast, changes in breast shape or size, nipple discharge, skin changes.
•Advanced Stages: Bone pain, unexplained weight loss, persistent cough.
Lung Cancer:
•Early Stages: Persistent cough, coughing up blood, chest pain, shortness of breath.
•Advanced Stages: Fatigue, unexplained weight loss, hoarseness, difficulty swallowing.
Colorectal Cancer:
•Early Stages: Changes in bowel habits, blood in the stool, abdominal pain, unexplained weight loss.
•Advanced Stages: Anemia, bowel obstruction, fatigue.
Prostate Cancer:
•Early Stages: Difficulty urinating, frequent urination, blood in the urine, erectile dysfunction.
•Advanced Stages: Bone pain, leg swelling.
Ovarian Cancer:
•Early Stages: Abdominal bloating, pelvic pain, changes in bowel habits.
•Advanced Stages: Ascites (fluid accumulation in the abdomen), loss of appetite, unexplained
weight loss.
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3. Symptoms:
Pancreatic Cancer:
•Early Stages: Abdominal pain, jaundice, unexplained weight loss.
•Advanced Stages: Digestive problems, back pain, blood clots.
Skin Cancer:
•Melanoma: Changes in the size, shape, or color of moles, new growths on the skin.
•Non-Melanoma (Basal Cell Carcinoma, Squamous Cell Carcinoma): Persistent sores, growths, or changes in the skin.
Leukemia:
•Common Symptoms: Fatigue, weakness, frequent infections, unexplained weight loss.
•Specific Types may have Additional Symptoms: Bruising, nosebleeds, bone pain.
Lymphoma:
•Enlarged Lymph Nodes: Painless swelling, often in the neck, armpit, or groin.
•Other Symptoms: Fever, night sweats, unexplained weight loss.
Brain Tumors:
•Headaches: Especially in the morning or with changes in position.
•Nausea and Vomiting: Especially in the morning.
Symptoms are observable or subjective signs of a disease, including physical, emotional, or cognitive changes,
serving as indicators for diagnosis. They vary in severity, duration, and individual experience, guiding healthcare
professionals in understanding and addressing underlying health issues.
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4. Why family history is important ?
Identification of Hereditary Cancer Syndromes:
• Certain cancers have a hereditary component, meaning they can run in families. A strong family history of specific
cancers may suggest the presence of hereditary cancer syndromes, such as BRCA1 or BRCA2 mutations associated
with breast and ovarian cancer, Lynch syndrome associated with colorectal and other cancers, or others.
Risk Assessment:
• A detailed family history helps assess an individual's overall risk of developing cancer. If several close relatives on
one side of the family have had a particular type of cancer, it may indicate a higher risk for other family members.
Early Detection and Screening:
• Family history may prompt healthcare providers to recommend earlier and more
frequent cancer screenings. For example, individuals with a family history of colorectal
cancer might be advised to start screening earlier than the general population.
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5. Definition:
• Cancer Screening:
Cancer screening
involves the
systematic
application of tests,
examinations, or
procedures to
identify individuals
at risk of
developing cancer
or those who may
have early-stage
cancer, often
before symptoms
appear.
• Cancer Diagnosis:
Cancer diagnosis
refers to the
process of
identifying and
confirming the
presence of cancer
in an individual
who exhibits signs,
symptoms, or
abnormal test
results.
Purpose:
• Cancer Screening:
The primary goal of
cancer screening is
early detection,
often in
asymptomatic
individuals, to
increase the
chances of
successful
treatment or
prevention of
cancer.
• Cancer Diagnosis:
The purpose of
cancer diagnosis is
to confirm the
presence of cancer
in individuals who
are symptomatic or
have abnormal
screening results,
allowing for specific
identification of the
type, stage, and
characteristics of
the cancer.
Timing:
• Cancer Screening:
Screening is
typically performed
in individuals
without symptoms
at regular intervals,
aiming to detect
cancer at an early,
more treatable
stage.
• Cancer Diagnosis:
Diagnosis occurs
when symptoms
are present, or
abnormalities are
detected through
screening tests,
leading to further
evaluation and
confirmation.
Methods:
• Cancer Screening:
Involves various
tests, examinations,
or procedures such
as mammography,
Pap smear,
colonoscopy, blood
tests (e.g., PSA),
and imaging studies
to identify
individuals at risk or
in early stages of
cancer.
• Cancer Diagnosis:
Includes a more
comprehensive set
of diagnostic
procedures, such as
biopsies, imaging
studies (MRI, CT
scans), laboratory
tests (tumor
markers), and
pathological
examinations of
tissues, to confirm
the presence of
cancer, determine
its type, and assess
its characteristics.
Risk Assessment:
• Cancer Screening:
Often targeted at
specific populations
or individuals with
known risk factors
for certain types of
cancer.
• Cancer Diagnosis:
Initiated based on
symptoms,
abnormalities
found in screening,
or specific risk
factors identified
during the
diagnostic process.
Outcome:
• Cancer Screening:
A negative
screening result
suggests no
apparent signs of
cancer at that point
in time. A positive
result may indicate
the need for further
diagnostic testing.
• Cancer Diagnosis:
Confirms the
presence of cancer,
allowing for the
development of a
treatment plan
based on the type,
stage, and
characteristics of
the cancer.
Frequency:
• Cancer Screening:
Conducted at
regular intervals
based on guidelines
and risk factors,
even in the absence
of symptoms.
• Cancer Diagnosis:
Initiated when
symptoms are
present, or
abnormalities are
detected, leading to
a diagnostic
workup.
6. Clinical / Physical method :
A thorough physical examination includes inspection, palpation, percussion, and
auscultation to assess general health and detect abnormalities.
Specific attention is given to the region where cancer symptoms are reported or suspected.
The main key point of physical examination :
Inspection : By looking at the person of a specific body parts.
Auscultation : By listening sound of the body.
Palpitation: Palpation in clinical examination is the hands-on
technique of feeling and assessing different body parts to gather
information about size, shape, and abnormalities.
Percussion: It is a method of producing a sound by tapping body
parts with fingers , hands or small instruments.
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7. Lymph Node Examination:
Palpation of lymph nodes to check for
enlargement or tenderness, as this may
indicate the spread of cancer.
Oral Examination:
Inspection of the mouth and throat for
signs of oral cancers.
Clinical / Physical method :
Abdominal Examination:
Palpation and percussion of the abdomen
to identify any masses or organ
enlargement.
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9. X-rays:
• Purpose: Detects abnormalities in bones and some soft tissues.
• Common Uses: Chest X-rays for lung cancer, Bone cancer detection.
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10. Mammography:
•Purpose: X-ray imaging of the breasts to detect and diagnose breast cancer.
•Common Uses: Breast cancer screening and diagnosis.
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11. Computed Tomography (CT) Scan:
•Purpose: Produces detailed cross-sectional images of the body.
•Common Uses: Staging and locating tumors in various organs.
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12. Magnetic Resonance Imaging (MRI):
•Purpose: Provides detailed images using magnetic fields and radio waves.
•Common Uses: Brain and spinal cord imaging, breast cancer evaluation.
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13. Fluoroscopy:
•Purpose: Real-time X-ray imaging to visualize moving structures.
•Common Uses: Guiding certain procedures, such as biopsies or angiography.
Angiography:
•Purpose: X-ray imaging of blood vessels.
•Common Uses: Assessing blood supply to tumors before surgery or embolization.
Ultrasound:
•Purpose: Uses sound waves to create images of organs and tissues.
•Common Uses: Assessing tumors in the liver, uterus, prostate, and other areas.
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14. Positron Emission Tomography (PET) Scan:
•Purpose: Detects areas of increased metabolic activity, highlighting cancer cells.
•Common Uses: Staging and monitoring treatment response.
Bone Scan:
•Purpose: Detects abnormalities in bones, such as metastases.
•Common Uses: Evaluating bone involvement in various cancers.
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17. Needle Biopsy:
•Fine Needle Aspiration (FNA): A thin, hollow needle is used to withdraw a small sample of cells or fluid from a
suspicious area. FNA is often used for sampling cysts or solid masses, such as those in the breast or thyroid.
•Core Needle Biopsy: A larger, hollow needle is used to extract a small core of tissue from the suspicious area.
This method is commonly used for sampling breast, prostate, and lung abnormalities.
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18. Surgical Biopsy:
•Incisional Biopsy: A portion of the abnormal tissue is removed for examination. This type of biopsy
is often performed when the entire mass cannot be easily removed or when the lesion is large.
•Excisional Biopsy: The entire abnormal tissue, along with a margin of normal tissue, is removed.
Excisional biopsy is often used for smaller tumors or lesions.
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19. Endoscopic Biopsy:
•Endoscopy-Guided Biopsy: An endoscope, a thin, flexible tube with a camera, is used to visualize and guide the
biopsy instrument to the target area. This is commonly used for gastrointestinal and respiratory tract biopsies.
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20. Bone Marrow Biopsy:
•A needle is used to collect a small sample of bone marrow from the hipbone or sternum. Bone marrow biopsy is
often performed to diagnose blood disorders, leukemia, or to assess the spread of certain cancers.
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21. Skin Biopsy:
•Punch Biopsy: A circular tool is used to remove a small, cylindrical core of tissue from the skin. This type of biopsy
is often used for skin lesions or rashes.
•Shave Biopsy: A razor or scalpel is used to remove a thin slice of the abnormal skin tissue. Shave biopsies are
commonly performed for superficial skin lesions.
Punch Biopsy Shave Biopsy
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22. •Brush Biopsy: A brush is used to collect cells from the surface of an organ or lesion. It is often used in
the diagnosis of lesions in the respiratory or gastrointestinal tract.
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26. A tumor marker is a specific molecule or substance produced by
cancer cells or normal cells in response to the presence of cancer.
These markers can be detected in blood, urine, or tissues, and their
elevated levels may provide information about the presence, growth,
or activity of a tumor.
Tumor markers are often used in cancer diagnosis, prognosis, and
monitoring of treatment.
Tumour markers
Human body Tumour
Tumour
markers
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27. Types of Tumour
markers
Hormones (hCG; calcitonin;
gastrin; prolactin;)
Oncofetal antigens (CEA,
AFP)
Cancer antigen proteins &
glycoproteins (CA125; CA 15.3;
CA19.9)
Genetic changes
(mutations/translocations, etc.)
Receptors (ER, PR, EGFR)
Normal proteins
(thyroglobulin)
Enzymes (acid phosphatase;
alkaline phosphatase; PSA)
Metabolites (norepinephrine,
epinephrine)
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28. Importance Tumour Markers
• Determine risk (PSA)
• Screen for early cancer (calcitonin, occult blood)
• Diagnose a type of cancer (hCG, catecholamines)
• Estimate prognosis (CA125)
• Predict response to therapy (CA15-3, CA125, PSA, hCG)
• Monitor for disease recurrence or progression (most widely used function)
• Therapeutic selection (her2/neu, kras)
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29. 1.Alpha-fetoprotein (AFP): Associated Cancer: Hepatocellular carcinoma (liver cancer), germ cell tumors
2.Beta-human chorionic gonadotropin (β-hCG): Associated Cancer: Choriocarcinoma, germ cell tumors
3.CA-125 (Cancer Antigen 125): Associated Cancer: Ovarian cancer
4.CA 15-3: Associated Cancer: Breast cancer
5.CA 19-9: Associated Cancer: Pancreatic cancer, colorectal cancer
6.CA 27-29: Associated Cancer: Breast cancer
7.Calcitonin: Associated Cancer: Medullary thyroid cancer
8.Carcinoembryonic Antigen (CEA):Associated Cancer: Colorectal cancer, pancreatic cancer, breast cancer
9.PSA (Prostate-Specific Antigen):Associated Cancer: Prostate cancer
10.AFP-L3% (Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein):Associated Cancer:
Hepatocellular carcinoma (liver cancer)
11.HER2/neu (Human Epidermal Growth Factor Receptor 2):Associated Cancer: Breast cancer, some
types of stomach and esophageal cancers
12.Thyroglobulin:Associated Cancer: Thyroid cancer
13.NSE (Neuron-Specific Enolase):Associated Cancer: Neuroendocrine tumors, small cell lung cancer
14.CA 72-4:Associated Cancer: Gastric (stomach) cancer
15.HE4 (Human Epididymis Protein 4):Associated Cancer: Ovarian cancer
16.Ki-67:Associated Cancer: Marker of cell proliferation, used in various cancers for determining the growth
fraction of tumor cells
Tumour Markers
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31. Completed Blood Count
A Complete Blood Count (CBC) is a blood test that measures different components of the
blood, including red blood cells, white blood cells, and platelets.
Detection of Anemia:
•Connection to Cancer:
Some cancers, such as
colorectal cancer, can
lead to chronic bleeding,
resulting in anemia (low
red blood cell count).
•CBC Relevance: A CBC
can reveal a decrease in
hemoglobin and
hematocrit levels,
indicating the presence of
anemia.
Identification of Infections
or Inflammation:
•Connection to Cancer:
Cancer and certain cancer
treatments can weaken
the immune system,
making patients more
susceptible to infections.
•CBC Relevance: An
increase in the white
blood cell count
(leukocytosis) may
suggest the presence of
an infection or
inflammation, which can
be related to cancer.
Monitoring Bone Marrow
Function:
•Connection to Cancer:
Some cancers, such as
leukemia, directly affect
the bone marrow where
blood cells are produced.
•CBC Relevance:
Abnormalities in the
levels of different blood
cell types can indicate
dysfunction in the bone
marrow, prompting
further investigation.
Platelet Count for
Bleeding Disorders:
•Connection to Cancer:
Certain cancers, like
leukemia or liver cancer,
can affect platelet
production or function,
leading to bleeding
disorders.
•CBC Relevance: A CBC
includes a platelet count,
and abnormalities may
suggest a need for further
investigation into
potential bleeding
disorders associated with
cancer.
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32. A positive IHC test means that a marker or receptor is found on the cell during the
biopsy or indicates a certain change in the protein of the tumor. The positive result
indicates that the person might have inherited a genetic condition.
IHC test
1.Tumor Classification: IHC aids in the identification and classification of tumors based on the expression of
specific proteins. For example, the determination of hormone receptor status (ER, PR) in breast cancer.
2.Prognostic Evaluation: Certain proteins, such as Ki-67, serve as prognostic markers, offering insights into the
tumor's proliferative activity and potential aggressiveness.
3.Therapeutic Target Identification: IHC assists in pinpointing proteins that can be targeted by specific cancer
therapies. HER2/neu testing in breast cancer is a notable example guiding targeted treatment decisions.
4.Tumor Grading: IHC contributes to the grading of tumors by assessing the differentiation of cancer cells, aiding
in predicting the tumor's behavior.
5.Differential Diagnosis: IHC facilitates the distinction between different types of cancers or helps identify the
primary site of metastatic tumors.
6.Molecular Subtyping: IHC is instrumental in molecular subtyping, categorizing tumors into distinct molecular
subgroups based on protein expression patterns, guiding tailored therapeutic strategies.
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33. Kidney Function Tests
• Urinalysis:
A urinalysis screens for the presence of protein and blood in the urine.
• Serum creatinine test:
This blood test examines whether creatinine is building up in your blood. The kidneys usually completely
filter creatinine from the blood. A high level of creatinine suggests a kidney problem.
• Blood urea nitrogen (BUN):
The blood urea nitrogen (BUN) test also checks for waste products in your blood. BUN tests measure the
amount of nitrogen in the blood. Urea nitrogen is a breakdown product of protein.
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34. Pap Test and Pelvic Exam
• A Pap test, or Pap smear, is a test for cervical cancer or precancerous
conditions of the cervix. The test is performed along with a pelvic
exam in a doctor’s office or clinic.
• For the test, a woman lies on an exam table with her knees bent and
her feet in stirrups. A doctor or nurse practitioner then gently inserts
a speculum and uses it to widen the patient’s vagina to examine the
vagina and cervix. The doctor or nurse practitioner then obtains a
sample of cells from the cervix, using a scraping tool or small brush.
The sample is put into a small bottle or onto a slide and sent to a
laboratory for analysis.
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35. Liver Function Tests
• Liver function tests, also known as liver chemistries,
help determine the health of liver by measuring the
levels of proteins, liver enzymes, and bilirubin in
blood.
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36. Pulmonary Function Tests
• Pulmonary function tests (PFTs) are noninvasive tests that show how well the
lungs are working. The tests measure lung volume, capacity, rates of flow, and gas
exchange. This information can help your healthcare provider diagnose and
decide the treatment of certain lung disorders.
❖Methods:
• Spirometry. A spirometer is a device with a mouthpiece hooked up to a small
electronic machine.
• Plethysmography. You sit or stand inside an air-tight box that looks like a short,
square telephone booth to do the tests
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37. Fecal Occult Blood Test (FOBT)
• A fecal occult blood test (FOBT) looks at a sample of your stool (feces)
to check for blood.
• Occult blood means that you can't see it with the naked eye.
• Blood in the stool means there is likely some kind of bleeding in the
digestive tract.
• Blood in the stool may also be a sign of colorectal cancer, a type of
cancer that starts in the colon or rectum.
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38. The PSA test, or Prostate-Specific Antigen test, is a blood test commonly used for screening and
monitoring prostate health. Here's an explanation of the PSA test:
Purpose: The primary purpose of the PSA test is to measure the levels of prostate-specific antigen (PSA)
in the blood. PSA is a protein produced by the prostate gland, and its levels can be elevated in various
prostate conditions, including prostate cancer.
Prostate-Specific Antigen test
•Normal PSA Levels: Typically, a low level of PSA is found in the blood of
healthy men. The normal range can vary, but generally, a PSA level below 4.0
nanograms per milliliter (ng/mL) is considered normal.
•Elevated PSA Levels: Higher PSA levels may indicate various prostate
conditions. While an elevated PSA level is not definitive proof of cancer, it can
prompt further investigation, such as additional tests or a prostate biopsy, to
determine the cause.
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39. 1.Question: Which imaging technique is commonly used for breast cancer screening?
1. A) MRI
2. B) CT scan
3. C) Mammography
4. D) X-ray
2.Question: What is the primary purpose of a biopsy in cancer diagnosis?
1. A) Genetic testing
2. B) Tumor staging
3. C) Tissue sampling
4. D) Blood analysis
3.Question: Which blood test is often used as a tumor marker for prostate cancer?
1. A) PSA (Prostate-Specific Antigen)
2. B) CA-125
3. C) AFP (Alpha-fetoprotein)
4. D) CEA (Carcinoembryonic Antigen)
4.Question: What is the main principle behind positron emission tomography (PET) scans in cancer diagnosis?
1. A) Magnetic resonance
2. B) Radioactive tracers
3. C) X-ray beams
4. D) Sound waves
5.Question: Which of the following is a non-invasive imaging technique often used for detecting brain tumors?
1. A) Endoscopy
2. B) Ultrasound
3. C) CT scan
4. D) PET scan
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40. 1.Question: What is the purpose of a Pap smear in cancer diagnosis?
1. A) Breast cancer screening
2. B) Cervical cancer screening
3. C) Prostate cancer screening
4. D) Lung cancer screening
2.Question: What is the primary purpose of a colonoscopy in cancer diagnosis?
1. A) Liver cancer screening
2. B) Colorectal cancer screening
3. C) Lung cancer screening
4. D) Pancreatic cancer screening
3.Question: Which blood test is commonly used as a tumor marker for ovarian cancer?
1. A) CA-125
2. B) PSA
3. C) CEA
4. D) AFP
4.Question: In cancer diagnosis, what does the term "Fine Needle Aspiration (FNA)" refer to?
1. A) Imaging technique
2. B) Tissue biopsy
3. C) Blood test
4. D) Genetic testing
5.Question: Which imaging method is particularly useful for detecting bone metastases in cancer patients?
1. A) Ultrasound
2. B) MRI
3. C) Bone scan
4. D) PET scan
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