Medical Terminology Lesson 20

toxins known to cause cancer

-Chlorine. Used in drinking water, chlorine produces carcinogenic compounds. Cancer risk among people drinking chlorinated water is 93% higher than that of people not drinking chlorinated water. -Lead. Found in lead-based paint and contaminated air, water, and soil, lead poisoning can severely affect mental and physical development, particularly in children younger than 6. In 2014, over 100,000 residents of Flint, Michigan, including 12,000 children, were exposed to high levels of lead in their drinking water. The lead came from the polluted river source of water and from lead pipes used to supply the water. -Polychlorinated biphenyls (PCBs). These were banned years ago but still persist in the environment, and are found in farmed salmon. -Pesticides. According to the Environmental Protection Agency (EPA), 60% of herbicides, 90% of fungicides, and 30% of insecticides are known to be carcinogenic (Figure 20.6). Farmers using pesticides have a 14% greater risk for developing prostate cancer than do organic farmers. -Dioxins. These are chemical compounds produced by combustion processes from waste incineration and from burning fuels like wood, coal, and oil. -Asbestos. This insulating material was used in the 1950s to 1970s on floors, ceilings, water pipes, and heating ducts. When the material becomes old and crumbly, it releases fibers into the air. Inhalation of the fibers is the cause of mesothelioma. -Arsenic. This is used by insecticide and herbicide sprayers and oil refinery workers. Occupational Safety and Health Administration (OSHA) regulations are designed to protect workers from these environmental hazards.

brachytherapy description

Brachytherapy implants radioactive seeds through thin tubes directly into the tumor to give high doses of radiation to the tumor while reducing radiation exposure to the surrounding tissues. It can be used for inoperable cancers.

FDA

Federal Drug Administration

CEA

carcinoembryonic antigen

CT

computed tomography

CHART

continuous hyperfractionated accelerated radiotherapy

surgical procedures for lung cancer

The type of surgery for lung cancer depends on the amount of lung tissue that has to be removed. -Wedge resection (segmentectomy) removes only a small part of the lung. It is used for carcinoma in situ, small tumors, frailer patients who cannot tolerate lobectomy, or patients with lung disease. -Lobectomy is removal of one lobe of the lung and is used if the cancer has not spread beyond the lobe or into lymph nodes. -Pneumonectomy removes an entire lung and has a mortality of 5% to 8%.

MRI

magnetic resonance imaging

BSE

breast self-examination

MOAB

monoclonal antibody

mutagen

muta= genetic change gen= produce agent that produces a mutation in a gene

mutation

muta= genetic change tion= process a change in the chemistry of a gene that is continued in subsequent divisions of the cell

Pap

papanicolaou cervical smear test

particulate

particul= little piece ate= composed of, pertaining to relating to a fine particle

PET

positron emission tomography

PCD

programmed cell death

SRS

stereotactic radiosurgery

TS

tumor suppressor

TNM

tumor-node-metastasis

air pollution description

Air pollution may be the cause of the 10% to 40% increase in lung cancer mortality between urban and rural areas. Particulate matter, especially very small particles, includes soot; organic material such as hydrocarbons; and metals such as arsenic, chromium, and nickel—all of which are known mutagens and carcinogens. A new analysis shows that premature death from cardiovascular ailments is increased by 24% among people exposed to tiny soot particles.

Biologic therapies description

Biologic therapies use the body's immune system, directly or indirectly, to attack cancer cells or to lessen the side effects that can be caused by radiation and chemotherapy. Biologic response modifiers alter the immune system's response to cancer cells and include interferons, interleukins, monoclonal antibodies, vaccines, and gene therapy.

cancer description

Cancer (CA) is a class of malignant diseases characterized by uncontrolled cell division. The basic cause of this uncontrolled growth is damage to the cells' DNA. This damage produces mutations to the genes that control cell division. These mutations, which can be inherited or acquired, lead to the uncontrolled cell division and malignant tumor formation. Thus, all cancer is genetic; that is, it develops because something in a cell's genes has changed (mutated). Less than 10% of all cancers are inherited; that is, the genetic change is passed from parent to child. Almost 90% of cancers are acquired—something has caused the gene mutation in specific cells in a particular individual. A few genes mutated within a cell nucleus are enough to cause cancer. These gene mutations give the cells a superpower to proliferate in an uncontrolled way.

carcinogenesis description

Carcinogenesis, literally the creation of cancer, is the abnormal rate of cell division as a result of damaged DNA causing gene mutation. Normally, the balance between cell division and proliferation and cell death (apoptosis, or programmed cell death [PCD]) is tightly controlled to maintain the integrity of organs and tissues. Gene mutations that cause cancer disrupt this orderly process. Mutation in a single gene is usually not enough to cause cancer, and carcinogenesis requires multiple mutations in many genes. Most normal cells cannot divide unless a growth factor binds to a receptor on the cell's surface. This growth factor then stimulates the cell to undergo mitosis and differentiate into mature, functional cells.

EPA

Environmental Protection Agency

external- beam radiation description

External-beam radiation focuses a beam of radiation directly on the tumor. It is generally used for metastasized cancer.

Gene therapy description

Gene therapy is now a focus of cancer therapy. In 2005, the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) announced a 3-year pilot project to map the genetic alterations in cancer cells. New technologies called microarrays or gene chips (small slivers of glass or nylon that can be coated with genes) enable every gene that is active in a cancer cell to be identified. Gene therapy involves introducing a normal gene into a person's cells to replace an abnormal disease-producing gene (see Chapter 21). Numerous trials are under way to define gene therapy's applications in the biologic treatment of cancer.

features of cells of malignant tumors

Have unlimited, unregulated growth potential. Grow directly into adjacent tissues (invasion or infiltration). Invade the lymphatic system and are carried to local and distant lymph nodes. Invade the bloodstream and are carried to other distant organs and tissues.

Continuous hyperfractionated accelerated radiotherapy (CHART) description

Continuous hyperfractionated accelerated radiotherapy (CHART) administers standard doses of radiation multiple times per day. It allows the total dose of radiation to be administered in a shorter period of time than the standard 6 weeks.

Cytostatics description

Cytostatics inhibit cell division. Examples include cyclophosphamide (Cytoxan) which is a potent agent; methotrexate (Amethopterin); cyclosporine (Cyclosporin A); mechlorethamine (Nitrogen mustard).

secondhand smoke description

Secondhand smoke, called environmental tobacco smoke (ETS), contains the same chemicals and carcinogens as those inhaled by smokers. It is responsible for 3,000 lung cancer cases each year in America. The genetic mutations caused by the carcinogens are probably similar to those in the subset of smokers discussed earlier, even though exposure to the carcinogens is much less than that for smokers.

3 subgroups of lung cancers

Lung cancer has three main subgroups: 1. Non-small cell lung cancer accounts for 85% of cases, and 80% of patients die within 5 years of diagnosis. Included in this type are: a. Squamous cell carcinoma, arising from round cells that have replaced damaged cells in the epithelial lining cells of a major bronchus. It accounts for 25% to 40% of lung cancers. b. Adenocarcinoma, arising from the mucus-producing cells in the bronchi. It accounts for between 30% and 50% of lung cancers. It is the most common lung cancer in women, and its incidence is increasing. c. Large cell carcinoma, which includes cancers that cannot be identified under the microscope as squamous cell or adenocarcinoma. It accounts for 10% to 20% of lung cancers. 2. Small cell lung cancer, like squamous cell carcinoma, is derived from the epithelial cells of the bronchi but replicates at a faster rate, producing smaller cells. It accounts for 14% of all lung cancers; most patients die within 18 months of diagnosis. 3. Mesothelioma is a rare tumor arising from the cells lining the pleura and is associated with asbestosis.

Monoclonal antibodies (MOABs) description

Monoclonal antibodies (MOABs) are antibodies produced by a single type of cell and are specific for a single antigen. Examples of MOABs are rituximab (Rituxan), used for non-Hodgkin lymphoma, and trastuzumab (Herceptin), used in breast cancer for tumors that produce a protein called HER-2.

OSHA

Occupational Safety and Health Administration

Oncologists description

Oncologists, who are physicians who specialize in the diagnosis and treatment of patients with cancer. There are many subspecialties of oncologists, including medical oncologists, surgical oncologists, pediatric oncologists, and radiation oncologists; their titles are self-explanatory.

Oncology clinical nurse specialists description

Oncology clinical nurse specialists, who are registered nurses with advanced clinical practice in the care of cancer patients.

Oncology social workers description

Oncology social workers, who have master's degrees in medical social work and provide for the social and emotional needs of cancer patients and their families.

Stereotactic radiosurgery (SRS) description

Stereotactic radiosurgery (SRS) uses three-dimensional computer programming to deliver a precise, single high dose of radiation in a 1-day session. The most common form of SRS used in the United States is a cobalt-60-based machine called the gamma knife. Though this technique is labeled and implied as "surgery," there is no actual surgery involved.

DRE

digital rectal examination

environment

environ= surroundings ment= resulting state all the external conditions affecting the life of an organism

environmental

environ= surroundings ment= resulting state al= pertaining to pertaining to the environment

ETS

environmental tobacco smoke

FOBT

fecal occult blood test

AMAS

anti malignin antibody screen

Targeted immune description

Targeted immune modulators are new drugs used for diseases such as rheumatoid arthritis and psoriatic arthritis.Evidence of their effectiveness is evolving.

biomarker

bi/o= life marker= sign a biological marker or product by which a cell can be identified

BAL

bronchoalveolar lavage

staging lung cancer

The tumor-node-metastasis (TNM) system is used to stage cancer: T stands for tumor and describes its size and its spread within the lung and to nearby tissues such as the pleura, diaphragm, and pericardium. N stands for spread to lymph nodes around the affected lung. M stands for metastasis to distant sites such as brain liver and bones. Once the TNM categories have been assigned, the information is combined and given an overall stage of O, I, II, III, or IV.

malignant

hurtful (latin) Capable of invading surrounding tissues and metastasizing to distant organs

hyperfractionated

hyper= excessive fraction= small amount ated= process given in smaller amounts and more frequently

treating cancer description

Treatment of any cancer depends on its location, its size, its localization or spread to surrounding tissues and lymph nodes, the presence of metastases, and the cancer's aggressiveness (as determined by pathologic findings on biopsy or surgical removal). If the cancer is still localized, it can be removed and cure is possible. Unfortunately, few patients are diagnosed at such an early stage, particularly with lung cancer. Even if the original tumor is removed, cancer recurrence rates are high. Additional treatments with radiation and chemotherapy are used and can produce unpleasant side effects. A patient will have to balance a diminished quality of life against a chance for a modestly prolonged survival. In the elderly, studies have shown that survival rates are the same for therapies aimed at relieving pain as they are for aggressive, unpleasant treatment regimens with their diminished quality of life.

adenocarcinoma

aden/o= tumor carcin= cancer oma= tumor a cancer arising from glandular epithelial cells

cancerous

cancer= cancer ous= pertaining to pertaining to a malignant neoplasm

carcinogen

carcin/o= cancer gen= produce cancer producing agent

carcinogenic

carcin/o= cancer gen= produce ic= causing cancer

carcinogenesis

carcin/o= cancer genesis= creation origin and development of cancer

carcinoma

carcin= cancer oma= tumor a malignant and invasive epithelial tumor

carcinoma in situ (CIS)

carcin= cancer oma= tumor in situ= in its place (latin) carcinoma that has not invaded surrounding tissues

CIS

carcinoma in situ

classes of cancer and cells of origin

carcinoma- epithelial sarcoma- connective tissue, bone, cartilage, muscle leukemia- blood forming tissues lymphoma- lymph nodes melanoma- melanocytes (pigment producing skin cells)

Chondrosarcoma

chondr/o= cartilage sarc= flesh oma= tumor cancer arising from cartilage cells

cancer

crab (latin) general term for a malignant neoplasm

infiltrate

in= in filtr= strain through ate= composed of, pertaining to to penetrate and invade a tissue or cell

infiltration

in= in filtr= strain through ation= process the invasion into a tissue or cell

laukemia

leuk= white emia= blood condition Disease in which the blood is taken over by white blood cells and their precursors

particle

little piece (latin) a small piece of matter

lymphoma

lymph= lymph oma= tumor any neoplasm of lymphatic tissue

malignancy

malign= cancer ancy= state of Tumor that invades surrounding tissues and metastasizes to distant organs

melanoma

melan= black oma= tumor, mass malignant neoplasm formed from cells that produce melanin

mesothelioma

meso= middle theli= lining oma= tumor cancer arising from the cells lining the pleura or peritoneum

metastasis/ metastases

meta= after, beyond stasis= stay in one place spread of disease from one part of the body to another

metastatic

meta= after, beyond stat= stand still ic= pertaining to able to metastasize

neoplasia

neo= new plas= molding, formation ia= growth process that results in formation of a tumor

neoplastic

neo= new plas= molding, formation tic= pertaining to pertaining to a neoplasm

neoplasm

neo= new plasm= to form a new growth, either a benign or malignant tumor

oncogene

onc/o= tumor gene= producer, give birth One of a family of genes involved in cell growth that work in concert to cause cancer

oncogenic

onc/o= tumor genic= creation, producing capable of producing a neoplasm

oncologist

onc/o= tumor logist= one who studies, specialist medical specialist in oncology

oncology

onc/o= tumor logy= study of the science dealing with cancer

osteosarcoma

oste/o= bone sarc= flesh oma= tumor cancer arising in bone forming cells

pesticide

pest/i= pest cide= to kill agent for destroying flies, mosquitoes, and other pests

PCBs

polychlorinated biphenyls

1°

primary

proliferate

prol/i= bear offspring fer= to bear ate= composed of, pertaining to to increase in number through reproduction

PCA3

prostate cancer antigen 3

PSA

prostate-specific antigen

rhabdomyosarcoma

rhabd/o= rod shaped, striated my/o= muscle sarc= flesh oma= tumor cancer derived from skeletal muscle

tumor

swelling (latin) an abnormal swelling

2 types of genes that play a part in abnormal cell division and proliferation of cancer cells

1. Protooncogenes are healthy genes that promote normal cell growth. Mutated oncogenes cause malfunctions in the normal growth mechanisms. For example, an oncogene called SIS stimulates blood vessels to grow into a tumor and provide the rich blood supply it needs to proliferate rapidly. An oncogene called RAS generates abnormal growth-factor receptors that switch on constant cell division signals. An oncogene called HER-2 causes many cases of breast and ovarian cancer. The drug Herceptin is an antibody that targets the HER-2 receptors on the cancer cells. This cuts off the chemical signals that the cell needs to keep proliferating. It also marks the abnormal cells for destruction by the immune system. 2. Tumor suppressor (TS) genes normally suppress mitosis and are activated by DNA damage. Their function is to stop cell division so that the abnormal genetic structure cannot be passed on to daughter cells. Mutated TS genes cannot do this, so the abnormal cells can divide and proliferate. A mutated TS gene called p53 is present in half of all cancers and is associated with a poor prognosis and resistance to chemotherapy.

Antiangiogenesis therapy description

Antiangiogenesis therapy interferes with the genetic mechanisms that increase blood supply for the active growth of cancer cells. The drug Avastin has led to a great increase in the survival of patients with colon cancer and also is being used in lung and breast cancer.

chemotherapy description

Chemotherapy (chemo) is the use of any drug to treat any disease, but the term is mostly used for drugs that treat cancer. Chemotherapy drugs target cells at different phases of the process of forming new cells. Cancer cells form new cells more quickly than normal cells and this makes them a better target for chemotherapy. But chemotherapy drugs cannot tell the difference between healthy cells and cancer cells. This means that normal cells are damaged along with cancer cells, and this causes side effects. Fatigue, nausea, vomiting, and hair loss are common side effects. Anemia and blood-clotting problems can arise from side effects on the bone marrow. Sometimes cancer can be treated solely with chemotherapy, either as a single drug or with several drugs commonly given at regular intervals, called cycles. A cycle can be a dose of chemotherapy followed by several days or weeks without therapy. This gives normal cells time to recover from the effects of the chemotherapy. More often, chemotherapy is used with surgery or radiation therapy, or both: -Chemotherapy can be used to shrink a tumor before surgery or radiation therapy. -Chemotherapy can be used after surgery or radiation therapy to help kill any remaining cancer cells. In many cases, with treatment the cancer does not go away but can be controlled and managed as a chronic disease. In other cases, the cancer may seem to have gone away but returns. Chemotherapy can then be given again. When the cancer is at an advanced stage, is not under control, and has metastasized to other parts of the body, chemotherapy can help shrink a tumor that is causing pain or pressure to improve the quality of life for the patient. This is called palliation. There are more than 100 chemotherapy drugs of a dozen different types.

Immune therapy description

Immune therapy is a recent focus of cancer therapy research. Vaccines against lymphoma, prostate cancer, breast cancer, and pancreatic cancer have shown promise in stimulating the immune system to attack cancer cells and extend survival rates. In 2010, the FDA approved the first-ever tumor vaccine, called Provenge, to treat prostate cancer. Another FDA-approved immunotherapy, Yervoy, is used in metastatic melanoma, but it only extends average survival by a few months.

more specific tests for detecting the presence of lung cancer

More specific tests for detecting the presence of lung cancer cells include: -Positron emission tomography (PET) scans are expensive and not widely available. They are the most accurate non-invasive test for identifying if the cancer has spread outside lung tissue. -Scintigraphy uses low-level radioactive agents that bind to cancer cells and can be tracked by special cameras to reveal the exact locations of cancer cells. -Bronchoscopy can locate cancers in the linings of the major airways. Biopsy specimens are obtained by cutting tissue, by brushings, or by a washing process called bronchoalveolar lavage (BAL). -Mediastinoscopy uses a fiber-optic tube with a camera and is inserted into the mediastinum via the suprasternal notch to locate affected mediastinal lymph nodes for biopsy. -Needle biopsy of tumors in the periphery of the lungs is performed by inserting a needle between the ribs and guiding it to the tumor with fluoroscopy or CT scan. Brain metastases are identified by MRI and bone metastases by technetium-99m radionuclide bone scans.

cancer prevention

More than 50% of cancers could be prevented by changes in lifestyle and environment. The same carcinogens that affect the lining of the respiratory tract cause cancer of the oral cavity, pharynx, larynx, and esophagus. They also are absorbed into the bloodstream and disseminated, thereby becoming factors that can cause cancer in the pancreas, stomach, kidney, bladder, prostate, and cervix. Stopping smoking alone would reduce most of the 30% of all deaths due to lung cancer and reduce the incidence of many of the other cancers related to smoking. Clean air measures that are being implemented to reduce the more than 2 billion pounds of toxic air pollutants emitted into the atmosphere annually in this country can reduce the incidence of cancer. Obesity is said to be linked to about 10% of breast and colorectal cancers and up to 40% of kidney, esophageal, and endometrial cancers. The mechanisms of obesity linked to these cancers are not understood.

NCI

National Cancer Institute

NHGRI

National Human Genome Research Institute

description of tumors

Normal tissue development is a balance between cell growth and cell death. If cells multiply more quickly than cells die, tumors (neoplasms) are formed. The study of tumors is called oncology, and medical specialists in this field are called oncologists. Neoplasms whose cells proliferate rapidly and spread to distant sites (metastasize) are called malignant. Neoplasms that grow slowly, stay localized, do not invade surrounding tissues, and do not metastasize are called benign.

radiotherapy description

Radiotherapy does not remove the lesion but distorts the DNA of the cancer cells so that they lose their ability to reproduce and to retain fluids; the cells shrink over time. Side effects of radiotherapy depend on the type of therapy used, and occur when healthy cells are damaged during the treatment. Tiredness, nausea, loss of appetite, and sore skin in the treatment area can be short-term effects.

radon description

Radon, a radioactive gas that you cannot see or smell, is the second leading cause of lung cancer (after smoking). It is produced by decaying uranium and is found in nearly all soils. In underground miners, it increases the risk of cancer to 40%. It gets into homes through cracks in the foundations or construction joints and is a problem in 1 out of 15 homes. Cigarette smoking on top of radon significantly increases the risk of lung cancer. Testing for radon is cheap and easy.

medical procedures used in screening for breast cancer

The medical procedures used in screening for breast cancer include: -Examination and palpation. -Self-examination of the breast following a period. -Mammograms to record images of the breast on x-ray film. -Digital mammography to record images in computer code. -Computer-aided mammography using a laser beam to produce a digital signal that can be processed by a computer to highlight suspicious areas. -Ultrasound using sound waves to make a computer image of the inside of the breast, particularly to see changes in women with dense breast tissue and to tell the difference between benign fluid-filled cysts and a possibly malignant solid mass. -Magnetic resonance imaging (MRI) creating detailed images of the breast in different planes. -Ductal lavage using saline solution introducd through a fine catheter inserted into a milk duct through its opening on the surface of the nipple. The solution is aspirated out and examined microscopically to check for abnormal cells. -Biopsy of a suspicious lesion can detect the type of lung cancer. X-rays or ultrasound are used to guide accurate insertion of a needle into the suspicious lesion. Several national organizations have developed guidelines for the age when screening for breast cancer should be started and how often procedures should be performed. Unfortunately, they are all slightly different, making it confusing for patients.

medical terms used in screening for lung cancer

The medical terms used in screening for and detecting lung cancer are: -Chest x-rays are thought of as the screening method for lung cancer. Frequently when lung cancer is detectable on chest x-ray it has spread beyond the lungs. -Computed tomography (CT) scans are more effective at identifying early lung cancers than are chest x-rays. -Magnetic resonance imaging (MRI) is being used to screen for lung cancer in high risk patients. -Sputum analysis of coughed up sputum can be a useful and cost-effective method of identifying cancer cells arising from the lining of the airways. -Biomarkers are substances released by specific cancers and can be found in blood, sputum, and tissue samples. The blood test anti-malignin antibody screen can detect the presence of any kind of cancer and is non-specific.