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Cancer 101: A Cancer Education
and Training Program for
American Indians & Alaska Natives
Version 2 – Updated October 2011
Date
Location
Presented by:
Presenter 1
Presenter 2
Cancer Diagnosis and
Staging
Cancer 101 – Version 2
Learning Module 6
Learning Objectives
At the completion of learning Module
6, you will be able to:
 Describe what is meant by the term
biopsy
 Describe how tumors may behave
differently from one another
 Give at least two examples of the
stages of cancer and their meaning
 Give at least two reasons why
staging is important
Case Study





Martha is 55 years old.
She had a mammogram 4 months ago,
which was normal.
When she was doing BSE this month,
she felt a lump in her left breast.
She scheduled an appointment to see
her doctor.
After CBE, the doctor recommended a
biopsy.
Diagnosing Cancer
To diagnose the presence of cancer, a
doctor must remove a piece of
affected tissue (biopsy) to look at it
under a microscope.
Biopsy
A biopsy is the
surgical removal of
a small piece of
tissue for
microscopic
examination.
Photo credit: John Crawford | Source: NCI
Types of Biopsies
Types of biopsies include:
 Endoscopy
 Needle biopsy
 Surgical biopsy


Excisional
Incisional
Case Study




On CBE, the doctor suspects
Martha’s lump is a cyst, and tries to
aspirate it with a needle biopsy.
The needle biopsy did not extract
any fluid.
The doctor now suspects it is a solid
mass and recommends a surgical
biopsy.
The surgical biopsy is done at the
end of the week.
Diagnosis of Cancer
Microscopic examination of the tissue
also helps the doctor determine the
“aggressiveness” or the behavior of
the cancer.
Cell Differentiation


Well differentiated cancer cells look
and function similarly to normal
cells of the same type.
Poorly differentiated, or
undifferentiated, cancer cells look
abnormal and disorganized.
What do cells look like
under the microscope?
Normal
Images Source: National Cancer Institute
Cancer
Case Study



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Martha’s surgical pathology report comes
back from the lab the following week.
The biopsy is positive for breast cancer.
The cells are well differentiated, and the
mass was small (<2 cm), so the doctor
suspects it is an early stage breast cancer.
To be certain, the doctor orders a sentinel
lymph node biopsy, a chest x-ray, and a CT
scan.
Diagnosing Cancer


Once the cancer diagnosis has been
made, more testing may be
necessary to determine the primary
site (where the cancer started).
The primary site helps determine
the type of treatment of the cancer.
Staging of Cancer


Staging is the process that tells the
doctor how far the cancer has
spread in the body.
Staging is important for the
following reasons:



Determines the extent of the disease
Treatment is determined by the stage
Determines a patient’s prognosis
Stages
The common stages of cancer are:
 In situ
 Localized
 Regional
 Distant
 Recurrent
 Unknown
Case Study



Martha’s sentinel node biopsy was
negative for cancer.
Martha’s x-ray and CT scan were
negative for cancer.
Martha is diagnosed with a Stage I
(local) breast cancer.
In Summary
You now have an understanding of:
 The way in which cancer is
diagnosed
 How the extent or stage of cancer is
determined