Paula's grandfather is diagnosed as having lung cancer. His physi...

Question

Paula's grandfather is diagnosed as having lung cancer. His physician takes biopsies of several lymph nodes from neighboring regions of the body, and Paula wonders why, since his cancer is in the lungs. What would you tell her?

Accepted Answer

Hi, everyone. Welcome back. Let's look at our next question in the TNM staging system. All of the following aspects are primarily used by physicians to study cancer except a, the number of nearby affected lymph nodes. B, the spread of cancer to other body parts c the history of cancer in the family or d the size and extent of the main tumor. So most of us are familiar with the fact that when a person receives a cancer diagnosis that's given with a description as stage something with numbers one through four, the TNM staging system is how that label is come up with. So we have an acronym right in our name to help us remember what goes into that system. And we are looking for the one of our four answer choices that is not part of that staging system. So we have three letters, three aspects of that system. We're looking for the one that isn't one of them. So let's work through our letters here. The first one is T which stands for tumor and that describes what is the size of the primary tumor and to what extent is their invasion of nearby tissues by that tumor. So when we look at our answer choices, we see that choice, the says the size and extent of the main tumor. So that is not our answer since that is part of that TNM system. Now let's look at our next letter N, this stands for nodes. And that means that an important or a crucial part of staging is has the cancer invaded nearby lymph nodes. So when we look at our answer choices, we see that choice. A is number of nearby affected lymph nodes. So that's not going to be the answer to our question. Since that refers to the n this is really, really important because having spread to nearby lymph nodes, especially more than one indicates a higher risk of metastasis when it comes to the cancer. And that will affect the patient's choice of treatment options in needing to understand how aggressive this cancer is likely to be. So, a cancer that has spread to lymph nodes likely to be more aggressive and you might make different treatment decisions than if it's still localized in the area of the primary tumor. And in fact, there's a name given to the lymph node that a particular cancer is most likely to spread to, that's called a sentinel lymph node. And the na name sentinel of course refers to a guard. So in the sense that that lymph node nearby that it's most likely to spread to is the warning system of a more aggressive cancer. So now let's move on to our last letter M which refers to metastasis. So are there metastases to distant tissues in the body? So in terms of our answer choices, that would correspond to choice B, the spread of cancer to other body parts. And this is an important part of staging because it indicates an advanced stage of disease. That would be stage four in terms of that staging system. And that would of course affect a patient's prognosis and treatment decisions. So by process of elimination, we're down to choice c the history of cancer in the family. This is an important aspect in terms of an individual's overall risk of developing certain kinds of cancer. So for instance, when making decisions about recommendations of when to start mammograms, you would ask someone for their family history of breast cancer at younger ages, but it's not part of the staging system once somebody has already been diagnosed with cancer. So our answer choice here for talking about the TNM staging system, what is the answer choice that is not used by physicians in studying cancer this way? And that is choice c the history of cancer in the family. See you in the next video.

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Paula's grandfather is diagnosed as having lung cancer. His physician takes biopsies of several lymph nodes from neighboring regions of the body, and Paula wonders why, since his cancer is in the lungs. What would you tell her?

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