ISM Original Work Product

#1 - Terminology

Terminology is a crucial part of the work I would like to accomplish as a summation of my

research in an original work. Listed below are some of the crucial terminologies and work parts
that I have started/would need to review that I have compiled from a cancer terminology website
into a glossary style list:

A B C D

Absolute risk Benign Cancer Disease-free

The difference Refers to a tumor that A group of more than survival (DFS)
between two risks, is not cancerous. The 100 different diseases The measure of time
usually smaller than tumor does not that can begin almost after treatment during
relative risk. usually invade nearby anywhere in the body, which no sign of
tissue or spread to characterized by cancer is found. This
other parts of the abnormal cell growth term can be used for
body. and the ability to an individual or for a
invade nearby tissues. group of people
within a study. This
term is usually used
in the context of
scientific research.

Acute Biopsy Carcinoma Deductible

Refers to symptoms The removal of a Cancer that starts in The amount of
that start and worsen small amount of skin or tissues that approved health care
quickly but do not tissue for line the inside or costs an insured
last over a long time. examination under a cover the outside of patient must pay
microscope. Other internal organs. out-of-pocket each
tests can suggest that year before the health
cancer is present, but care plan begins
only a biopsy can paying any costs.
make a definite
diagnosis.

Adjuvant therapy Bone marrow Case manager Disability insurance

Treatment is given The soft, spongy A health care Insurance that
after the main tissue found in the professional, often a provides an income
treatment to reduce center of large bones nurse with experience on either a short-term
the chance of cancer where blood cells are in cancer, who helps or a long-term basis
coming back by formed. coordinate the care of to a person with a
destroying any a person with cancer serious illness or
remaining cancer before, during, and injury that prevents
cells. It usually refers after treatment. At a the person from
to chemotherapy, medical center, a case working.
radiation therapy, manager may provide
hormone therapy, a wide range of
and/or services for patients
immunotherapy given that may include
after surgery. managing treatment
plans, coordinating
health insurance
approvals, and
locating support
services. Insurance
companies also
employ case
managers.

Americans with Bone marrow Chemoprevention

Disabilities Act transplant The use of natural, -
(ADA) A medical procedure synthetic (made in a
A federal (national) in which diseased laboratory), or
law that protects bone marrow is biologic (from a
people with replaced by healthy living source)
disabilities from bone marrow from a substances to reverse,
discrimination. It volunteer donor. slow down, or
requires employers to prevent the
make reasonable development of
accommodations in cancer.
the workplace for
qualified individuals
with a disability.

Chemotherapy
- - The use of drugs to -
kill cancer cells.

E F G H

Event-free survival Family and Medical HIPAA

(EFS) Leave Act (FMLA) - Health Insurance
The measure of time This federal law Portability and
after treatment that a offers specific Accountability Act.
group of people in a protections for This is a set of
clinical trial has not employees during
had cancer come back medical leave (when
or get worse. This the employee is ill)
term is also usually and family leave
used in the context of (when the employee
scientific research. must care for a
spouse, child, or
parent who is ill).
Endpoint Fee-for-service
The results measured This is a type of - Health Maintenance
at the end of a study private health
to see whether the insurance in which a
research question was person visits a doctor,
answered. submits a claim form,
and the insurance
plan pays the bill
using a co-insurance
structure. Deductibles
are common.
Essential health Follow-up care
benefits Medical examinations - Treatment that
A set of services that and tests the doctor
an insurance plan is recommends after the
required to provide to active treatment
patients. There can be period. This care is
no dollar limits each used to monitor a
year on the cost that patient’s recovery and
insurance pays for check for signs of
essential health recurrence.
benefits. According
to the Affordable
Care Act, plans
offered in small
group and individual
national rules that
help protect the
privacy of a patient's
personal medical
information, provide
patients with access
to their medical
records, and help
people with health
problems, such as
cancer, get health
insurance for
themselves and their
family members.
HMO
Organization; a type
of private health
insurance. In an
HMO, a person
chooses a primary
care doctor from an
approved list called
the network.
Specialist care must
be approved by that
primary care doctor,
called a referral.
Hormone therapy
removes, blocks, or
adds hormones to
destroy or slow the
growth of cancer
cells. It is also called
hormonal therapy or
endocrine therapy.
markets must provide
items and services in
at least 10 categories
for the plan to be
certified and offered
in the health care
exchanges. Benefit
categories include
emergency services,
preventive wellness
and chronic disease
management, and
prescription drugs..

I J K L

Imaging test Laboratory test

A procedure that - -
creates pictures of
internal body parts,
tissues, or organs to
make a diagnosis,
plan treatment, find
out whether treatment
is working, or
observe a disease
over time.
A procedure that
evaluates a sample of
blood, urine, or other
substance from the
body to make a
diagnosis, plan
treatment, check
whether treatment is
working, or observe a
disease over time.

Immunotherapy Late effects

A type of cancer - -
treatment designed to
boost the body's
natural defenses to
fight the cancer. It
uses materials made
either by the body or
in a laboratory to
improve, target, or
restore immune
system function. It
may also be called
biologic therapy.
Side effects of cancer
treatment that occur
months or years after
a diagnosis of cancer
because of the related
treatments, such as
chemotherapy,
radiation therapy, or
surgery.
In situ Leukemia
In place. Refers to - - A cancer of the
cancer that has not blood. Leukemia
spread to nearby begins when normal
tissue, also called white blood cells
non-invasive cancer. change and grow
uncontrollably.

In-network care Lifetime risk

Health care providers - - The probability of
or facilities that are developing a disease
part of an HMO or or dying from that
PPO plan's approved disease across a
list or network are person’s lifetime.
considered “in
network.” In general,
in-network care costs
patients less than
out-of-network care.

Integrative medicine Localized cancer

A combination of - - Cancer that is
medical treatments confined to the area
for cancer and where it started and
complementary has not spread to
therapies to help other parts of the
manage the body.
symptoms and side
effects of cancer.

Invasive cancer
Cancer that has - - -
spread outside the
layer of tissue in
which it started and
has the potential to
grow into other
tissues or parts of the
body, also called
infiltrating cancer.

M N O P

Mass Neoadjuvant Odds ratio Palliative care

A lump in the body. therapy A comparison of Palliative care is any
Treatment given whether the form of treatment
before the main likelihood of an event that concentrates on
treatment. It may is similar between reducing a patient’s
include two groups; a ratio of symptoms or
chemotherapy, 1 means it is equally treatment side
radiation therapy, or likely between both effects, improving
hormone therapy groups. quality of life, and
given before surgery supporting patients
to shrink a tumor so and their families. It
that it is easier to may also be called
remove. supportive care.

Median Non-essential Oncologist

The middle value in a benefits A doctor who treats -
range of Services provided by cancer and provides
measurements an insurance plan that medical care for a
ordered by value. are outside the person diagnosed
“essential benefits” with cancer. The five
category. Patients main types of
may be responsible oncologists are
for some or all of medical, surgical,
these costs. radiation,
gynecologic, and
pediatric oncologists.

Medicare Oncology Patient navigator

This is a type of - The study of cancer. A person, often a
health insurance nurse or social
provided by the worker, helps guide
federal government patients, survivors,
for people 65 or families, and
older, as well as for caregivers through
some people with the health care
disabilities. Medicare system. Navigators
is divided into four offer numerous
parts: Parts A, B, C, services, including
and D. Part A covers arranging financial
in-patient hospital support,
care. Part B provides transportation, and
financial coverage childcare during
using premiums, treatment;
deductibles, and a coordinating care
co-insurance structure among several
 for other medical
expenses, such as
doctor visits.
Medicare Advantage
plans, or Part C, are
insurance plans
managed by private,
approved companies.
Part D provides
prescription drug
coverage.
Metastasis
The spread of cancer
from the place where
the cancer began to
another part of the
body. Cancer cells
can break away from
the primary tumor
and travel through the
blood or the
lymphatic system to
the lymph nodes,
brain, lungs, bones,
liver, or other organs.
Mortality rate
The number of deaths
in a particular
population during a
specific time.
#2 - Chemotherapy Treatments
Below is a compiled list of my findings on common chemotherapy drug combinations used in
treatment that I will use in the website I create for my original work. These drug combinations
doctors; and
providing emotional
support.
Out-of-network care Patient Protection
- Health care providers and Affordable
or facilities that are Care Act
not part of an HMO Often called “health
or PPO plan's care reform,” this is a
approved list or 2010 federal law that
network are changed certain rules
considered “out of regarding health
network.” insurance coverage in
Out-of-network care the United States.
often costs patients
more than in-network
care and may involve
a deductible and
require pre-approval
for certain services.
Placebo
- - An inactive drug or
treatment in a clinical
trial.
will also help me understand treatments being used in the clinic better as I participate in
in-person clinic shadowing.

Adriamycin Blenoxane Mechlorethamine

Blenoxane Etopisode Adriamyicin
Velban Adriamyicin Vinblastine
Cyclophoshamide Oncovin
Darcabazide
Oncovin Blenoxane
Procarbazide Etoposide
Prednisone Prednisone

Rituximab Ifosfamide Cyclophosphamide

Cyclophosphamide Carboplatin Chlorambucil
Hydroxydoxorubicin Etopisode Bendamustine
Oncovin Ifosfamide
Prednisone

Prednisone Cisplatin Cladribine

Dexamethasone Carboplatin Fludarabine
Oxaliplatin Pentostatin

Capecitabine Immune Modulators Blenoxane

Cytarabine Monoclonal Antibodies Adriamycin
Gemcitabine Proteasome Inhibitors Etopisode
Methotrexate Small Molecule Treatments Mitoxantrone
Pralatrexate Oncovin

ISM OW Checkpoint #3

This section will cover the diseases and disorders portion. This section is important
because several cancers have symptoms and signs that can be used for early detection, such as
skin tags for melanoma. Informing the public on topics like these can potentially save lives, as
people may be able to identify cancer in themselves or a family member/friends before it has
begun to take its course.

The information I have gathered from various sources regarding the diseases I will be covering
in my original work will be organized below in the table shown.
Disease Population Affected Signs and Symptoms Likelihood
(the name of the (used to determine if (used to identify the (used to determine
disease, and other the patient falls type of cancer the the chance that the
names it may go by) within the normally patient likely has) exhibited symptoms
affected population) are a certain disease)

Bladder Cancer Men are 4x more Bloody urine, Rare, fewer than
(Bladder likely to develop the abnormally dark 200,000 cases per
Carcinoma) cancer than women, urine, more frequent year
but the cancer is more urination.
fatal in women.
Arsenic, smoking,
and workplace
exposure pose the
highest risk for
patients.

Breast Cancer Women are much More often than not, Common, more than
more likely to people do not 200,000 cases per
develop this, and men experience any major year
rarely see breast symptoms, so getting
cancer cases. regular checkups is
recommended. If
symptoms are
experienced, they can
be lumps in the breast
area, abnormal
discharge, and
red/swollen lymph
nodes.

Colorectal Cancer The large majority of Symptoms include Common, more than
colorectal cancer blood in stool, 200,000 cases per
patients are over the abdominal year
age of 50, which is discomfort, changes
why regal screening in bowel habits, and
is strongly changes in stool
recommended after consistency.
this age. Despite this,
there are a few cases
recorded as early as
the teenage years.

Endometrial Cancer This cancer is only Symptoms include Common, more than
(Uterine Cancer) developed by those abnormal vaginal 200,000 cases per
why have a uterus bleeding, pelvic pain; year
 and a uterine lining, however, some
and it occurs most experience no
commonly in women symptoms at all.
over the age of 55.

Kidney Cancer It is commonly seen Symptoms include Common, more than

in patients of older bloody urine, pain in 200,000 cases per
age, mainly those the kidney area along year
who are smokers, the back, appetite
dialysis patients, loss, tiredness, and
obese, or have fever.
hypertension.

Leukemia Leukemia forms Leukemia can grow Rare, fewer than

mostly in adult fast or slow. For 200,000 cases per
patients, however, people with year
pediatric cases of slow-growing types,
leukemia are rare but the symptoms may
possible. not be present or be
less apparent. For
those with
fast-growing types,
symptoms can
include pain in the
bones and joints,
bleeding, easy
bruising, mouth
ulcers, swollen lymph
nodes, weakness, and
fever.

Liver Cancer It is normally found Symptoms are very Rare, fewer than
in older patients, with uncommon in the 200,000 cases per
those who are early stages of this year
alcoholic beverage cancer, making it
drinkers being difficult to catch.
significantly more at After the disease has
risk. progressed, signs
include weight loss,
stomach pain,
vomiting, and yellow
skin.

Lung Cancer Smokers are at the Symptoms include Common, more than
highest risk for lung bloody coughing, 200,000 cases per
cancer, as tobacco chest pain, wheezing, year
 smoke is a very and weight loss.
potent carcinogen or
cancer-causing agent.
It can also be passed
down genetically.

Melanoma The highest risk Symptoms include Common, more than

(Malignant patients are those mole-like growths on 200,000 cases per
Melanoma) with significant the skin or changes to year
exposure to UV rays already-present moles
(often through on the skin. Moles
sunlight), and those will often be larger in
who are outside for size and have no
long periods of time definite shape, almost
with direct sun like “splotches”
exposure.

Non-Hodgkin Older patients tend to Symptoms include Common, more than

Lymphoma develop this swollen lymph nodes, 200,000 cases per
lymphoma more fever, chest pain, and year
frequently, and more stomach pain.
male patients develop
this condition
compared to female
patients.

Pancreatic Cancer Smoking is the Symptoms for this Rare, fewer than
biggest risk factor for cancer are very 200,000 cases per
those who develop non-specific, are not year
pancreatic cancer. It experienced in early
is also more stages, and further
commonly seen in testing is almost
older patients. always required. The
patient may
experience
hunger/appetite loss
and weight loss as a
result.

Prostate Cancer Older men are most Symptoms include Very Common, more
at risk for the urination difficulty, than 3,000,000 cases
development of this but more often than per year
cancer. not, there are no
symptoms at all, so
regular checkups are
encouraged.
 Thyroid Cancer It is the most Symptoms include Rare, fewer than
common in women possible lumps in the 200,000 cases per
during their neck, and many year
reproductive years, patients do not
with the highest experience any
number being symptoms.
diagnosed between
the ages of 44 and 49.

While each caner has unique risk factors and causes, the one overarching factor that
many have in common is age. This is because cancer itself, a lot of the time, is considered a
disease of age, as when people age, gradual exposure to carcinogens externally can pile up and
cause various conditions, and mutations become more and more likely.

#4 - Treatment Pathways

With all of the different types of cancer, the treatment pathways professionals take in order to
create the best quality of life for the patient can also vary. With this summation of research, I am
going to go over different types of treatment pathways that occur, and how cancer is detected,
staged, and treated.

Below is a chart that I came upon in ISM I. In ISM I, I only focused on one of the pathways
which was the one that dealt with the complete blood count test (CBC). Since I have expanded
my study to encompass more types of cancers this year, I will focus on all of the pathways
present in the diagram, which also covers cancers like breast cancer and lymphoma, versus solely
leukemia, which is what I studied last year.
The first sublevel of this diagram is the differentiation between the detection of the symptoms.
Whether the symptoms are detected via the patient experiencing them or in a yearly checkup will
determine what tests are run. In a yearly checkup, preemptive screening is run. This means that
the testing is looking for cancer without any symptoms, in areas that are at risk for cancer
development. This can include blood counting and mammography, scanning for leukemia and
lymphoma indicators, and breast cancer tissues, respectively. For those who come in with
symptoms, such as fever, pain, and fatigue, they are sent directly to oncology consult for further
testing, as opposed to yearly testing, which results in a consult only after concerning test results.

In the next stage of the diagram, an oncology consult sends the patient to a pathology consult.
The pathologist works in partnership with the oncologist to determine the best treatment plan for
the patient. This is why the collaboration on the chart leads to the Dx and Px, which is the
diagnosis and prognosis, or the official decision on what the patient has and what the future
outlook is.
This leads to further testing, which is often led by a genetic counselor and a cytogeneticist. This
can include genetic sequencing, which helps figure out exactly which base pairs are mutated,
genetic counseling, which helps the patient figure out which of their family members carries the
same mutated gene they may have so that that family can be on the lookout for any conditions in
the future. Immunophenotyping, another lab procedure that happens after diagnosis, is the
process of using antibodies to determine the makeup of the cell surface receptors that the
patient's immune system has. This can help the professionals tailor the treatments of the patient
even more specifically to the specific makeup of the patient's immune system.

After the individualized examination of the patients’ cells and genetics, the cancer is first staged
in one of four stages: I, II, III, or IV. The staging of cancers varies on a set of guidelines, which
can be shown in the gathered research below.

I II III IV

This stage is usually a In general, these 2 In general, these 2 This stage means that
cancer that has not stages are cancers stages are cancers cancer has spread to
grown deeply into that have grown more that have grown more other organs or parts
nearby tissues. It also deeply into nearby deeply into nearby of the body. It may be
has not spread to the tissue. They may tissue. They may also called advanced
lymph nodes or other have also spread to have also spread to or metastatic cancer.
parts of the body. It is lymph nodes but not lymph nodes but not
often called to other parts of the to other parts of the
early-stage cancer. body. body.

After this initial staging process, other terminology is also used to classify the cancer. This can
include Tx for no other information, T0 for no evidence of a tumor, Tis for tumor in situ
(meaning there is no metastasis), N for node (meaning the cancer has affected lymph nodes), and
M for metastasis. The exceptions to this system are that cancer must be restaged after treatments
and that this staging process does not apply to childhood cancers.

Bibliography
https://www.cancer.gov/types/common-cancers#:~:text=The%20most%20common%20type%20
of,are%20combined%20for%20the%20list.
https://www.cancer.net/navigating-cancer-care/cancer-basics/cancer-terms
https://pubmed.ncbi.nlm.nih.gov/32283210/
https://www.cancer.net/navigating-cancer-care/cancer-basics/cancer-terms
https://pubmed.ncbi.nlm.nih.gov/32283210/