ONS/ONCC Certification Complete Solutions 2024

ONS/ONCC Certification Cancer Epidemiology - ✔Study of the distribution and determinants of cancer in population groups Global Cancer Statistics - ✔cancer is the leading cause of disease worldwide Cancer rate - ✔suppouse to increase by 75% to 22 M new cases in 2030 Causes of cancer rate increase - ✔because of increasing tobacco use aging population reproductive dietary and hormonal risk factors Top 5 most commonly diagnosed cancers - ✔Lung (13%) breast (11%) colorectal (10%) stomach (8%) prostate (7%) Make up 50 % of all cancer diagnosed - ✔Lung breast colorectal stomach prostate Most common cancer in men - ✔Lung cancer Most common cancer in woman - ✔Breast cancer Cancer mortality - ✔An stimated 756 M people died in 2008 Top 5 most common causes of death - ✔Lung (18%) Stomach(10%) Liver (9%) Colorectum (6%) Breast (6%) Both sexes combined - ✔prostate(14.4%) breast(14.1%) lung (13.7%) colorectal (8.6%)

melanoma of the skin (4.6%) Among women top 5 (common) diagnosed cancers - ✔breast (29%) lung(14%) colorectal (9%) uterine(5%) thyroid(6%) Among men top 5 (common) diagnosed cancers - ✔prostate (28%) lung (14 %) colorectal (9%) urinary bladder(6%) melanoma of the skin (5%) Cancer - ✔is the second leading cause of death in second to heart disease.

Women leading cause of death - ✔lung (26%) breast(14%) colorectal (9%) pancreas (7%) ovary(5%) Men leading cause of death - ✔lung (28%) prostate(10%) colorectal(9%) pancreas(6%) liver and intrahepatic bile duct (5%) Cancer health disparities - ✔adverse difference in incidence, prevalence, mortality, survivorship, and burder of cacer or related health conditions that exist among specific population groups in US. Highest incidence rate of cancer - ✔1-African American 2-whites 3-hispanic 4-asian 5-american indian Highest incidence rate of mortality - ✔1-african american 2-whites 3-american indian 4-hispanic 5-Asian breast cancer - ✔highest diagnosed (white)

highest mortality (african american) cervical cancer - ✔highest incidence (hispanic) highest mortality (african american) prostate cabcer - ✔highest incidence and mortality (african american) lung cancer - ✔highest incidence & mortality (african america) colorectal cancer - ✔highest incidence & mortality (african american) liver cancer - ✔highest incidence & mortality (asian/pacific islanders) stomach cancer - ✔highest incidence &mortality (asian/pacific islanders) kidney cancer - ✔american indian/ alaska natives overweight - ✔BMI 25-29.9 Obese - ✔BMI > 30 Vegetable and fruits - ✔associate with decreased risk of lung, esophageal, stomach and colorectal cancers whole grain fruits - ✔decreased risk of colorectal cancer alcohol consumption - ✔risk factor mouth, pharynx, larynx, esophagus,liver,colorectum, pancreas, and breast.

Sun - ✔risk factor for melanoma and basal and squamous cell skin cancers most common skin cancer - ✔basal cell carcinoma squasmous cell carcinoma - ✔begin with solar keratoses or actinic keratoses (head,neck and arms) Hep B - ✔associated with liver cancer HIV - ✔Increases risk of Karposi sarcoma and B cell lymphomas Epstein-Barr virus (EBV) - ✔Endemic because more than 90% worldwide is seropositive Epstein-Barr virus (EBV) - ✔causes infectious mononucleosis

Epstein-Barr virus (EBV) - ✔associated with Burkitt lymphoma, nasopharyngeal cancers, undifferentiated parotid carcinoma, hodgkin's disease, b cell lymphoma and gastric carcinoma.

Human Papillomavirus (HPV) - ✔cervical cancer HPV (human papilloma virus) - ✔app 70% of cervical cancer caused by HPV types 16 or 18 oral cancer - ✔HPV-16 detected in a substantial proportion of squamous cell carcinomas of the soft palate, tonsil, and base of the tongue oral cancer - ✔HPV-16 decteted in 60% to 70% of all HPV associated cancer of the oral cavity and oropharynx.

Human T-cell lymphotropic virus 1 (HTLV-1) - ✔Associated T-cell lymphotropic virus Hormone replacement therapy (HRT) - ✔Combined estrogen-progesterone HRT given to postmenopausal women increases the risk of breast cancer.

Estrogens - ✔may have protective role in preventing colorectal cancer long term use of HRT hormone replacement therapy - ✔increases risk of endometrial cancer.

Selective estrogen receptors modulators - ✔include tamoxifen and raloxifene Selective estrogen receptor modulators - ✔FDA-approved for use the used to reduce risk of breast cancer. for up to 50% among high risk women reduce risk of cancer of ovary and uterus - ✔use of oral contraceptive associated with breast cancer anabolic steroids - ✔associated with liver cancer Menotropins (Pergonal, Repronex, Menopur) - ✔may increase the risk for ovarian cancer. growth hormone - ✔may increase risk of leukemia immunosupressive agents (organ recipients) - ✔increase risk of non-hodgkin lymphoma

increases risk the risk of secondary cancers - ✔prior exposure to antineoplastic agents (specially alkylating agents).

Gardasil or Cervarix - ✔routine vaccination at 11-12 year of age(may start at 9) with 3 doses vaccination from 13-26 for those not previously vaccinated Hep B vaccine - ✔1-at birth 2-1-2 month 3-6-18 month which of the following statements are true about cancer mortality in the US? - ✔among women the 5 leading causes of cancer-related death are lung, breast, colorectal, pancreas, and ovary Breast cancer lifestyle-related risk factors include which of the following? - ✔combined estrogen and progesterone hormone replacement therapy for postmenopausal women. use of oral contraceptive alcohol consumption the five most common cancer diagnoses worldwide - ✔lung, breast, colorectal, stomach and prostate cancer health disparities - ✔white women highest incidence of breast cancer hispanic women have the highest incidence of cervical cancer african american men have the highest mortality rate for prostate cancer. risk factor associated with oral cancer include - ✔human papillomavirus (HPV) infection, tobacco use, and alcohol consumption. cancer risk assessment biggest benefit to the pt - ✔choose appropriate cancer prevention strategies rubber workers - ✔highest rates of prostate cancer miners - ✔increase rates of gastric cancer chemical workers - ✔increase rates of bladder cancer steel workers - ✔increase rates of lung cancer primary prevention - ✔the most effective treatment for cancer secondary prevention - ✔early detection of cancer

tertiary prevention - ✔effective therapy diagnosis - ✔clinical problems- solving process applied to asymptomatic individuals who either screen positive or present in an already symptomatic state incidence - ✔number of new cases identified in a specified population in a defined period (generally a year) prevalence - ✔percentage of all individuals with disease at a given point in time in a specified population validity - ✔accuracy of screening tool. measure by sensitivity and specificity sensitivity - ✔measure of the rest ability to correctly identify persons with disease (true positive) among the population screened (100% sensitivity= no false negative how sensitive a test is to the outcome for which is testing. specificity - ✔measure of the test's ability to correctly identify persons who do not have the the disease in the group being screened ( test will not be positive in anyone who does not have cancer) 100 specificity= no false positive how acurate a test will be in testing for one particular item. predictive value - ✔influenced by the prevalence of the disease in population as well as the sensitivity and specificity of the test the chance a test will have a false reading. positive predictive value - ✔the percentage of person who screen positive who actually have the disease negative predictive value - ✔the percentage of persons who screen negative who do not have the disease lead time bias - ✔screening most often performed on asymptomatic individuals who will generally have more indolent cancers selection bias - ✔those choosing to undergo cancer screening or select in differ from those who do not overdiagnosis - ✔diagnosis of an indolent cancer in a person who if not screened would not have been diagnosed not have needed treatment

PSA - ✔the only marker used in cancer screening programs, an its efficacy (ability to decrease mortality) remains controversial Proteomics - ✔study of the structure, function and patterns of expression of proteins. gail model - ✔tool developed to help estimate a woman's personal risk age age of menarche age at first live birth number of first degree relative with breast cancer number of previous benign breast biopsies atypical hyperplasia in a previous breast biopsy race breast cancer - ✔BRCA1 & BRCA2 gene mutation ashkenazi jewish heritage breast cancer treatment - ✔herceptin (adjuvant therapy such as hormone therapy) trastuzumab colorectal cancer - ✔1-guaiac based fecal occult blood test (GFOBT) 3 consecutive tool specimen 2-fecal immunochemical test (FIT) or immunochemical fecal occult blood test (iFOBT) 3- stool deoxyribonucleic acid (sDNA) 4-Barium enema 5-flexible sigmoidoscopy 6- colonoscopy 7-ct colonography also known as virtual colonoscopy (VC) 8-capsule endoscopy cervical cancer - ✔1- pap smear 2-cellular specimen from cervix 3-morphologic changes of precancerous cells cervical intraepithelial neoplasm (CIN) 4- Bethesda system (uniform cervical cytology) 5-low sensitivity of single pap est 6-HPV 7- Colposcopy- a primary method for evaluation of abnormal pap tests 8- tactic acid applied before viewing which allows a directed biopsy of any grossly visible abnormalities prostate cancer - ✔1-digital rectal examination (DRE) 2-serum PSA lung cancer - ✔1- chest x ray 2-sputum cytology with or w/o cxr

cancer incidence is defined as - ✔the number of new cases identified in a specified population during a defined period of time secondary prevention - ✔consists of methods of early detention such as mammography and other screening tests primary prevention - ✔aim to prevent the disease, encourage individuals to protect themselves from ultraviolet light, example for skin cancer tertiary prevention - ✔targets the pt who is already symptomatic by treating to slow the disease progression and prevent complications from occurring. quaternary prevention - ✔refers to avoiding the consequences of unnecessary or excessive intervention within the healthcare system which screening test has the strongest evidence (randomized clinical trials) to decrease mortality in a defined population. - ✔pap test for cervical cancer Cancer Epidemiology - ✔The study of the distribution and determinants of cancer in population groups The Incidence of cancer - ✔the rates of cancer occurrence in a population increase cancer incidences - ✔kidney and pancreas as well as melanoma, thyroid, liver and bile duct mass screening - ✔a testing that is done to a large group of people. ex state mandatory testing on newborns. selective or prescriptive screening - ✔testing that is done for a specific disease on patients who are risk for developing that disease. ex testing for the genetic for the presence for a tumor marker for cystic fibrosis. single screening - ✔done to check for the presence of a specific disease such as hypercholesterolemia. multiple screening - ✔looking for at least two abnormalities at one time. example screening for elevated cholesterol and PSA at the same time. multiohasic screening - ✔looking at a person over a period of time for the development of any conditions.example is assessing children for appropriate development with each well child visit.

annual mamography - ✔every year starting 40 adjunct screening with MRI only those with 20-25% or greater lifetime risk of breast ca. including strong family hx of breast ca, ovarian ca and woman treated for hodgkin disease. ductal lavage - ✔cells are collected from the breast ducts and examined for any changes. contrast dye can also be injected through the duct system to detect any tissue changes. cervical cancer - ✔screening is recommended to be ever 3 years starting at 21 regardless age of onset of sexual activity. colon cancer screening - ✔begin at age 50. screening can be using high sensitivity fecal occult blood testing (yealrly) sigmoidoscopy (every 5 years or is performed with fecl occult blood testing every 3 years colonoscopy every 10 years. colorectal cancer screening - ✔double contrast barium enema ct colonography stool dna test advance directives - ✔decisions about end of life care, such as living wills and the right to assign a surrogate person to make decisions through a durable power of attorney. extravasation sign and symptoms - ✔swelling redness stinging pain buring leaking extravasation nursing in - ✔SLAPP stop infusion leave catheter A= rate Pull catheter Physician notified.

Tumor Lysis Syndrome (TLS) - ✔chemotherapy increase cell death increase K increase Phosphate increase uric acid decrease calcium sign and symptoms of tumor lysis - ✔decrease urine output, hematuria

palpitations skipping beats confusion, hyperactive reflexes muscle spasm seizure lethargy trousseau sign (sign in hypocalcemia) chvostek sign (sign of hypocalcemia) preventive measure of TLS - ✔vigorous hydration allopurinol labs including uric acid monitor input and output treatment for TLS - ✔Rasburicase (breakdown) cancer incidence - ✔refers to the amount of new cases that are diagnosed each year also described as ratio. cancer prevalence - ✔total number of people who had a diagnosis in the past. cancer mortality - ✔number of people who have died from cancer. case-fatality - ✔referes to the mortality from a specific type of cancer such as colon cancer. cancer survival - ✔number of patients who were diagnosed with cancer at least five years previously absolute risk - ✔number of cancer diagnoses as far as incidence and cancer death are concerned. most of time is an average of cancer diagnoses within a group. relative risk - ✔the chance of being diagnosed with cancer because of certain risk factors that are specific to a certain cancer. attributable risk - ✔the number of cancer diagnoses that could be prevented if the pt did not have certain risk factors. cumulative risk - ✔the chance of a person developing cancer throughout their lifetime most affected ethnic group - ✔african americans the ethnic group with the lowest rate of cancer overall - ✔native americans prostate cancer highest in - ✔african american

the highest 5 year rate survival group from all types of cancer - ✔the japanese the lowest 5 year survival group - ✔native american class with the highest incidence of cancer whatever the ethnic group - ✔lower socioeconomic class lung cancer - ✔causes more death than any other cancer environmental exposure to carcinogens - ✔such as asbestos, uranium and radon bladder cancer - ✔men are more likely to develop blasser ca and caucasian are twice as likely to develop bladder cancer as african american. smoking cigarettes, industrial chemicals and poor dietary habits. prostate ca - ✔genetic link whose female relatives has breast cancer may also be at an increased risk for prostate ca. secondary survivors - ✔caregivers and family members survivor - ✔cancer pt from the moment of diagnosis (5y) acute stage of suvivorship - ✔initial stage when person is first diagnosed. NI education on disease process, treatment available and community resources. extended stage of survivorship - ✔after selected treatments are completed and includes the stage in where long term therapy may occur. NI compliance with long term therapy. includes continuing screening procedures to monitor for recurrrence. permanent stage of survivorship - ✔pt is considered to be cancer free (5) NI education compliance in screening for recurrence. cardiac effects - ✔such as heart failure from anthracycline agents (doxo, donarubicin) pulmonary toxicity - ✔inflammation of lung specially from bleomycin, radiation treatment and steroid breast cancer pt high risk recurrence - ✔first 2 years following treatment colon cancer high risk recurrence - ✔within 3 years of the initial treatment physical therapy - ✔help pt with movement , relieve pain and perform acitvities

occupational therpay - ✔help pt perform ADL independently aim of rehabilitation - ✔to cure pt and back to original enviroment reintegration - ✔the process of assisting the pt to return to work. survivors of childhood, adolescent and young adults guidelines - ✔providing standardization and enhancement breast cancer survivors first 3 years - ✔exam every 3-6 m breast cancer survivors year 4-5 - ✔exam 6-12 m colorectal cancer survivors - ✔exam 3-6 m for a period of 5 years colorectal cancer testing - ✔ct abdomen and chest annually for the first 3 years law protecting cancer survivors - ✔-ADA the american disability act and the federal rehabilitation act prohibits employers from discriminating against their employees.

-GINA genetic information nondiscrimination protects pt based on genetic testing or family history -the family and medical leave act requires employers to provide 12 w of unpaid leave during any 12 m period to attend to serious health conditions. patient advocate foundation - ✔assist pt with chronic diseases help with healthcare, job retention or discrimination COBRA - ✔A federal law that someone who leaves employment may be eligible to keep insurance coverage at his/her own expense up to six months. patient advocate foundation - ✔provides asistance with co-pays and transportation expenses for pt breast cancer and multiple myeloma partnership for prescription assistance - ✔provide info for free or low cost prescription drugs PAN foundation - ✔offer financial assistance to pay medical cost through 60 diseasespecific program Healthwell foundation - ✔provides financial assistance through the emergency cancer relief fund cancer care - ✔provide financial assistance assits cost of transportation, home care child care and co-payments

The Samfund - ✔provides twice yealry grants to assist young(21-39) cancer pt with living expenses, tuition education, medical bills healthcare related expenses.

Cancer Hope Network - ✔provides confidential one to one support at no cost the angel foundation - ✔offer different camps, retreats and support groups fro family members of survivors the live strong foundation - ✔created survivor ship centers provide direct services to pt and families cardiovascular problems due to - ✔anthracyclines (doxoruvbicin, epirubicin) target therapies(bavacizumab and trastuzumab) mitoxantrone hearing loss - ✔platinum based chemotherapies (cisplatin and carboplatin) Alkylating agents - ✔cyclophosphamide carmustine chlorambucil increases the risk of MDS & AML within 2 years Platinum-based agents - ✔cisplatin carboplatin increases the risk of AML Topoisomerase II inhibitors - ✔Etoposide mitoxantrone increases the risk of AML within 2-3 years Targeted therapy - ✔vemurafenib dabrafenib increase risk of squamous cell carcinoma thermoregulatory center - ✔in the hypothalamus controls the rise and fall of the body's temperature cancer that causes fever - ✔usually in the lymph system, bone and the liver.

Kubler-Ross stages of grief - ✔1. Denial 2. Anger 3. Bargaining 4. Depression

5. Acceptance cancer - ✔irregular cell growth and production carcinogenesis - ✔process of normal genes are damaged, so cell lose control mechanism and proliferate out of control. familial carcinogenesis - ✔cancer suppressor genes that are present normally but when changed cause cancer by their absence. breast cancer is ex. viral carcinogenesis - ✔hep B virus, human T-cell leukemia-lymphoma virus, human papilloviruses and epstein-barr virus bacterial carcinogenesis - ✔helicobacter pylori is associated with mucosa-associated lymphoid tissue lymphoma chemical carcinogenesis - ✔induced by chemical/toxin exposure ex lung cancer from smoking environmental carcinogenesis - ✔from secondary smoke physical carcinogenesis - ✔squasmous cell cancer caused by exposure to UA of the sun steps in metastatic sequence - ✔1-tumor growth and neovascularization 2-tumor cell invasion 3-detachment and embolism of tumor cell aggregates 4-arrest in distant organ capillary beds 5-extravasation 6-proliferation within the organ parenchyma invasion - ✔process in which cancer cell reproduce and take over an area of normal health tissue. angiogenesis - ✔tumor causes the body to produce blood vessels that enable the tumor to survive and grow. metastasis - ✔extension of cancer cells to other parts of the body tumor heterogeneity - ✔used to describe the dissimilarities found in between cancer cells within a tumor. the more heterogeneous a tumor is the more difficult its to be treated. initiation - ✔action the cancer causing substance entering the body

promotion - ✔the process in which the body is repeatedly expose to cancer causing subtance progression - ✔occur when malignant cancer cells begin to outnumbered the normal healthy cells because of continued replication.

Pleomorphism - ✔cells are of different dimension and forms polymorphism - ✔the ability of the cell's nucleus to expand and change its form hyperchromatism - ✔chromatin within the cell's nucleus that is seen clearly when staining is done for studies translocations - ✔changes in the chromosomes in which the genetic information is swapped deletions - ✔occurs when portions of a chromosome's genetic information is obliterated amplifications - ✔refers to multiple reproductions of a sections of DNA aneuploidy - ✔refers to an atypical quantity of chromosomes blood supply is produce through - ✔angiogenesis Gompertzian growth - ✔terms that refers to a generality that is made regarding tumor growth hyperplasia - ✔process in which the quantity of cells within a certain tissue multiplies. occurs in both healthy and cancerous tissue metaplasia - ✔one type of cell is interchanged with another within a specific tissue. this occurs in response to chronic damage inflicted on a certain type of cell dysplasia - ✔is a change in normal cells. anaplasia - ✔is used to explain cancer cells oncogenes - ✔are present within the body's cells and play role in the development of cancer. they are altered portions of the cells DNA that function to promote the reproduction of cancer cells body ways to prevent oncogenes from reproducing cancer cells - ✔proto-oncogenes tumor suppression genes

proto-oncogenes - ✔make up a portion of DNA within cells. they are responsible for the replacement of normal cells and also play role on fixing cell that have been damaged tumor suppression genes - ✔responsible for halting the replication of cells they can also function to stop the reproduction of cancer cells immunology - ✔field in medicine that examines the body ability to fight infection categories of immunity - ✔nonspecific immunity specific immunity nonspecific immunity - ✔are the skin along with mucous membrane (barrier) specific immunity - ✔immune system response to an invader or antigen recognized by the body as nonself specific immunity - ✔1-humoral immunity 2-cell mediated primary lymph organs - ✔are responsible for the development of lymphocyytes. they also form the receptors in which cancer cells bind bone marrow (primary lymph organ) - ✔where b cells are formed thymus (primary lymph organ) - ✔within the mediastinum where t cells are developed secondary lymph organs - ✔are locations at which cancer cells frequently atttempt to take over normal tissue, tonsils, the spleen bone marrow - ✔is the only lymphatic substance that functions as both primary and secondary lymph tissue dendritic cells - ✔responsible for activating t cells in fighting foreign cells lymphocytes - ✔necessary for the immune system to function b-cells formed in the bone marrow t cells mature in the thymus glans and function to produce substances that assist the immune system phagocytes - ✔responsible for enclosing foreign substance and destroying them basophils - ✔responsible for traveling to areas where there is tissue injury and causing the release of substances that stimulate an allergic reactions.

mast cells (granuloctes) - ✔factors that stimulate the immune system to cause an inflammatory reaction null cells - ✔derived from lymph tissue, once fully formed,they work with macrophages and neutrophils to trigger immune response natural killer cells - ✔hold materials that functions as enzyme to destroy foreign cells lymphokine-activated cells - ✔are formed outside of the circulatory system by combining lymphocytes with interleukin-2 and then replacing the cells in the pt body cytokines - ✔refers to a group of cells that function to promote maturity of wbc interferons - ✔activated in response to viral invasions within the body interleukins - ✔are created by T-cells hematopoiwtic growth factors - ✔or colony growth factors work in organizing and leading cell reproduction. they also trigger the process that distinguished stem cells from wbc tumor necrosis factors - ✔are activated in response to inflammation and actions that lead to cell death chemokines - ✔are produced by wbc and work to direct wbc through the body in response to an antigen's presence the complement system - ✔is made up of proteins that function in immunity frameshift mutation - ✔is a protein that has been modified because it has at least one base attached or deleted from it. missense mutation - ✔occurs when amino acids is replaced by a different amino acid within a protein. a nonsense mutation - ✔is an alteration in the construction of protein because the amino acids are "told" to quit constructing a protein. this results in a protein that is incomplete and cannot function normaly RNA-negative mutations - ✔are proteins that do not have RNA because of an error in duplication

splicing - ✔results when unnecessary DNA is preserved or when necessary DNA is omitted. this causes the frameshift mutation polymorphisms - ✔are alterations in the DNA sequence phase 1 clinical trials - ✔patient safety and maximum dose is tolerated phase 2 clinical trials - ✔preliminary data of the drug effectiveness is establish. short term adverse effects are studied Phase 3 clinical trials - ✔overall benefits versus the rusk of the drug is evaluated and more data regarding safety and efficacy is established. phase 4 clinical trials - ✔the drug has been approved by FDA from marketing purposes. prognosis - ✔outcome of the disease process carcinoma - ✔cancer of epithelial tissue cells sarcoma - ✔a malignant tumor growing from mesodermal tissue lymphoma - ✔cancer coming from the nodes or glands of the lymphatic system leukemia - ✔cancer of the bone marrow stopping the marrow from producing normal blood cells myeloma - ✔cancer in the plasma cells of the bone. In many bones it is called multiple myeloma Invasive - ✔the tumor can invade the tissues surrounding it by sending the cancerous cells of the tumor into the surrounding normal tissue metastatic - ✔cancer cells from the tumor that have migrated to other tissues near or far from the original tumor. primary tumor - ✔the original tumor secondary tumor - ✔new tumors of the same identical tumor cells located in far organs there by cancer cells circulating through the blood circulatory system or through the lymphatic system. "well differentiated " tumor cells - ✔the most normal like normal cells, they may also be referred as low grade

"undifferentiated" cancer cells - ✔more abnormal and associated with poor prognosis may also be refer as high grade Paget's disease - ✔orange peel appearance along skin changes over the nipple and areola invasive breast cancer - ✔involves breast tissue but also extends into adjacents tissues invasive ductal carcinoma - ✔located within the ducts but extends beyond the basement membrane to consume surrounding tissues invasive lobular carcinoma - ✔begins in the lobe tissue within the breast and invades surrounding tissue Paget's disease - ✔begins as a malignant lesion around the nipple and areola. it usually begins as a ductal carcinoma. noninvasive cancer(in-situ cancers) - ✔are restricted to the ductal-lobular units and don't extend into the lymphatic or circulatory system ductal carcinoma - ✔in situ stage 0 localized within the ductal lobular units lobular carcinoma - ✔ussually not identified on mammogram adenocarcinomas - ✔prostate cancers simple squamous cells - ✔replaced the damaged columnar epithelium AML (acute myelogenous leukemia) - ✔symptoms similar to the flu.

ALL (acute lymphocytic leukemia) - ✔symptoms similar to aml but has enlarged lymph nodes and enlarged spleen CML (Chronic myelogenous leukemia) - ✔same symptoms by also complain of left side abdominal pain or feeling fullness , liver an spleen may be enlarged and bleeding disorders CLL (chronic lymphocytic leukemia - ✔symptoms of anemia and bleeding disorder may be present