Medical Terminology for Cancer

© Copyright 1996-2013

Introduction 8: The Cardiovascular System (Heart and blood)

What is Cancer?

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Contents
Components of
Recommend 102
Terminology
Functions of the cardiovascular system
Abbreviations
Blood
Body Systems Blood vessels
Skin The heart
Skeletal The spleen
Muscular
Roots, suffixes, and prefixes
Cardiovascular
Cancer Focus
Lymphatic

Gastrointestinal
Related Abbreviations and Acronyms
Urinary Further Resources
Respiratory

Endocrine
Functions of the cardiovascular system
Nervous

Reproductive Blood circulates through a network of vessels throughout the body to provide individual
cells with oxygen and nutrients and helps dispose of metabolic wastes. The heart pumps
Index

Disclaimer
the blood around the blood vessels.
© 1996-2013
Functions of blood and circulation:
CancerIndex
Circulates OXYGEN and removes Carbon Dioxide.
Provides cells with NUTRIENTS.
Removes the waste products of metabolism to the excretory organs for disposal.
Protects the body against disease and infection.
Clotting stops bleeding after injury.
Transports HORMONES to target cells and organs.
Helps regulate body temperature.

Blood
Blood is made up of about 45% solids (cells) and 55% fluids (plasma). The plasma is
largely water, containing proteins, nutrients, hormones, antibodies, and dissolved waste
products.
General types of blood cells: (each has many different sub-types)
ERYTHROCYTES
(red cells) are small red disk shaped cells. They contain HAEMOGLOBIN, which
combines with oxygen in the lungs and is then transported to the body's cells. The
haemoglobin then returns carbon dioxide waste to the lungs. Erythrocytes are
formed in the bone marrow in the knobby ends of bones.
LEUKOCYTES
(white cells) help the body fight bacteria and infection. When a tissue is damaged or
has an infection the number of leukocytes increases. Leukocytes are formed in the
small ends of bones. Leukocytes can be classed as granular or non granular. There
are three types of granular leukocytes (eosinophils, neutrophils, and basophils), and
three types of non-granular (monocytes, T-cell lymphocytes, and B-cell
lymphocytes). See also the lymphatic system.
THROMBOCYTES
(platelets) aid the formation of blood CLOTS by releasing various protein
substances. When the body is injured thrombocytes disintegrate and cause a
chemical reaction with the proteins found in plasma, which eventually create a
thread like substance called FIBRIN. The fibrin then "catches" other blood cells
which form the clot, preventing further loss of blood and forms the basis of healing.

Blood vessels

Simplified diagram of the circulatory system. Image Source: http://en.wikipedia.org/wiki/File:Circulatory_System_en.svg

ARTERIES
carry oxygenated blood away from the heart. They are thick hollow tubes which are
highly ELASTIC which allows them to DILATE (widen) and constrict (narrow) as
blood is forced down them by the heart. Arteries branch and re-branch, becoming
smaller until they become small ARTERIOLES which are even more elastic.
Arterioles feed oxygenated blood to the capillaries. The AORTA is the largest artery
in the body, taking blood from the heart, branching into other arteries that send
oxygenated blood to the rest of the body.
CAPILLARIES
distribute the nutrients and oxygen to the body's tissues and remove deoxygenated
blood and waste. They are extremely thin, the walls are only one cell thick and
connect the arterioles with the venules (very small veins).
VENULES
(very small veins) merge into VEINS which carry blood back to the heart. The vein
walls are similar to arteries but thinner and less elastic. Veins carry deoxygenated
blood towards the lungs where oxygen is received via the pulmonary capillaries.
The PULMONARY Veins then carries this oxygenated blood back to the heart.

Image source: http://commons.wikimedia.org/wiki/File:Illu_capillary.jpg

The heart
The heart is a hollow muscular organ which beats over 100,000 times a day to pump
blood around the body's 60,000 miles of blood vessels. The right side of the heart
receives blood and sends it to the lungs to be oxygenated, while the left side receives
oxygenated blood from the lungs and sends it out to the tissues of the body. The Heart
has three layers; the ENDOCARDIUM (inner layer), the EPICARDIUM (middle layer),
and MYOCARDIUM (outer layer). The heart is protected by the PERICARDIUM
which is the protective membrane surrounding it.
The heart has FOUR CHAMBERS, in the lower heart the right and left Ventricles, and
in the upper heart the right and left Atria. In a normal heart beat the atria contract while
the ventricles relax, then the ventricles contract while the atria relax. There are VALVES
through which blood passes between ventricle and atrium, these close in such a way that
blood does not backwash during the pauses between ventricular contractions. The right
and left ventricles are divided by a thick wall (the VENTRICULAR SEPTUM), babies
born with "hole in the heart" have a small gap here, which is a problem since oxygenated
and deoxygenated can blood mix. The walls of the left ventricle are thicker as it has to
pump blood to all the tissues, compared to the right ventricle which only pumps blood as
far as the lungs.

Image source: http://commons.wikimedia.org/wiki/File:Diagram_of_the_human_heart_(cropped).svg" License: Creative

Commons

The spleen
This is a large flat oval organ located below the diaphragm, it's main function is to
STORE BLOOD. The size of the spleen can vary, for example it may enlarge when the
body is fighting infection also it's size tends to decrease with age. It is a non-vital organ
and it is possible to survive after removal of the spleen.
Perinicious anaemia is a Vitamin B12 deficiency resulting in a reduction in number of
erythrocytes.
Aplastic anemia is a failure of the bone marrow to produce the enough red blood cells.
Septicaemia - bacterial toxins in blood.

Roots, suffixes, and prefixes

Most medical terms are comprised of a root word plus a suffix (word ending) and/or a
prefix (beginning of the word). Here are some examples related to the Integumentary
System. For more details see Chapter 4: Understanding the Components of Medical
Terminology

component meaning example

CARDIO- heart echocardiogram = sound wave image of the heart.
CYTE- cell thrombocyte = clot forming cell.
haematoma - a tumour or swelling filled with
HAEM- blood
blood.
thrombocytopenia = deficiency of thrombocytes
THROMB- clot, lump
in the blood
ETHRO- red ehtrocyte = red blood cell
LEUKO- white leukocyte = white blood cell
SEP, toxicity due to micro-
SEPTIV- organisms septicaemia
cerebrovascular = blood vessels of the cerebrum
VAS- vessel / duct
of the brain.
hyperglycaemia = excessive levels of glucose in
HYPER- excessive
blood.
hypoglycaemia = abnormally low glucose blood
HYPO- deficient / below
levels.
neutropenia = low levels of neutrophilic
-PENIA deficiency
leukocytes.
anaemia = abnormally low levels of red blood
-EMIA condition of blood
cells.

Cancer Focus
Overview of Haematological Malignancies
The most common haematological malignancy is leukaemia - cancer of the white
blood cells. There are many types of leukaemia; Acute types progress rapidly, while
Chronic types develop more slowly. Leukaemia is often accompanied by anaemia
because the red oxygen carrying cells in the blood are crowded out by the cancerous
white cells. There are a number of malignancies and disorders affecting other types
of blood cells.

Internet Resources for Leukaemia

Acute Lymphoblastic Leukaemia (ALL)
Acute lymphoblastic leukaemia (also known as acute lymphocytic leukaemia or
ALL) is a disease where too many immature lymphocytes (a type of white blood
cell) are found in the blood and bone marrow. Symptoms can include persistent
fever, weakness or tiredness, achiness in the bones or joints, or swollen lymph
nodes. Adult ALL and its treatment is usually different to childhood ALL. Almost a
third of adult patients have a specific chromosome translocation; "Philadelphia
Positive" ALL.

Internet Resources for Acute Lymphoblastic Leukaemia

Acute Myeloid Leukaemia (AML)
Acute myeloid leukemia (AML) is a disease in which too many immature
granulocytes (a type of white blood cell) are found in the blood and bone marrow.
There are a number of subtypes of AML including acute myeloblastic leukemia,
acute promyelocytic leukemia, acute monocytic leukemia, acute myelomonocytic
leukemia, erythroleukemia, and acute megakaryoblastic leukemia.

Internet Resources for Acute Myeloid Leukaemia

Other Types of Leukaemia
Chronic Lymphocytic Leukaemia
Chronic Myelogenous Leukaemia
Hairy Cell Leukaemia

Internet Resources for Leukaemia

Childhood Leukaemia
Childhood leukaemias tend to have different characteristics and treatments
compared to adult leukaemias. There is a "childhood peak" of Acute Lymphoblastic
Leukaemia, there is a lower proportion of Acute Myeloid Leukaemias compared to
adult patients. Clinical prognostic factors include age, White Blood Cell count
(WBC) at presentation, and Central Nervous System (CNS) involvement. Infants
less than 1 year and adolescents over 10 years of age, WBC greater than 50,000, or
CNS involvement are associated with a less favourable prognosis.

Internet Resources for Childhood Leukaemia

Other Haematological Malignancies
- Lymphomas
These are covered in the chapter on the Lymphatic System
- Myelodysplastic Syndromes
Myelodysplastic syndromes, sometimes called "pre-leukaemia" are a group of
diseases in which the bone marrow does not produce enough normal blood cells.
Common symptoms are anaemia, bleeding, easy bruisability, and fatigue. These
Myelodysplastic syndromes can occur in all age groups but are more common in
people aged over 60. Myelodysplastic syndromes may develop spontaneously or
be secondary to treatment with chemotherapy / radiotherapy. There is an
association with Myelodysplastic syndromes and acute myeloid leukaemia.
- Myeloproliferative Disorders
Myeloproliferative disorders are diseases in which too many blood cells are
made by the bone marrow, there are 4 main types of myeloproliferative
disorders: chronic myelogenous leukaemia, polycythemia vera, agnogenic
myeloid metaplasia, and essential thrombocythemia. Chronic myelogenous
leukaemia is where an excess of granulocytes (immature white blood cells) are
found in the blood and bone marrow. Polycythemia vera is where red blood cells
become too numerous often resulting in a swelling of the spleen. Agnogenic
myeloid metaplasia is a condition in which certain blood cells do not mature
properly, this may result in a swelling of the spleen and anaemia. Essential
thrombocythemia is a disease in which the body produces excessive numbers of
platelets (cells in the blood that make it clot) which impedes the normal
circulation of blood.
- Aplastic Anaemia
Anaplastic Anemia is not a cancer. AA is a rare disease in which the bone
marrow is unable to produce adequate blood cells; leading to pancytopenia
(deficiency of all types of blood cells). AA may occur at any age, but there is a
peak in adolescence / early adulthood, and again in old age. Slightly more males
than females are diagnosed with AA, also the disease is more common in the
Far East. Patients successfully treated for aplastic anemia have a higher risk of
developing other diseases later in life, including cancer.
- Fanconi Anaemia
Fanconi Anaemia is not a cancer, it is a rare disorder found in children that
involves the blood and bone marrow. The symptoms include severe aplastic
anemia, hypoplasia of the bone marrow, and patchy discoloration of the skin.
Recent research has shown an association between Fanconi anaemia and
leukaemia.
- Waldenstrom's Macroglobulinemia
This is a rare malignant condition, involving an excess of beta-lymphocytes (a
type of cell in the immune system) which secrete immunoglobulins (a type of
antibody). WM usually occurs in people over sixty, but has been detected in
younger adults.
Internet Resources for Haematological Malignancies
French-American-British (FAB) Classification Scheme
Leukaemia can be classified using the French-American-British (FAB) criteria. for
cell morphology:
L1 - ALL: small lymphoid cells, regular nuclei
L2 - ALL: large lymphoid cells, irregualr nuclei
L3 - ALL: large homogeneous cells with prominent nucleolus
M1 - Myeloblastic leukemia without maturation
M2 - Myeloblastic leukemia with maturation
M3 - Promyelocytic leukemia
M4 - Myelomonocytic leukemia
M5 - Monocytic leukemia
M6 - Erythroleukemia
M7 - Megakaryoblastic leukemia
M0 - AML with minimal differentiation
CNS Prophylaxis
Leukaemia can sometimes spread to the spinal cord and brain (Central Nervous
System). Intrathecal chemotherapy (injection into the fluid around the spine) may be
given to combat or prevent CNS relapse.
Blood Counts
Blood counts are done to test the number of each of the different kinds of cells in the
blood. This may be an aid to diagnosis or done to monitor toxicity after each course
of chemotherapy. The next course of chemotherapy may be delayed until white
cells, neutrophils, and platelets have recovered to a safe level.
Cardiotoxicity
Cardiotoxicity (damage to the heart) is associated with certain anti cancer drugs,
especially Adriamycin. As such the total dose of these drugs may be limited to
reduce the risk of cardiotoxicity.
Echocardiagram
An Echocardiogramis where an image of the heart is formed when high frequency
sound waves are reflected from the muscles of the heart. An echocardiogram may be
done before treatment starts to establish a baseline from which to compare future
tests.
Metastases through the cardivascular system
The network of blood vessels reach all parts of the body and may provide one of the
routes for cancer cells to spread to secondary sites.

Related Abbreviations and Acronyms

AA Anaplastic Anaemia
ALL Acute lymphoblastic leukaemia
AML Acute Myeloid leukaemia
ANC Absolute neutrophil count
ANLL Acute non-lymphatic leukaemia
ASH American Society for Hematology
B-ALL B-cell Acute Lymphoblastic Leukaemia
BP Blood pressure
CALGB Cancer and Leukemia Group B (USA)
cALL Common ALL
CGL Chronic Granulocytic Leukaemia
CHF Congestive heart failure
CLL Chronic lymphocytic Leukaemia
CML Chronic myeloid leukaemia
CMML chronic myelomonocytic leukemia
CPR Cardio pulmonary resuscitation
CVA Cardiovascular Accident (stroke)
CVC Central venous catheters
ECG Electrocardiogram - heart scan
FAB French American and British classification scheme for leukaemia
FBC Full Blood Count
G-CSF Granulocyte colony stimulating factor promotes production of white blood cells
GM-CSF Granulocyte and macrophage colony stimulating factor
Hb Haemoglobin
HCL Hairy Cell Leukaemia
HD Hodgkin's Disease (lymphoma)
HTLV Human T-cell leukemia-lymphoma virus
IV Intravenous - into a vein
LVEF Left Ventricular Fjection Fraction - a heart function test
LVSF Left Ventricular Shortening Fraction - a heart function test
MM Multiple Myeloma
RBC Red blood cell / red blood count
WBC White blood cell count
WCC White cell count

Further Resources (4 links)

Cardiovascular System
SEER, National Cancer Institute
Part of a SEER training module for cancer registry staff.
Cardiovascular System - Self Test questions
WebAnatomy, University of Minnesota
Test your anatomy knowledge with these interactive questions. Includes different
question types and answers.
Human Anatomy - Heart circulatory system

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The Circulatory System
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Paul Andersen
Paul Andersen surveys the circulatory system in humans. He begins with a short
discussion of open and closed circulatory systems and 2,3, and 4-chambered hearts.
He describes the movement of blood through the human heart and the blood
vessels. He discusses the major components of blood and the cause of a heart
attack.

This guide by Simon Cotterill

First created 4th March 1996
Last modified: 1st February 2014