Introduction to Cancer

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Course Objectives
  1. Classify the different types of cancer
  2. Explain cancer stages
  3. Review risk factors that can increase the risk of cancer development
  4. Outline testing and treatment options for cancer, highlighting the phlebotomist’s role in the process

Course Content
Course Creator: Nichelle Volker RMA
Total CE Hours: 1 Credit Hour 
Pace Course #: 586-2222-25

Key Terms:
CDC
EPA
HHS
IARC
Cancer
Germline mutations
Metastasized
Oncogenic
Somatic mutations
Tumor
Benign
Malignant

Outline:
  • Introduction
  • Key Terms
  • Cancer: Defined and Differentiated 
    • Defined
    • Stages
    • Wordparts
      • Word parts applied 
    • How cancer changes cells
    • Cancer classifications
  • Risk factors
    • Cancer and Genetics 
    • Gene Mutations - Inherited
      • BRCA1 and BRCA2 
      • Other Inherited Gene Markers
    •  Gene Mutations - Acquired
  • Behavioral/Lifestyle Factors
    • Tobacco Use 
    • Alcohol Use
    •  Obesity
  •  Environmental Factors
    • Ionizing Radiation
    •  Ultraviolet Radiation
    •  Asbestos 
      • Asbestos and Cancer
  • Microorganisms Factors
    • Viral Factors
    •  Human Papillomavirus (HPV)
    •  Epstein-Barr virus (EBV)
    •  Hepatitis B Virus and Hepatitis C Virus
    •  Human Immunodeficiency Virus (HIV)
    •  Human Herpes Virus 8 (HHV-8)
    •  Human T-Lymphotrophic Virus-1(HTLV-1)
  •  Treatment Methods
    • Chemotherapy
    •  Hormone Therapy
    •  Hyperthermia Therapy
    •  Immunotherapy
    •  Photodynamic Therapy
    •  Radiation Therapy
    •  Blood Stem Cell transplant
    •  Surgical 
    • Targeted Therapy and How it Works
  •  Phlebotomy & Cancer
    • The Phlebotomist’s Role 
    • Testing and Diagnosis
      • CBC
      •  CMO
      •  LDH
      •  ESR
      •  CRP
      •  PSA
      •  CA-125
      •  CEA
      •  AFP
      •  CA-19
      •  Electrophoresis Testing
      •  Liquid Biopsy
    •  Monitoring and Follow-up 
      • Routine Draws for Treatment Monitoring
      •  Draws for Transfusions
    •  Clinical Research and Trials
      • Phlebotomists play a vital support role in cancer research by
    •  Patient Interaction, Safety, and Advocacy 
      • Support Patients During Testing
      •  Infection Control and Safety

References: 
  1. Cancer. (2025, June 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12194-cancer
  2. Du Cancer, C. C. S. /. S. C. (n.d.). How cancer starts, grows and spreads. Canadian Cancer Society. https://cancer.ca/en/cancer-information/what-is-cancer/how-cancer-starts-grows-and-spreads
  3. Professional, C. C. M. (2025, May 6). Cancer staging. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22607-cancer-stages-grades-system
  4. Cancer. (2025b, June 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12194-cancer
  5. Li, C., & Lu, H. (2018). Adenosquamous carcinoma of the lung. OncoTargets and Therapy, Volume 11, 4829–4835. https://doi.org/10.2147/ott.s164574
  6. Tobacco and cancer. (2025, June 11). Cancer. https://www.cdc.gov/cancer/risk-factors/tobacco.html
  7. Alcohol and cancer. (2025, June 11). Cancer. https://www.cdc.gov/cancer/risk-factors/alcohol.html
  8. Obesity and Cancer fact sheet. (2025, January 28). Cancer.gov. https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#how-might-obesity-increase-the-risk-of-cancer
  9. Ultraviolet radiation and skin cancer. (2025, June 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10985-ultraviolet-radiation
  10.  Asbestos exposure and cancer risk fact sheet. (2021, May 20). Cancer.gov. https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/asbestos/asbestos-fact-sheet
  11.  Viruses that Can Lead to Cancer. (n.d.). American Cancer Society. https://www.cancer.org/cancer/risk-prevention/infections/infections-that-can-lead-to-cancer/viruses.html
  12.  About ionizing radiation. (2024, February 19). Radiation and Your Health. https://www.cdc.gov/radiation-health/about/ionizing-radiation.html
  13.  Types of cancer treatment. (n.d.). Cancer.gov. https://www.cancer.gov/about-cancer/treatment/types
  14.  The genetics of cancer. (2024, August 8). Cancer.gov. https://www.cancer.gov/about-cancer/causes-prevention/genetics
  15.  Gene changes (Mutations). (n.d.). Nemours KidsHealth. https://kidshealth.org/en/parents/gene-mutations.html
  16. The genetics of cancer. (2024, August 8). Cancer.gov. https://www.cancer.gov/about-cancer/causes-prevention/genetics
  17. Genetic mutations. (n.d.). American Cancer Society. https://www.cancer.org/cancer/understanding-cancer/genes-and-cancer/gene-changes.html
  18. Inherited mutations and cancer. (n.d.). Inherited Mutations and Cancer. https://www.facingourrisk.org/info/hereditary-cancer-and-genetic-testing/hereditary-cancer/inherited-mutations-and-cancer?
  19. BRCA1 gene: MedlinePlus Genetics. (n.d.). https://medlineplus.gov/genetics/gene/brca1
  20. What is the Difference Between BRCA1 and BRCA2? (n.d.). Roswell Park Comprehensive Cancer Center. https://www.roswellpark.org/cancertalk/202006/what-difference-between-brca1-brca2
  21. Triple-negative breast cancer | Details, diagnosis, and signs. (n.d.). American Cancer Society. https://www.cancer.org/cancer/types/breast-cancer/about/types-of-breast-cancer/triple-negative.html
  22. BRCA2 gene: MedlinePlus Genetics. (n.d.). https://medlineplus.gov/genetics/gene/brca2/
  23. 005009: Complete blood count (CBC) with differential, reflex to peripheral smear review. (n.d.). Labcorp. https://www.labcorp.com/tests/005009/complete-blood-count-cbc-with-differential-reflex-to-peripheral-smear-review
  24. 001487: protein electrophoresis, serum. (n.d.). Labcorp. https://www.labcorp.com/tests/001487/protein-electrophoresis-serum#test-specimen
  25. 002303: Cancer Antigen (CA) 125. (n.d.). Labcorp. https://www.labcorp.com/tests/002303/cancer-antigen-ca-125#test-specimen
  26. 850450: Plasma Complete. (n.d.). Labcorp. https://www.labcorp.com/tests/850450/plasma-complete
  27. Admin. (2025, April 2). What cancers can be detected through genetic testing? A complete guide to genetic risks. BeatCancer. https://beatcancer.eu/resources/science/article/what-cancers-can-be-detected-through-genetic-testing/
  28. The Cleveland Clinic. (2025, March 19). LDH test. Cleveland Clinic. Retrieved July 9, 2025, from https://my.clevelandclinic.org/health/diagnostics/22736-lactate-dehydrogenase-ldh-test
  29. Understanding cancer-related blood tests: tumor marker tests. (n.d.-b). Iris. https://content-dev.irisoncology.com/library/understanding-cancer-related-blood-tests-tumor-marker-tests?
  30. 010322: Prostate-specific Antigen (PSA). (n.d.). Labcorp. https://www.labcorp.com/tests/010322/prostate-specific-antigen-psa
  31. 002139: Carcinoembryonic Antigen (CEA). (n.d.). Labcorp. https://www.labcorp.com/tests/002139/carcinoembryonic-antigen-cea
  32. 002253: Α-Fetoprotein (AFP), tumor marker. (n.d.). Labcorp. https:/www.labcorp.com/tests/002253/fetoprotein-afp-tumor-marker
  33. 002261: Carbohydrate antigen (CA) 19-9. (n.d.). Labcorp. https://www.labcorp.com/tests/002261/carbohydrate-antigen-ca-19-9#test-specimen

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