Cancer Flashcards
What are the common key features of cancer?
- Uncontrolled proliferation
- Self sufficiency in growth signals
- Insensitivity to anti-growth signals
- Avoiding cell death (apoptosis)
- Establish blood flow (for oxygen and nutrients)
- Tissue invasion
- Metastasis i.e. can spread to other parts of the body
Most common types of cancer in males and females?
Males
1. Prostate
2. Trachea, bronchus and lungs
3. Colorectal
Females
1. Breast
2. Trachea, bronchus and lungs
3. Colorectal
What signs indicate that someone may have lung cancer?
- Cough
- Smokes
- Tired and breathless
- Dull chest pain
- Haemoptysis
- Weight loss/appetite change
- Change in voice
If someone is suspected of having lung cancer, what investigations should be performed?
- Chest X-ray (urgent, within 2 weeks)
- Full blood count, Urea and electrolytes, calcium
What signs indicate that someone may have colorectal cancer?
- Change in bowel habits, motions and distension
- Abdominal pain
- Fatigue
- Breathless
- Blood in stool (mixed in)
If someone is suspected of having colon cancer, what investigations should be performed?
- Full blood count, urea and electrolytes, liver function tests
- Refer for investigation for colorectal cancer - Colonoscopy
What signs indicate that someone may have back cancer?
- Back Pain
- Nocturnal pain
- Weakness in his leg
- Weight loss
- Urinary urgency / nocturia (wake up at night to pee)
If someone is suspected of having back cancer, what investigations should be performed?
- Full blood count, urea and electrolytes, calcium, prostate specific antigen
- MR scan spine
What is prostate specific antigen?
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland
Normal to have circulating levels, but elevated levels could be indicative of cancer.
Note - prostate cancer typically metastasize to bones
What causes elevated calcium levels in bony cancers?
- Excessive secretion of parathyroid hormone-related protein (PTHrP)
- Bony metastases with the release of osteoclast activating factors
- Production of 1,25-dihydroxy vitamin D (calcitriol).
What are risk factors for breast cancer?
- Family history – patients should be invited early/prophylactic surgery is also possible
5-10% likely genetic - Obesity post menopause
- Alcohol
- Hormone replacement therapy
- Inactivity
- Early menarche (before age 12) and later menopause (after 55) increases risk
- Pregnancy: earlier first pregnancy and more pregnancies reduces risk
How are people screened for breast cancer? What happens if they have a positive result?
Screening
Women aged 50-70
Mammogram every 3 years
Positive screening – people recalled back to the breast clinic
1. Further examinations
2. If Magnified mammogram-Tomosynthesis & Breast ultrasound are suspicious - biopsy required
What is cancer overdiagnosis?
This is detecting a cancer that would not have caused harm to person in their lifetime
Estimated that 20% of all breast cancers detected in screening are over-diagnosis
Used as a justificaiton to screen people between 50-70 - cost of overdiagnosis
What is the presentation for breast cancer?
- Screening mammogram ~50% of cases - detected from screening
- Breast mass
- Lymphadenopathy - lymph node involvement
- Skin changes
- Metastatic disease
What is the triple assessment used to investigate breast cancer?
What are the different types of interventions used to manage breast cancer patients?
