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BioMed S2 > 17. Oncology - Types of cancers > Flashcards

17. Oncology - Types of cancers Flashcards

(101 cards)

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1
Q

Lung Cancer: peak incidence

A

60-70 yrs

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2
Q

Lung Cancer: epidemiology

A

More common in men - 3:1

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3
Q

Lung Cancer: 5 year survival rate

A

15%

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4
Q

Lung Cancer: secondary to which cancers?

A

Colorectal
Prostate

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5
Q

Lung Cancer: aetiology

A

90% - due to smoking*
COPD

* can be from passive smoking

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6
Q

Lung Cancer: signs and symptoms

A 
Dry and persistent cough
Dyspnoea 
Chest pain (later stage)
Weight loss (later stage)
Voice hoarseness
Haemoptysis * 
Wasting of hands (apical tumours compress nerves to hands)
Clubbing of fingernails

*Blood in sputum

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7
Q

Lung Cancer: diagnostics

A

X-ray
CT scan
FBC
Sputum culture

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8
Q

Colorectal Cancer: peak incidence

A

Common over 50 yrs old

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9
Q

Colorectal Cancer: metastasis locations

A

Liver
Lungs
Brain
Bone

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10
Q

Colorectal Cancer: 5 year survival rate

A

93% (stage 1)
3% (stage 4)

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11
Q

Colorectal Cancer: aetiology

A

Strong link with diet high in non-organic meat, low fibre, lack of vit D
Polyps
Family history

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12
Q

Colorectal Cancer: signs and symptoms

A

Fluctuating bowel habits (constipation/diarrhoea)
Blood (and mucus) in stools
Abdominal pain (usually left side)
Anaemia (due to blood loss)

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13
Q

Colorectal Cancer: diagnostics

A 
Colonoscopy, biopsy
Stool analysis (occult blood and M2PK - tumour marker found in stools)
Blood test (CEA*, inflammatory markers, low Hb)

Carcinoembryonic Antigen, tumour marker

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14
Q

Breast Tumours: characteristics

A

Cysts or fibroadenomas
Most breast lumps are benign
Benign tumours - mobile, smooth, regular borders (different from malignant mass)
Fibrocystic breast disease - breast pain, tender masses, nodules - usually pre-menstrual

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15
Q

Breast Cancer: pathophysiology

A

Ductal or lobular
Endogenous/exogenous oestrogens*
Breast cancer cells contain receptors that hormones or other proteins bind to that promote tumour growth
Oestrogen receptors - 80%
Also progesterone and epidermal growth factor receptors
If none of these receptor types present, the cancer is triple negative (15% cases)

*oestrogen is a growth stimulate

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16
Q

Breast Cancer: aetiology

A

Family history and age
Genetic mutations in BRCA1 or BRCA2
Obesity - increase of IGF-1 and oestrogen
Regular alcohol intake and smoking
Oestrogen excess - early menarche/late menopause/OCP/HRT
Aluminium/parabens* - mimic oestrogen
BPA (in plastics) - mimics oestrogen

*in antiperspirants and deodrants

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17
Q

Breast Cancer: signs and symptoms

A 
Asymptomatic usually
Painless, unilateral fixed lump
Overlying skin changes e.g. dimpling, orange peel appearance
Inverted/discharging nipple
Enlarged axillary lymph nodes
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18
Q

Breast Cancer: diagnostics

A

Mammography
Thermography

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19
Q

Breast Cancer: complications

A

Metastatic spread via lymphatics

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20
Q

Breast cancer: Treatment

A

Radiotherapy, chemotherapy, surgery.
Hormonal therapy: If oestrogen positive — tamoxifen (blocks oestrogen receptors). This can cause hot flushes, joint pains, osteoporosis, DVT and sleep irregularities.

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21
Q

Ovarian Cancer: epidemiology

A

Mostly affects women over 40 yrs

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22
Q

Ovarian Cancer: aetiology

A

Family history and age
Genetic mutations in BRCA1 or BRCA2
Oestrogen excess - early menarche/late menopause/OCP/HRT
Infertility/never given birth
Poor lifestyle: exercise, smoking, obesity
Diet rich in animal fats
Talcum powder used between legs

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23
Q

Ovarian Cancer: signs and symptoms

A

Early stage asymptomatic
Vague abdominal discomfort/bloating
Abdominal mass with pelvic pain, ascites
75% present with advanced disease
Later: change in bowel habits

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24
Q

Ovarian Cancer: diagnostics

A

Ultrasound
CT/MRI
Blood test: CA-125

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25
Ovarian Cancer: 5 year survival rate
38% Most lethal gynaecological malignancy
26
Cervical Cancer: epidemiology
Most common in young women - 25-35 yrs
27
What percentage of female cancers does cervical cancer form?
20% of all cancers
28
Cervical Cancer: aetiology
Persistent HPV infection (strains 16 & 18 cause 70%) Sexual behaviour (multiple partners, younger age) Smoking COCP
29
Cervical Cancer: signs and symptoms
Non-specific symptoms Abnormal vaginal bleeding (inter-cycle bleeding, after intercourse) Vaginal discharge White/red patches on cervix
30
Cervical Cancer: diagnostics
Screening - detects 30% - smear test Biopsy MRI/CT scan
31
Cervical Cancer: allopathic treatment
Brachytherapy (internal radiotherapy) Chemo-radiotherapy Surgery - hysterectomy (preferred up to stage 2)
32
Liver Cancer: types of
Primary - if from liver cirrhosis Secondary - if spread from elsewhere
33
Liver Cancer: aetiology
Associated with liver cirrhosis Alcohol, toxins = necrosis = chronic inflammation and cell proliferation (turnover) Hepatitis B/C = viral integration into host genome affecting DNA
34
Liver Cancer: signs and symptoms
``` In advanced stages: Jaundice Ascites Hepatomegaly Pruritus (itchy skin) Bleeding oesophageal varices (secondary to portal hypertension) Loss of appetite Feeling very full after eating Nausea/vomiting Pain or swelling in the abdomen Fatigue and weakness ```
35
Liver Cancer: allopathic treatment
Surgery - transplant
36
Liver Cancer: epidemiology
More common in men Peak around 60
37
Gastric Cancer: epidemiology
Male 55 yrs+ 2nd highest cause of cancer-related death in the world Highest in Korea and Japan (diet)
38
Gastric Cancer: areas affected/percentages
50% affects pylorus 25% affects lesser curvature
39
Gastric Cancer: aetiology
Smoking H. pylori infection Diet rich in salted, pickled and smoked foods (N-nitroso compounds) Low food/veg diet
40
Gastric Cancer: signs and symptoms
Early stages - persistent indigestion, frequent burping, heartburn, feeling full quickly when eating, bloating, abdominal discomfort Advanced stages - black blood in stools Loss of appetite, weight loss, tiredness, anaemia, jaundice
41
Gastric Cancer: diagnostics
Stool analysis (blood*) Endoscopy Biopsy Tumour markers - CEA, CA 19-9 | black, tarry
42
Gastric Cancer: allopathic treatment
Gastrectomy Chemo/radiotherapy
43
Oesophageal Cancer: aetiology
``` Chronic irritation Alcohol Smoking GORD and Barrett's oesophagus Obesity Low fruit/veg diet Age ```
44
Oesophageal Cancer: signs and symptoms
Few early symptoms, obstruction may occur later* Dysphagia (difficulty swallowing) Extreme weight loss Melaena (blood in stools) | Obstruction can reach 75% before it's noticed
45
Pancreatic Cancer: pathophysiology
Most arise from the exocrine cells Less common from the endocrine cells
46
Pancreatic Cancer: metastatic percentage
Approx 60% metastatic at diagnosis
47
Pancreatic Cancer: aetiology
Cause is unknown Risks include age, smoking, family history Diabetes, chronic pancreatitis, H. pylori
48
Pancreatic Cancer: signs and symptoms
``` Asymptomatic early on Epigastric pain, radiating to back Unexplained weight loss Fatigue Jaundice (bilirubin can't get out) Nausea after eating Glucose intolerance ```
49
Pancreatic Cancer: allopathic treatment
Surgery Chemotherapy Radiotherapy
50
Prostate Cancer: epidemiology
The most common cancer in men Generally 50+ yrs
51
Prostate Cancer: aetiology
Obesity Diet - high meat consumption (esp. chargrilled), dairy and saturated fats, refined sugars Ethnicity - black men at highest risk Genetics - BRCA1/2
52
Prostate Cancer: signs and symptoms
``` Obstructed/poor urinary flow Increased urinary frequency Intermittent urine flow and dribbling of urine Nocturia Haematuria Back pain can indicate bone metastases ``` | Same urinary symptoms as BPH
53
Prostate Cancer: diagnostics
Elevated PSA Digital rectal exam Biopsy
54
Prostate Cancer: allopathic treatment
Radiotherapy Androgen deprivation therapy Chemotherapy Surgery (removal) - 50% never recover urinary/erectile function
55
Bladder Cancer: epidemiology
More common in men - 2:1 70-80 yr group
56
Bladder Cancer: where does it originate?
Originates from transitional epithelial cells in bladder
57
Bladder Cancer: aetiology
Smoking - carcinogens pool in bladder and induce mutations Chronic cystitis Increasing age Catheterisation
58
Bladder Cancer: signs and symptoms
Painless haematuria (90%) Increased urine frequency & urgency Dysuria Bone metastases (with pain in spine)
59
Bladder Cancer: allopathic treatment
Transurethral resection Cystectomy
60
Testicular Cancer: epidemiology
Young men (15-35 yrs)
61
Testicular Cancer: aetiology
Higher risk if undescended testes Family history
62
Testicular Cancer: signs and symptoms
Hard, painless, unilateral mass Dragging sensation Dull ache Metastastises to bone, brain, lungs, liver
63
Skin Cancer: prognosis
Visible, generally easily detectable Develops slowly - good prognosis
64
Skin Cancer: typical locations for moles
Usually arises on head, neck or back
65
Skin Cancer: epidemiology
Most common in fair-skinned people, 40+ Becoming more prevalent Highest rate of recurrence
66
Skin Cancer: what to look out for
``` Asymmetry Border Colour Diameter Evolving ```
67
What is the most common skin cancer?
Basal cell carcinoma
68
What is the second most common skin cancer?
Squamous cell carcinoma
69
Who is more likely to develop melanoma?
Women, 30-50 yrs
70
What is the 5 year survival rate for melanoma?
80%
71
Basal cell carcinoma: signs and symptoms
Raised, smooth, pearly bump on sun-exposed skin Sometimes small blood vessels can be seen within the tumour Crusting and bleeding in the centre
72
Squamous cell carcinoma: signs and symptoms
Red, scaling thickened nodule/patch Some are firm hard nodules with central necrosis = ulcer/bleeding
73
Melanoma: signs and symptoms
Brown/black lesions Change in size, colour, elevation of a mole or new mole
74
Bone Tumours: definition
Can be malignant or benign Most commonly secondary tumour
75
What is osteosarcoma?
Malignant bone tumour
76
Who is most likely to be affected by primary osteosarcomas?
Teenagers
77
Where are osteosarcomas most likely to form?
Typically occur around the knee or humerus
78
Bone Tumours: signs and symptoms
Worsening pain that becomes unremitting Wake patient at night Systemic symptoms - weight loss, malaise, fatigue, night sweats
79
Brain Tumours: types of
High grade - rapid growth tumours Low grade - lower growth tumours
80
Example of high grade brain tumour
Mostly gliomas (common type is astrocytoma) glioblastomas (immature cells)
81
Example of low grade brain tumours
Meningiomas Pituitary tumours
82
Brain Tumours: epidemiology
Most common 50-70 yrs
83
Where do malignant brain tumours usually metastasise from?
Metastatic 10x more common than primary * Lung * Breast * Stomach * Prostate
84
Brain Tumours: aetiology
Mobile phone use
85
Brain Tumours: signs and symptoms
Morning headaches, increasing in frequency Nausea, vomiting, seizures Uneven pupils, double vision Papilloedema - bulging of optic nerve
86
Lymphoma: definition
Malignancy of lymphatic cells
87
Types of lymphoma
Non-Hodgkin's lymphoma Hodgkin's lymphoma
88
Non-Hodgkin's lymphoma: epidemiology
5 times more common Peak age - 50+ and children/young adults
89
Hodgkin's lymphoma: epidemiology
Peak age 20-35 Also paediatric
90
Which cells are involved in lymphomas?
B-lymphocytes
91
Lymphoma: aetiology
``` EBV - found in 50% of patients with Hodgkin's HIV General immunosuppression Pesticides/herbicides Chemo/radiotherapy ```
92
Lymphoma: signs and symptoms
Enlarged and asymptomatic lymph node in neck Chest discomfort*, cough Dyspnoea Drenching night sweats, fever, weight loss Lymphadenopathy Hepatomegaly, splenomegaly | *can be created by enlarged thymus
93
Lymphoma: diagnostics
Biopsy of lymph node - surgical/fine needle Blood tests - raised ESR, leukocytosis, lymphopenia, anaemia, HIV testing
94
Leukaemia: definition
Bone marrow cancers characterised by over-production of leukocytes
95
Leukaemia: pathophysiology
Over-proliferation in leukocytes results in supressed RBC production (=anaemia) and suppressed platelet production (=thrombocytopenia)
96
Acute leukaemias: characteristics
``` All ages Rapid onset More aggressive Immature (blast) cells Anaemia/thrombocytopenia prominent ```
97
Chronic leukaemias: characteristics
``` Usually adults Gradual onset More mature Differentiated cells Lymph node enlargement/splenomegaly prominent ```
98
Leukaemia: Signs and symptoms
``` Anaemia symptoms Malaise Frequent infections Fever, weight loss Easy bleeding/bruising Splenomegaly - excess haemolysis causes spleen to enlarge Lymph node enlargement ```
99
Leukaemia: diagnostics
Bone marrow biopsy Blood test - FBC and blood film
100
Leukaemia: allopathic treatment
Chemotherapy Bone marrow transplant Radiotherapy Relapse is common
101
Leukaemia: types
Four types of leukaemia: 1. Acute myelogenous leukaemia (AML) 2. Acute lymphocytic leukaemia (ALL) 3. Chronic myeloid leukaemia (CML) 4. Chronic lymphocytic leukaemia (CLL)

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