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Flashcards in Investigation of Disease - Cancer Investigation Deck (112)
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What is the lifetime risk of cancer for people born since 1960?



What is cancer?

Disease caused by uncontrolled cell division of normal body cells


What is the definition of a tumour and neoplasia?

Tumour - swelling of a part of the body generally caused by abnormal cell growth
Neoplasia - new growth
Term can be used interchangably


What are the main 2 types of cancer?

1) Benign
2) Malignant - a malignant neoplasm is termed cancer


Describe the difference between a benign and malignant tumour in terms of the following; size, border, differentiation, growth rate, mitotic figures (dividing cells), cell death, invasion and metastasis

B - small
M - large
B - well defined
M - ill defined
B - resembles tissue of origin
M - Variable
Growth rate:
B - Slow
M - Rapid
Mitotic figures:
B - Rare
M - Common
Cell death:
B - No
M - Yes
B - No
M - Yes
B - No
M - Yes


What is the difference between cancer detection and diagnosis?

Detection: The action or process of identifying the presence of cancer in the absence of signs or symptoms
Diagnosis: The action or process of identifying the presence of cancer from its signs or symptoms


How is early detection of cancer achieved?



What are the 3 types of cancer screened for in adults in England, how are they performed and what age groups are tested?

1) Cervical screening
- Check health of cervical cells
- Offered every 3 years to women aged 26-49
- Every 5 years for women aged 50-64
2) Breast cancer screening
- Uses a mammogram (x ray) to spot cancer
- Offered to women aged 50 - 70
- NHS extending programme - trail in screening aged 47 - 53
3) Bowel cancer screening
- 2 types:
> Home testing kit (Faecal occult blood (FOB) test) offered to men and women aged 60-74
> Bowel scope screening -offered to men and women 55+, being introduced in England
- uses small camera on end of flexible tube


Define the terms histopathology, cytopathology and molecular pathology

Histopathlogy - the microscopic study of diseased tissue
Cytopathology - The microscopic study of diseased cells
Molecular pathology - the study of molecules in a disease state


What are the 4 main stages in histo-, cyto- and molecular pathology?

1) Specimen collection
2) Sample preservation
- formalin fixation etc
3) Sample processing e.g dissection, microtomy etc
4) Sample analysis


What are the 6 types of patient biopsy?

- Cell scraping
- punch biopsy
- endoscopy
- needle biopsy
- surgical biopsy
- surgical resection


What is cell scraping?

Taking a small sample of cells and observing them under the light microscope for the presence of disease


What are the advantages of cell scraping over a tissue biopsy?

- Easier to get
- Causes less discomfort to patient
- Less likely to result in serious complications
- Costs less


What type of cytology is cell scraping?

Exfoliative cytology


For what 2 cancers would you use scrapes?

- Skin cells for melanoma
- Cervical cells for cervical cancer


What is punch biopsy??

Involves taking a small disc of full thickness skin using a special punch biopsy instrument with a circular blade


When would a punch biopsy be used?

For diagnosing skin diseases such as cancer


What is the procedure of a punch biopsy?

1) Skin numbed with local anaesthetic
2)Instrument rotates into dermis
3) Instrument removed - sample either removed with instrument or with forceps
4) Samples over 3mm will need 1 or 2 stitches
4) 5mm or larger prefered for histopathology


What is endoscopy?

Looking inside the body to check for growths or abnormal looking areas


What is the endoscopy procedure?

Uses an endoscope - flexible tube with camera, light and sampling equipment on the end
Tissue sample can be taken


What are the 4 main types of endoscopy?

1) Oseophageal and upper GI tract endoscopy - look at oesophagus, stomach and duodenum
2) Bronchoscopy - look and trachea and bronchi
3) Sigmoidoscopy - lower bowel
4) Colonoscopy - look at colon


What is fine needle aspiration (FNA) (needle biopsy)

Involves using a thin, hollow needle to remove samples of tissue fragments or cells in fluid from an organ of the body or lump found under the skin


What is the FNA procedure?

- Tip of 22 or 23 gauge needle attached to a 20 cc syringe is inserted into the mass
- Plunger withdrawn
- Needle removed - aspirate is expelled on one or more glass microscope slides and smeared


What cancers can FNAs be used to diagnose?

- Breast
- Thyroid
- Lung
- Pancreatic


What is core needle biopsy (needle biopsy)

Uses a larger needle than FNA (11 to 16 gauge)
Used to extract a cyclinder of tissue, which provides more sample for analysis


What is the core needle biopsy procedure?

- Often skin is numbed with LA and small incision made
- Needle inserted 3-6 times into palpable (detected by touch) lesion to obtain cores
- If lesion is not palpable then imaging technique used to guide operator
- The include; Ultrasound, MRI or stereostatic radiography


What types of cancer can core needle biopsy be used to diagnose?

- Liver
- Prostate
- Breast


What is surgical biopsy, what are the 2 types and what does each diagnose?

Surgical biopsy is a surgical procedure to remove tissue samples
1) Incisional biopsy
Removes sample of diseased tissue/tumour
- Breast
- Skin
- Soft tissue cancers - sarcomas (GI tract, gynecological)
2) Excisional biopsy
Removes all of diseased tissue - lump often with some healthy tissue
- Breast
- Skin
- Prostate
LA usually used
If tumour is in chest or abdomen, GA used


What is resection?

Resection is medical term for surgically removing part or all of a tissue, structure or organ


What are the common types of resection?

- Lung
- Liver
- Small bowel - removal of small parts of small intestine
- Brain