Flashcards in Investigation of Disease - Cancer Investigation Deck (112)
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?
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
B - Slow
M - Rapid
B - Rare
M - Common
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
- 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?
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?
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?
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
- Soft tissue cancers - sarcomas (GI tract, gynecological)
2) Excisional biopsy
Removes all of diseased tissue - lump often with some healthy tissue
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