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Y1 - PP > Lecture 17 - Neoplasia 5 > Flashcards

Lecture 17 - Neoplasia 5 Flashcards

1
Q

What are the most common cancers world wide?

A

Female breast
Prostrate cancer
Lung
Bowel

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1
Q

What are the 4 most common cancers world wide?

A

Female breast
Prostrate cancer
Lung
Bowel

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2
Q

What are the most common causes of cancer in Males?

What are the most common causes of cancer in Females?

A

Males = Prostate
Females = Breast

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3
Q

Why are most cancers diagnosed at age over 65yrs?

A

There’s more time for initiation, promotion and progression to take place

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4
Q

What are some common cancers in children?

A

Leukaemia
CNS tumour
Lymphomas

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5
Q

What is a commonly used chemotherapeutic drug for prostate cancer?

A

Cisplatin

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6
Q

Why have the incidences of malignant melanoma decreased?

A

Inc public awareness
Better suncream usage

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7
Q

What can be biopsied to see if a malignant melanoma has spread?

A

Sentinel lymph nodes

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8
Q

Why are brain cancers difficult to treat?

A

Hard for chemotherapy agents to cross blood brain barrier

Radiotherapy damages surrounding healthy brain

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9
Q

What determines whether an individual will have a favourable outcome with cancer?

A

Co-morbidities
Age
Tumour site
Tumour type
Tumour stage
Well differentiated

Availability of treatment

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10
Q

What is the definition of cancer specific survival?

A

% of patients with a specific type and stage of cancer who have not died from their cancer during a certain period of time after diagnosis

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11
Q

What is the definition of relative survival?

A

% of cancer patients who have survived for a certain period of time after diagnosis compared to people who do not have cancer

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12
Q

What is the definition of disease free survival?

A

% of patients who have no signs of cancer during a certain period of time after treatment

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13
Q

What is the definition of Cure?

A

There are no traces of cancer after treatment and the cancer will NEVER come back

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14
Q

What is the definition of Resmission?

A

Signs and symptoms of your cancer have reduced

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15
Q

What are the 2 types of remission?

A

Partial remission
Complete remission

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16
Q

What is partial remission?

A

Signs + symptoms of the cancer have reduced

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17
Q

What is complete remission?

A

Signs + symptoms have disappeared

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18
Q

Why is it risky to say that a patient is cured from cancer?

A

May still be some cancer cells in the body and these can come back one day to causes cancer
(Melanoma does this a lot)

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19
Q

How are tumours/cancers classified?

A

TNM staging system (can only be used for solid tumours

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20
Q

What does the TNM staging system mean?

A

T = size of primary Tumour
N = extent of regional lymph Node involvement
M = Metastatic spread via the blood

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21
Q

What are the tumour sizes?

A

T1 (smallest)
T2
T3
T4 (largest)

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22
Q

What are the (N) regional lymph node involvement classifications?

A

N0
N1
N2
N3

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23
Q

What does N0 mean?

A

No evidence of lymph node metastasis

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24
What does N1, N2 and N3 mean?
N1 = evidence of a single group of lymph nodes with metastasis N2 = more lymph nodes affected N3 = many lymph nodes affected
25
What does M0 mean in terms of metastatic spread?
Don’t have metastasis
26
What does M1 mean in terms of metastatic spread?
Do have Metastatic spread
27
What is meant by tumour stage?
A measure of the overall burden of the malignant neoplasm
28
What does a Stage 1 tumour/cancer mean?
Early local disease
29
What does a Stage 2 tumour/cancer mean?
Advanced LOCAL disease So N0 and M0 (Large size like T3 or T4)
30
What does a Stage 3 tumour/cancer mean?
Regional metastasis (Does not spread through blood so is M0)
31
What does a Stage 4 tumour/cancer mean?
Advanced disease with distant metastasis (M1) METASTATIC
32
What is the Ann Arbor Staging system used to classify?
Lymphomas
33
What are the 4 stages of the Ann Arbor Staging system?
I - Lymphoma affects only 1 set of lymph nodes II - more than 1 lymph nodes affected III - lymph nodes that are affected are on different sides of the diaphragm IV - non lymph nodes are also affected
34
What is the Dukes Staging System used to classify?
Bowel cancers
35
What are the 4 classes of the Duke Staging System for bowel cancer?
A - Cancer only penetrated inner lining of bowel B - Cancer penetrates through inner lining penetrating muscle wall C - Cancer all way through muscle wall affect lymph nodes D - Cancer metastasises
36
What is tumour grading?
When the degree of differentiation of the neoplasm is described
37
What does G1, G2, G3 and G4 mean?
G1 = well-differentiated G2 = moderately differentiated G3 = poorly differentiated G4 = undifferentiated or anaplastic
38
How does a Grade 1 breast tumour compare to a Grade 3 tumour in a microscopic view?
G1: -low mitotic count -low pleomorphism -low nuclear to cytoplasm ratio G3: -high mitotic count -high pleomorphism -High nuclear to cytoplasm ratio
39
When a patient has a prostate cancer to you treat them straight away?
Depends how serious it is Normally you would monitor their PSA levels
40
What are some examples of different types of treatments for cancer?
Surgery Radiotherapy Chemotherapy Hormone therapy Immunotherapy
41
What are treatments that can be given before or after surgery?
Adjuvant Neoadjuvant
42
What is an adjuvant (surgery)?
Treatment is given AFTER a surgical removal of a primary tumour to eliminate sub clinical disease (any excess cancer cells floating at distant site)
43
What is a Neoadjuvant?
Treatment that is given PRIOR/BEFORE surgical excision to reduce the size of the primary tumour (hopefully making surgery easier)
44
What is radiation therapy?
Where high dosage ionising radiation (like x-rays, gamma rays, alpha particles) are used to kill proliferating cells
45
How does Radiation therapy kill proliferating cells?
Triggering apoptosis or interfering with mitosis DIrect DNA or free radicals induced damage which is detected by cell cycle triggering apoptosis Double stranded DNA breaks
46
What sort of doses are given for Radiation therapy? Why is this done?
Fractioned doses Minimise damage to normal cells
47
What are the 2 types of radiation therapy?
External beam radiotherapy Internal radiation therapy
48
What is external beam radiotherapy?
External machine aims radiation at the cancer
49
What are the 2 types of internal radiation therapy?
Brachytherapy - seeds of radiation particles, ribbons or capsules are place in or near the tumour Systemic - radioactive iodine (I-131
50
What must people undergoing systemic internal radiation therapy no do?
Go near children or pregnant women
51
What is therapy induced cancer? What helps reduce this when radiation therapy is being given to treat cancer?
When cancer s acquired as a result of exposure to radiation from treatment Fractioned doses (multiple smaller doses of radiation)
52
What is Chemotherapy?
Systemic treatment kills cancer cells that have spread to other parts of the body
53
How do alkylating and Platinum based drugs work?
Cross link the 2 strands of the DNA helix
54
What are some examples of Alkylating and Platinum based chemothrapeutic drugs?
Cisplatin Cyclophosphamide
55
How do Antimetabolite chemotherapeutic drugs work?
Mimics normal substrates involved in DNA replication
56
How does Vincristine act as a chemotherapeutic drug?
Blocks microtubules assemble and interferes with mitotic spindle formation
57
Why does chemotherapy have a negative side effects on the body?
Targets rapidly proliferating cells
58
What are some negative side effects of chemotherapy on the body?
Hair loss Mouth sores Weakened immune system Bruising Bleeding Nausea, vomiting Constipation, diarrhoea Ulcers of GI tract
59
Why is the bodies immune system weakend as a result of chemotherapy?
Stops blood cells proliferating Low WBC = Low immunity Low RBC = Anaemia Low Platelets = Bruising + bleeding
60
What is bio marker testing?
Precision medicine where specific genes, proteins and other bio makers are looked for
61
What type of breast cancers can be treated with Selective Oestrogen Receptor Modulators? (Hormone Therapy)
ER +ve (Oestrogen Receptor positive)
62
What is an example of a Hormone (Selective Oestrogen Receptor modulator)?
Tamoxifen
63
How does Tamoxifen act as a Hormone Therapy to ER +ve Breast cancer?
It is a Selective Oestrogen Receptor Modulator Binds to oestrogen receptors preventing oestrogen binding to oestrogen receptors
64
What 2 drugs can be used to target oncogenes so will target cancer cells?
Trastuzumab(Herceptin) Imatinib(Gleevec)
65
What is Herceptin/Trastuzumab used to treat?
HER2 +ve breast cancers
66
What is imatinib used to treat?
Lymphoma (Targets their oncogenes)
67
What does HER2 stand for?
Human epidermal growth factor receptor 2
68
How can HER2 +ve breast cancers be identified?
Monoclonal antibodies
69
What is used to treat HER2 +ve breast cancer?
Trastuzumab/Herceptin
70
What is immunotherapy?
When the immune system is targeted to help it by recognising and attacking
71
Are tumour infiltrating lymphocytes a good sign? What do they indicate?
Good sign TILs indicate that the immune system is responding to the tumour
72
What are some examples of immuotherapeutic drugs that can attack and shrink tumours?
Ipilimumab Nivolumab
73
How do immune checkpoint inhibitors work in immunotherapy?
Block immune checkpoints allowing immune cells to respond more strongly
74
How do monoclonal antibodies be used in immunotherapy?
Proteins bind to specific targets making cancer cells stand out
75
What is an example of a vaccine used to help treat a cancer?
Oncolytic virus therapy
76
How does oncolytic virus therapy work?
Herpes simplex virus type 1 given Virus infects cancer cells and healthy cells Healthy cells can destroy virus Cancer cant Cancer cells destroyed by virus
77
What are tumour markers?
Substances released by cancer cells into circulation Can be measured assessing response to therapy, recurrence, diagnosis
78
What is a tumour marker used to detect a Testicular Tumour and Choriocarinoma?
HCG (human Chorionic Gonadotrophin)
79
What is a tumour marker used to detect a hepatocellular carcinoma and germ cell tumours?
Alpha fetoprotein
80
What is a tumour marker used to detect a prostate carcinoma?
Prostate specific antigen (PSA)
81
What is a tumour marker used to detect Ovarian cancer?
CA125
82
What is a tumour marker used to detect pancreatic, gallbladder, bile duct and gastric cancers?
CA19.9
83
What is a tumour marker used to detect colorectal cancer?
CEA
84
What is a tumour marker used to detect neuroendocrine tumours?
Chromgranin A

Y1 - PP (20 decks)

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