Neoplasia 4 Flashcards

(43 cards)

1
Q

What are the commonest cancers in Men and Women

A

Men: Lung, Bowel, Prostate

Women: Lung, Bowel, Breast

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2
Q

What are the commonest cancers in Children (below 14)

A

Leukaemias
CNS tumours
Lymphomas

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3
Q

State the survival rates for;

  • Testicular cancer
  • Melanoma
  • Breast cancer
  • Pancreatic cancer
  • Lung cancer
  • Oesophageal cancer
A
  • Testicular: 98%
  • Melanoma: 90%
  • Breast: 87%
  • Pancreatic: 3%
  • Lung: 10%
  • Oesophageal: 15%
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4
Q

Which cancer is the biggest cause of deaths in the UK?

A

Lung cancer

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5
Q

What are 7 factors that influence the outcome of a malignant neoplasm?

A
  • Age
  • General health status
  • Tumour site
  • Tumour type
  • Grade (differentiation)
  • Tumour stage
  • Availability of effective treatments
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6
Q

Tumour stage is a measure of the malignant neoplasm’s overall burden.

The most common system used to measure this is the TNM system. Explain this system

A

T: Refers to size of primary tumour (T1-T4)

N: Describes the extent of regional lymph node involvement (N0-N3)

M: Denotes the extent of metastatic spread via blood (M0 or M1)

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7
Q

For a given cancer the T,N and M status are usually converted to stages 1-4. The staging varies for each cancer.

Give broad descriptions of each stage

A

Stage I: Early local disease

Stage II: Advanced local disease (N0, M0)

Stage III: Regional metastasis (M0 with N1 or more)

Stage IV: Advanced disease with distant metastasis (M1)

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8
Q

Name and describe the staging system used for Lymphoma (Has its own staging system)

A

Ann Arbor Staging System

Stage I: Lymphoma in a single node region

Stage II: Lymphoma in 2 separate regions on same side of diaphragm

Stage III: Spread of lymphoma to both sides of diaphragm

Stage IV: Indicates diffuse/ disseminated involvement of 1/ more extra-lymphatic organs (Such as lungs, bone marrow)

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9
Q

Dukes’ Staging System used to be used specifically for one kind of cancer.

It is now incorporated into the TNM system.

Which cancer was it, and is still used for?

A

Colorectal carcinoma (bowel cancer)

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10
Q

Describe the Stages in Dukes’ Staging System (Colorectal carcinoma)

A

Dukes’ A: Invasion into, but not through bowel

Dukes’ B: Invasion through bowel wall

Dukes’ C: Involvement of lymph nodes (outside bowel wall)

Dukes’ D: Distant metastases (such as in liver)

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11
Q

Tumour grade describes the degree of differentiation of a neoplasm

What do the 4 grades mean?

A

G1: Well-differentiated

G2: Moderately differentiated

G3: Poorly differentiated

G4: Undifferentiated or Anaplastic

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12
Q

For what 2 cancers, is the Tumour Grading system used?

A

Squamous cell carcinoma

Colorectal carcinoma

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13
Q

Name the grading system used for Breast Carcinoma

What 3 things does it asses?

A

Bloom-Richardson System

Assesses;

  • Tubule formation
  • Nuclear variation
  • Number of mitoses/ mitotic figures
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14
Q

Tumour grade is more important than tumour stage, for planning treatment and estimating prognosis in certain types of malignancy.

Name 4 of these malignancies

A
  • Soft tissue sarcoma
  • Primary brain tumours
  • Lymphomas
  • Breast and prostate cancer
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15
Q

List 6 types of Cancer Treatment

A
  • Surgey
  • Radiotherapy
  • Chemotherapy
  • Hormone therapy
  • Targeted molecular therapies
  • Immunotherapy
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16
Q

In reference to cancer, when is Adjuvant Treatment given? What is its purpose?

A
  • Given after surgical removal of a primary tumour

- To eliminate subclinical disease (micrometastases)

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17
Q

In reference to cancer, when is Neoadjuvant Treatment given? What is its purpose?

A
  • Given before surgical removal of a primary tumour

- To reduce size of the primary tumour

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18
Q

Radiotherapy kills proliferating cells by triggering apoptosis or interfering with mitosis.

What are 2 ways it minimises damage to normal tissues

A
  • Focused on tumour (with shielding of surrounding healthy tissue)
  • Given in fractionated doses
19
Q

How does Radiotherapy kill rapidly dividing cancer cells (especially in G2 of cell cycle)?

A

High dosage causes either Direct or Free-radical Induced DNA damage.

This is detected by cell cycle check points triggering apoptosis

20
Q

How does Radiotherapy interfere with mitosis in cancer cells?

A

Causes double strand DNA breaks, leading to damaged chromosomes

Thus, M phase is prevented from completing correctly

21
Q

List 4 classes of Chemotherapy agents

A
  • Antimetabolites
  • Antibiotics
  • Plant derived drugs
  • Alkylating and Platinum based drugs
22
Q

Antimetabolites are a class of chemotherapy agents.

How do they work?
Give 1 example

A
  • Mimic normal substrates involved in DNA replication

- Fluorouracil

23
Q

Antibiotics are a class of chemotherapy agents.

Give 2 examples
How does each one work?

A

Doxorubicin;
- Inhibits DNA topoisomerase (needed to make DNA)

Bleomycin;
- Causes double strand DNA breaks

24
Q

Plant derived drugs are a class of chemotherapy agents.

Give 1 example
How does it work?

A

Vincristine (from Periwinkles);

- Blocks microtubule assembly and interferes with mitotic spindle formation

25
Alkylating and Platinum based drugs are a class of chemotherapy agents. How do they work? Give 2 examples
Cross link the 2 strands of the DNA helix - Cyclophosphamide - Cisplatin
26
List 4 side effects of Chemotherapy, other than Pain, Vomiting and Hair loss
- Mouth sores - Weakened immune system - Rashes - Nausea/ vomiting - Constipation/ diarrhoea - Bruising/ bleeding
27
Hormone therapy is a relatively non-toxic treatment for certain malignant tumours What kind of drugs do use to treat hormone receptor positive breast cancer? Give an example?
Selective Oestrogen Receptor Modulators (SERMs) Tamoxifen
28
How do Selective Oestrogen Receptor Modulators (SERMs) work? | One example is Tamoxifen
Bind to oestrogen receptors, preventing oestrogen from binding
29
Give an example of using Selective Oestrogen Receptor Modulators (SERMs) to treat prostate cancer
Androgen blockade
30
Identifying cancer specific alterations (such as oncogene mutations) allows us to create drugs targeted specifically at cancers cells Give 2 examples of such drugs
Herceptin (trastuzumab) Gleevec (imatinib) (These are oncogene targeting drugs)
31
A quarter of breast cancers have over-expression of the HER2 gene (Encodes a GF receptor). Suggest 1 oncogene targeting drug that can be used, and how it works
Herceptin, blocks HER2 signalling
32
Chronic Myeloid Leukaemia (CML) creates an abnormal Philadelphia chromosome in which an oncogene could fusion protein (BCR-ABL) is encoded. Suggest an oncogene targeting drug that can be used How does it work?
Gleevec (imatinib), inhibits the fusion protein
33
Cancer cells release various substances into circulation. These are called Tumour Markers. What are they used for?
- Mainly, to monitor tumour burden during treatment and follow up - Some have a role in diagnosis
34
List 4 types of Tumour Markers
- Hormones - Oncofetal antigens - Specific proteins - Mucins/ glycoproteins
35
Given an example of a Hormone Tumour Marker | What kind of cancer releases it?
- Human Chorionic Gonadotropin (HCG) | - Testicular tumours
36
Given an example of an Oncofetal antigen Tumour Marker | What kind of cancer releases it?
- Alpha fetoprotein (AFP) - Hepatocellular carcinoma (Another example is CEA- Carcinoembryonic Antigen)
37
Given an example of a Specific Protein Tumour Marker | What kind of cancer releases it?
- Prostate specific antigen (PSA) | - Prostate carcinoma
38
Given an example of a Mucin/ Glycoprotein Tumour Marker | What kind of cancer releases it?
- CA125 (cancer antigen 125) | - Ovarian cancer
39
Cancer screening is meant for healthy people with no symptoms. What are 3 possible problems with screening?
- Over diagnosis - Lead time bias - Length bias
40
In the UK, name 3 cancers that have established national screening programmes
- Cervical cancer - Breast cancer - Bowel cancer
41
Who is offered Breast cancer screening?
Women, aged 50-71 | 2 tests every 3 years, looks for tumours that can be surgically removed
42
Who is offered Cervical Cancer Screening in the UK? How often? (Tests for HPV)
Women aged 25-64 Every 3 years for women aged 25-49 Every 5 years for women aged 50-64
43
Describe Bowel Cancer Screening in the UK
2 methods - Home testing kit: For men and women aged 60-74 (Every 2 years) - Bowel scope screening: For men and women 56 or above (Only in some parts of England)