neoplasia 5

Question 1

what are the most common types of cancer in women?

Answer 1

1. breast
2. lung
3. bowel

Question 2

what are the most common types of cancer in men?

Answer 2

1. prostate
2. lung
3. bowel

Question 3

what are the 4 most common cancers worldwide?

Answer 3

1. lung
2. femal breast
3. bowel
4. prostate

Question 4

what are the most common cancers in children?

Answer 4

1. leukaemia
2. CNS tumour
3. lymphomas

Question 5

what are the different outcomes for cancer patients?

Answer 5

• cure
• remission
• death

Question 6

what is meant by the term cure in regards to cancer outcomes?

Answer 6

no traces of cancer after treatment and cancer will never come back (most cancers return within 5 years of treatment)

Question 7

what is meant by the term remission in regards to cancer outcomes?

Answer 7

signs and symptoms of cancer are reduced (partially or completely)

Question 8

what is cancer specific survival?

Answer 8

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

Question 9

what is relative survival?

Answer 9

% of cancer patients who have survived for a certain period of time after diagnosis compared to people who dont have cancer

Question 10

what is disease free survival?

Answer 10

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

Question 11

what is the tumour stage?

Answer 11

standardised staging system across the world to describe solid tumours (not leukaemias):
TNM staging system
T = size of PRIMARY tumour (T1 = small, T2 = larger etc.)
N = extent of regional lymph node involvement (N0 = no lymph nodes, N1 = 1 lymph node etc.)
M = metastatic spread via blood (M0 = no metastasis, M1 = metastatic)

Question 12

what are the 4 different tumour stages?

Answer 12

1. stage 1 = early local disease
2. stage 2 = advanced local disease
3. stage 3 = regional metastasis
4. stage 4 = advanced disease with distant metastasis

Question 13

what is the ann arbor staging system?

Answer 13

determines the severity of a lymphoma:
Stage 1 = lymph nodes effected are on same side of diaphragm
Stage 3 = lymph nodes effected on different sides of diaphragm
Stage = spreads to other organs

Question 14

what is the Duke staging system?

Answer 14

staging system specific to bowel cancer
Duke A = cancer is only just invading the bowel
Duke B = cancer has infiltrated muscle wall
Duke C = cancer has fully infiltrated and lymph node involvement
Duke D = metastises

Question 15

what are the different grading stages?

Answer 15

G1 = well differentiated
G2 = moderately differentiated
G3 = poorly differentiated
G4 = undiferentiated or anaplastic

Question 16

what are the different treatments for cancer?

Answer 16

• surgery
• radiotherapy
• chemotherapy
• hormone therapy
• treatments targeted to specific molecular alterations
• immunotherapy

Question 17

what are adjuvant treatments?

Answer 17

treatment given after surgical removal of primary tumour to eliminate subclinical disease
(trying to mop up and rogue cells)

Question 18

what are neoadjuvant treatments?

Answer 18

treatment is given prior to surgical excision to reduce size of primary tumour

Question 19

what are the basic principles of radiation therapy?

Answer 19

• kills proliferating cells by triggering apoptosis and interfering with mitosis
• doesnt kill cancer cells immediately but has longer lasting affects
• given in fractionated doses to minimise normal tissue damage
• causes either direct damage or free radical damage which is detected by cell cycle checkpoints

Question 20

what are the types of radiation therapy?

Answer 20

1. external beam radiotherapy - external machine aims radiation at cancer
2. internal radiation therapy - source of radiation put in body:
   * local = radiation put inside tumour
   * systemic = radioactive iodine

Question 21

what are the basic principles of chemotherapy?

Answer 21

• systemic treatment
• kills cancer cells that have spread to other parts of body
• used in isolation or with other chemotherapeutic agents
• usually used with other cancer treatments

Question 22

what are differnet types of chemotherapy?

Answer 22

• antimetabolites = mimic normal substrates involved in DNA replication
• alkylating + platinum based drugs = cross link 2 strands of DNA helix causing damage
• antibiotics = damage DNA
• plant derived drugs = prevents spindle formation which stops DNA replication

Question 23

what are some consequences of chemotherapy?

Answer 23

• hair loss
• pain
• mouth sores
• weaken immune system
• anaemia
• stops platelet production - results in bleeding

Question 24

what is biomarker testing?

Answer 24

• precision medicine
• process to look for genes, proteins and biomarkers
• therapies are then selected based on gene profiling

Question 25

what are hormone therapies and how do they work?

Answer 25

selective oesterogen receptor modulators (SERMs): Tamoxifen * bind to oestrogen receptors thus prevent oestrogen receptors to prevent oestrogen from binding * used to treat hormone receptor positive breast cancer

Question 26

what are targeting oncogene drugs?

Answer 26

identifying cancers which have caused mutations in oncogenes allows us to use drugs which can target the specific cancer cells

Question 27

what are the basic principles of immunotherapy?

Answer 27

* targets immune system to help it fight cancer * detects and destroys abnormal cells + prevents growth of cancers * tumours infiltrating the lymphocytes are a sign that the immune system is responding to the tumour

Question 28

what are the different types of immunotherapy?

Answer 28

* Immune checkpoint inhibitors = block immune checkpoints which allows immune cells to respond more strongly * T cell transfer therapy = boosts natural ability of T cells to fight cancer * Monoclonal antibodies = help immune system proteins to bind to specific targets on cancer cells - names usally end in -mab * Treatment vaccines = boost immune response against cancer cells (e.g. oncolytic virus therapy)

Question 29

what are tumour markers?

Answer 29

substances that are released by cancer cells into blood these can be measured: * to help diagnose * measure tumour burden * assess response to therapy * assess recurrence

Question 30

What are the the side effects of tamoxifen?

Answer 30

Increased risk of endometrial cancer Induces menopause

Question 31

What are some drugs which target oncogenes and what cancer are they used for?

Answer 31

Trastuzumab - for HER2 positive breast cancers Imatinib - for leukaemias