Oncology Flashcards
(21 cards)
4 main classification of cancer
- carcinoma
- sarcoma: supporting tissue (etc. bone, fat, connective tissue)
- lymphoma (lymphoidal)
- leukemia (blood)
Diagnosis of cancer
- Biopsy (in or excisional)
- Endoscopy (for organs like bladder, colorectal)
- Imaging (etc. CT, MRI, mammo)
- Bloods
Blood test cancer markers
Lung, Pancreatic and Ovarian: CA125, CEA
Breast: CA125, CEA, HER2
Stomach and Colon: CEA
Liver: AFP
Prostate: PSA
Testicular: AFP, HCG
Cancer grading
Grade 1 (best): well differentiated,
Grade 2:
Grade 3: spread more aggressively
Grade 4 (worst): no resemblence to normal skills
Cancer stages
Stage 0 to Stage IV
Stage 0: no spread yet (in situ)
Stage I: localized to one part of the body
Stage II/III: locally advanced (spread to lymph nodes)
Stage IV: metastasized to other organs/ throughout body
Cancer spread mechanism
EMT: cancer breaks apart to travel through bloodstream to reach distal sites and establish spread
CTC: detaches from primary tumor and undergoes metastasis, uses other cells to remain undetected through body
Cancer treatment
- Surgery + chemo: solid, localized cancer, clear margin
- Chemo: pre and post surgery, and to treat metastatic cancer (chemoprophylaxis to prevent relapse); commonly used for breast cancer
- Radiotherapy: pre&post-surgery, local treatment (highbeams cancer area specifically)
Chemotherapy administration
- IV
- Oral
- Infusion pump (which is still IV)
Breast cancer diagnosis
- Clinical examination
- Mammogram
- Ultrasound
- MRI
- Biopsy (Fine needle aspiration (FNA), Core needle, Large core needle, excision)
Staging breast cancer
Stage 0: carcinoma in situ
Stage I-II: early breast cancer
Stage III: locally advanced
Stage IV: metastatic
Tested via estrogen marker.
estrogen receptor positive (ER+) = breast cancer present
estrogen receptor negative (ER-) = no breast cancer
Breast cancer treatment
- Surgery + radiotherapy
- Hormone therapy (etc. tamoxifen to block ability of estrogen to stimulate proliferation of breast cells)
- Chemotherapy (etc. Taxanes (Taxol) for Stage I-IV breast cancer)
- Targetted therapy (drugs etc. Trastuzumab, Pertuzumab for HER2 inhibition)
Colorectal cancer
Forms on wall lining of colon and rectum
Cancer grows and projects into colon lumen and spreads via:
- neighbouring intestines and organs
- lymphatic system to neighbouring lymph glands
- blood stream to liver
Colorectal cancer diagnosis
- physician exam (if showing symptoms of anemia, weight loss, swollen left lymph nodes, abdominal lump, lump on digital rectal examination)
- fecal immunochemical test (FIT) for blood in stool
- barium enemea where abnormalities show up as bulges or craters
- colonoscopy
- CT scan
- cancer markers (bloods: CEA or fecal tumor DNA testing: KRAS mutation)
- Biopsy
Colorectal cancer staging
Stage CIS: cancer only found on innermost lining of colorectal
Stage I: Cancer spread to most of innerlining, but not to muscle layer
Stage II: Cancer breached muscle layer with or without involvment of nearby tissues, but hasn’t reach lymph nodes
Stage III: Cancer spread to outer lining of colon or to nearby lymph node, but hasn’t spread to other parts of the body
Stage IV: distant metastases etc. liver metastasis
Colorectal cancer treatment
- Surgery
- radiotherapy: post op care, or pre-op for advanced cancer to shrink
- chemotherapy: for advanced CRC (stage II-IV) post op for improved rate of survival. Includes weekly shots (etc. 5-flurouracil), optional other drugs (Avastin)
Lung cancer
Most common cancer in the world
Abnormal growth of cells impacts normal lung function
abnormal cells pass from original part of lung to other parts of the body (etc. other lung, lymph nodes, bones)
Lung cancer diagnosis
- Chest x-ray
- sputum test for cancer cells
- CT scan: for suspicious mass and staging
- biopsy
- lung function test (spirometry)
But greatly limited by:
1. high false positives
2. high testing cost
3. radiation exposure due to constant testing
Lung cancer markers
- CEA
- CA125
- SCC
- CYFRA 21-1
- NSE
- ProGRP
Lung cancer staging
Abides by normal staging, likely due to limited diagnosis method
Stage I: localized
Stage II: locally advanced
Stage III: locally advanced, may reach lymph nodes
Stage IV: distant metastasis
type of lung cancer
- Non-small cell lung cancer (NSCLC)
-most common due to smoking, also common in non-smokers
-grows slow, confined to lungs for longer - Small cell lung cancer (SCLC)
-10-15% of cases
-extremely aggressive, higher link to smokers
Lung cancer treatment
NSCLC
- Surgery, radiotherapy, chemotherapy (cisplatin + gemcitabine/paclitaxel/docataxel)
stage I and II cancer: surgery and chemo followup
Stage III: chemo + radiotherapy
Stage IV: chemo + targetted therapy (etc. erlotinib, afatinib)
- SCLC
- Chemo because it’s highly metastatic (etc. cisplatin & etoposide)
-if early stage and cancer is still localized to one part of the lung and within the lymph nodes of the lung: radiotherapy + chemo
- forget about surgery.
