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402 Oncology & Haematology > Oncology > Flashcards

Oncology Flashcards

(67 cards)

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1
Q

What 4 infections contribute towards the development of cancer?

A

HPV
Helicobacter pylori
HBV
HCV

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2
Q

Define adjuvant therapy?

A

Chemotherapy given after a debulking procedure to remove micro-metastases

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3
Q

Define neoadjuvant therapy

A

Chemotherapy given before a debulking procedure to reduce the size of mass

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4
Q

What is the term used to describe tumours that have not yet invaded the basement membrane ?

A

In situ tumours

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5
Q

What does the greek suffix “-oma” mean and what is it used to denote?

A

Swelling - a benign tumour

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6
Q

What is the suffix for malignant epithelial tumours?

A

-carcinoma (greek for crab)

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7
Q

What is the suffix for tumours derived from connective tumours?

A

-sarcoma (greek for flesh)

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8
Q

What are the 4 main originating tissues for cancer?

A

Epithelial
Connective
Lymphoid & Haemopoetic
Germ

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9
Q

What is the suffix used for tumours derived from germ cells?

A

-terato (Greek for monster)

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10
Q

How are tumours graded?

A

By degree of differentiation

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11
Q

What is the tumour grading scale?

A

1 - Well differentiated
2 - in the middle
3 - Poorly differentiated

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12
Q

How do the grades of differentiation relate to how closely cancer cells resemble origin tissue?

A

Well differentiated = more closely resemble

Poorly differentiated = do not resemble origin tissue

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13
Q

How does differentiation relate to mitotic and therefore growth rate of cancer cells?

A

Well differentiated - slower

Poorly differentiated - faster, more aggressive

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14
Q

What term is used to describe cancer cells which are so poorly differentiated that they have very few features of their origin tissue?

A

Anaplastic

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15
Q

How does tumour grading relate to prognosis?

A

1 - (well differentiated) favourable prognosis

3 - (poorly differentiated) worse prognosis

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16
Q

With regard to tumour grading, why is it important to sample a sufficient amount of tissue and microscopic sections?

A

They can be heterogenous such that different areas of it will have different amount of differentiation and mitotic activity within the tumour.

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17
Q

Prolonged exposure to what hormone is thought to play a role in breast cancer and how does this relate to menarche and menopause as a risk factor?

A

Oestrogen
Early menarche
Late menopause

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18
Q

How does parity relate to risk of breast cancer?

A 
Null parity 
Late parity (35+) increase of breast cancer
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19
Q

Does the combined oral contraceptive pill significantly increase the risk of breast cancer?

A

Not significantly no

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20
Q

How does HRT relate to the risk of breast cancer?

A

Increases it (1.66)

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21
Q

What is the commonist breast cancer in terms of histology?

A

invasive ductal carcinoma (DCIS)

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22
Q

What is there a high risk of with DCIS?

A

it becoming invasive

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23
Q

In terms of masses, how does breast cancer usually present?

A

a mass that persists throughout the menstrual cycle

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24
Q

In breast cancer how often does nipple discharge and pain occur?

A

discharge - 10%

pain 7%

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25
What are the 4 communist sites of breast cancer metastasis?
Bone Lung Liver Pleura
26
What are triple negative breast cancers?
Triple-negative breast cancer is cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein.
27
What are the implications of a breast cancer being triple negative in terms of treatment?
Triple negative cancers are not fuelled by hormones (progesterone/oestrogen) ot HER2 protein and so wil not respond to hormone treatment or medicines that target HER2 receptors
28
In what age group do the majority of colorectal cancer deaths occur?
Over 60s (85%)
29
Is their a gender bias in colorectal cancer?
No
30
How do colorectal cancer rates differ between developing and developed world?
More common in developed world
31
What aetiological factors are colorectal cancer most commonly related to?
Lifestyle | Advancing age
32
What dietary factors are thought to increase the risk of colorectal cancer?
red meat calorie alcohol
33
How does IBD relate to risk of colorectal cancer and what are the caveats applied to this?
Increases risk | But risk is also related to duration and severity of inflammation
34
Around 5% of colorectal cancers occur as a consequence of genetic syndromes, which of these is the most common?
hereditary non-polyposis colorectal cancer
35
What is the inheritance pattern of HNPCC?
Autosomal dominant
36
How does the gene mutation for HNPCC relate to rissk of developing colorectal caner?
40% lifetime risk
37
In which decade to pts with genetic predisposition most commonly develop HNPCC?
4th
38
What is a rare but important genetic condition that significantly increases chances of developing bowel cancer?
familial adenomatous polyposis
39
What is the inheritance pattern of FAP?
Autosomal dominant
40
How does FAP usually develop over lifetime?
Numerous benign colonic polyps from young age. | Cancerous lesions in 3rd and 4th decade
41
What prophylactic procedure would be strongly advised in pts with FAP?
colectomy
42
What drug is used for oestrogen positive (ER+) breast cancer?
Tamoxifen (oestrogen antagonist)
43
Can tamoxifen be used in post or pre menopausal women?
Both
44
What drug only works if women have HER2 receptor?
Herceptin
45
What type of drugs are used in post menopausal women and 3 examples?
Aromatase inhibitors
46
10 hallmarks of cancer
``` Genome instability Resisting cell death Evading growth suppressors Evading replicative mortality Angiogenesis Invasion and metastasis Tumour inflammation Evading immune destruction Reprogramming energy metabolism Sustaining proliferative signalling ```
47
What is the most important genetic regulator of tumour suppression via apoptosis?
TP53
48
What tumour suppressor is most commonly lost in cancer cells?
TP53
49
Angiogenesis is dependent upon which growth factors?
Vascular and platelet derived endothelial growth factors: VEGF PDGF
50
What is the most common metabolic emergency in malignancy?
Hypercalcaemia
51
What does hypercalcaemia in malignancy indicate about prognosis?
That it's shit
52
In what type of cancers in hypercalcaemia particularly common?
``` Multiple myeloma Breast Lung Head & neck Lymphoma ```
53
What are the vast majority (80%) of malignancy related hypercalcaemia caused by?
Parathyroid hormone related peptide (PTHrH) release by the tumour
54
What are the minority (20%) of malignancy related hypercalcaemia caused by?
Release of calcium by osteoclasts in malignant cells
55
10 signs and symptoms of hypercalcaemia
``` Weight loss Anorexia Polydipsia Polyurea Constipation Abdominal pain Dehydration Weakness Confusion Seizure Coma ```
56
What is the management of hypercalcaemia and how long does it usually take to normalise?
Aggressive Rehydration Bisphosphonates IV 3 days
57
Is there a genetic mutation to routinely screen for in lung cancer?
No
58
5 Local problems to suspect lung cancer?
``` Cough Haemoptosis Pain Recurrent pneumonia SoB ```
59
Systemic problems associated with lung cancer
``` Weight loss/anorexia - shite prognosis Voice change Dysphagia paraneoplastic syndromes Clubbing ```
60
What is an EBUS?
Endobroncial utrasound scan
61
Investigaions for suspected lung cancer
``` CXR Bloods Sa02 CT EBUS PET CT ```
62
What does radical treatment mean?
Curative
63
When would you not order a PET CT?
If someone has known metastatic disease.
64
2 broad categories of lung cancer?
Small cell | Non small cell
65
What type of lung cancer accounts for about 20% of cancers and usually affects the larger airways?
Small cell
66
With which type of lung cancer usually presents with systemic disease and metastasis?
Small cell
67
What syndromes might be associated with small cell lung cancer and why?
Cushings (ACTH) SIADH The small cells contain neurosecretory granules.

402 Oncology & Haematology (2 decks)

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