Oncology altered Flashcards
(121 cards)
1
Q
What is a neoplasm?
A
A mass of tissue that grows faster than normal in an uncoordinated manner
2
Q
What is a tumour?
A
Mass / growth of tissue.
benign or malignant
Tumour means ‘swelling’
3
Q
‘RED’ how does a tumour no longer respond?
A
Tumour no longer responds to normal growth factors, GROWING FASTER THAN NORMAL - UNCO-ORDINATED MANNER
4
Q
What are the most common causes of cancer death in the world?
A
LungLiverColorectalStomachBreast
5
Q
Which types of countries have higher cancer rates?
A
Developed countries
6
Q
Globally no. of people with cancer is projected to…?
A
double by 2030
7
Q
WHO links what in developed countries to cancer
A
environment
lifestyle
diet
drugs
meds
8
Q
What type of cell division do cancer cells undergo?
A
Mitosis
Mitosis is growth and repair of somatic cells
9
Q
What architecture do normal cells have?
A
Differentiated and specialised
Organised in the tissue and fulfil a particular function
10
Q
What architecture do cancer cells have?
A
Not differentiated
Grow in an uncontrolled manner
function is lost Becoming irregular and disorganised Specialised
11
Q
How does cancer come about?
A
Through genetic mutations
Result of an underlying cause
environmental interaction Promoting mutations of multiple genes
12
Q
What are tumour suppression genes (TSG)?
A
They tell a cell when to stop dividing
Like an off switch
13
Q
What happens to tumour suppression genes (TSG) during cancer cell growth?
A
TSG becomes deactivated oncogenes are formed
(genetic mutations)
14
Q
We have these genes called ONGOGENES
A
When we have these genetic mutations, these ONCOGENES are formed - they promote growth Factors which INCREASES the rate of cell division so these cells need a blood supply so they undergo ANGIOGENISIS
15
Q
What is angiogenesis?
A
Growth of new blood vessels
16
Q
What is contact inhibition
A
Proteins produced by cells preventing cells dividing beyond the space available
17
Q
Why do malignant cells undergo angiogenesis?
A
As they can only grow to 12 mm³ without a blood supply
18
Q
What is the prime environment for cancer cells to thrive in?
A
Acidic
Anaerobic
Glucose rich
19
Q
What is contact inhibition?
A
We have this spread and growth - Proteins produced by cells preventing cells dividing beyond the space available
20
Q
Do cancer cells have contact inhibition?
A
No
21
Q
What is mutation?
A
Change in genetic sequence
22
Q
What is a mutagen?
A
An agent that changes the genetic sequence
23
Q
Examples of mutagens
A
Chemicals
Radiation
Viruses
Inflammation (chronic)Stress emotional trauma
Defective immunity
Environmental hazards
24
Q
What is a carcinogen?
A
A cancer-causing agent
25
What is carcinogenesis?
process of normal, healthy cells becoming cancer cells
26
Examples of carcinogens
Heavy metals
Asbestos
X-ray
UV rays
Parabens
Formaldehyde
27
What percentages of cancers are attributed to genetics vs environmental factors?
5-10% genetics
90-95% environment lifestyle
28
How long can tumours take to develop?
20-40 years
29
What are risk factors for cancer?
Genetics
Chronic inflammation
Chronic stress
Smoking
Radiation excess alcohol
alcoholObesityExcessive exposure to sunlight Compromised immunity
Metal toxins
Medications
Vaccine ingredients
Drugs cosmetics
GIT dysfunction
(poor liver function)
Sexual behaviour
Vit D deficiency
thyroid disease
30
What are dietary risk factors for cancer?
Red meats
Burnt food
Low fibre
Refined sugars
Dairy
Table salt
Pesticides
Aspartame
N-nitroso compounds
(cured meats)
31
How can chronic immunodeficiency increase the risk of cancer?
Cytotoxic T-cells, NK cells, macrophages are needed to destroy abnormal cells. However..HIV targets CD4 cells, compromising the immune system
32
How can chronic stress suppress the immune system?
By elevating cortisol levels
33
What is the architecture for benign tumours?
Differentiated cells Appear similar to normal cells
May be functional
34
How do benign tumour cells reproduce?
At a higher rate than normal
35
How do benign tumour cells grow?
Very slowlyDoesn't spread (encapsulated - no metastasis)
36
Are benign tumours life-threatening?
No but damage can result from compression of tissues*| eg brain tumour increasing intra-cranial pressure
37
What is the architecture for malignant tumours?
Undifferentiated cells
Non functional
Varied shapesand sizes
Large nuclei
38
How do malignant tumour cells reproduce?
Much faster than normal
39
How do malignant tumour cells grow?
RapidlyNot encapsulated so they metastasiseCan spread quickly to other organs
40
Are malignant tumours life-threatening?
Yes due to tissue destruction and spread
41
What is grading?
measure of degree of cell differentiation abnormality
42
What are grade 1 tumours?
BenignSimilar to original cellsDifferentiated and specialised
43
What are grade 4 tumours?
UndifferentiatedAbnormal cells varying in size and shape
44
What is staging?
Classification of malignant tumours according to size and spread of the tumour
45
What are the benefits of staging?
Helps to identify treatment approaches, disease progression and prognosis
46
What is stage 0 cancer?
Pre-cancerous cells
47
What is stage 1 cancer?
Cancer limited to tissue of origin
48
What is stage 2 cancer?
Limited local spread of cancerous cells
49
What is stage 3 cancer?
Extensive local and regional spread
50
What is stage 4 cancer?
Distant metastasis
51
What is the TNM staging system?
TumourNodeMetastasis
52
What does T (1-4) staging stand for?
Size of primary tumour
53
What does N (0-3) staging stand for?
Degree of lymph node involvement
54
What does M (0-1) staging stand for?
Metastasis - 1 indicates metastasis
55
What are the local effects of a tumour?
Compresses blood vessels - leads to necrosis of surrounding tissue or tumour itself
Obstruction of tubes or ducts Tissue ulceration necrosis may produce infection (increased risk with chemo)|
calcification can be seen on x-ray
56
What are the systemic effects of a tumour?
Weight loss & Cachexia - strong appetite
Anaemia
Infection
Para-neoplastic syndromes
57
What are para-neoplastic syndromes?
Set of signs and symptoms as a result of a cancerous tumoureg lung cancers may produce ACTH leading to Cushing's syndrome (excess corticosteroids produced by lung tumour cells)
58
What is metastasis?
Describes spread of a malignant tumour
Cells break off (non-encapsulated tumour) spread via blood or lymphatic system
produce secondary tumours
59
How do malignant tumours spread?
Via blood or lymph
Produce secondary tumours
60
Are secondary tumour cells similar to parent tumour?
Yes
61
What are the common sites for metastasis?
BoneLiverLungsBrain
62
How can cancer present in signs and symptoms?
```Solid lumpSwollen lymph nodesDifficulty swallowingPersistent coughChange in bowel/bladder habitsAppearance of wart/moleUnexplained weight loss (red flag)Anaemia/fatigueDrenching night sweats```| Initially few vague symptoms
63
What are the typical diagnostic tests for cancer?
Blood testsTumour markersImagingBiospies| None 100% reliable, also more effective in later stages
64
What do blood tests look for?
HaemoglobinErythrocytesLeukocytesPlatelets
65
What are tumour markers?
Substances (usually proteins) produced by tumours
66
Where can tumour markers be found?
BloodUrineStoolsTissues| Depends on the specific marker
67
Can tumour markers be used on their own to diagnose cancer?
No, must be used in context of patient presentation and other clinical findingsTumour markers can be present in non-cancerous conditions
68
Examples of tumour markers
```CA-125 (ovarian cancer)CA 15-3 (breast cancer)CEA (colorectal cancer)PSA (prostate cancer)hCG (testicular cancer)Tumour M2-PK (colorectal cancer)```
69
What is CEA?
Carcinoembryonic antigenGlycoprotein present in normal mucosal cells Normally undetectable after birthBlood-borne marker
70
How is CEA tested?
Blood test
71
What is CEA testing used for?
MonitoringDue to low sensitivity and specificity| Small raises could be due to smoking
72
In which conditions may CEA be elevated?
Colorectal cancerUlcerative colitisPancreatitisLiver cirrhosis
73
What is PSA?
Prostate specific antigenProtein produced by prostate glands
74
In which conditions may PSA be elevated?
Prostate cancerBenign Prostatic hyperplasia
75
What is PSA testing used for?
Diagnosis of prostate cancer
Monitor tumour progression
Monitor metastasis
76
What is hCG?
Human chorionic gonadotrophin
77
What is hCG testing used for?
Testicular cancer
Pancreatic cancer
Pituitary gland cancer
Pregnancy
Should only be present in pregnant women
78
What is tumour M2-PK?
Not organ specific so may be elevated in many tumour types
79
How is tumour M2-PK tested?
Stool test
80
In which conditions may tumour M2-PK be elevated?
Colorectal cancer
Gastric cancer
81
What is CA-125 used to test for?
Ovarian cancer
82
How is CA-125 tested?
Blood test
Normal range <35 U/ml
83
What is CA-15-3 used to test for?
Breast cancer
84
How is CA-15-3 tested?
Blood test
Normal range <30 U/ml
85
Examples of imaging
X-rays
MRI
CT scan
Radioisotopes
86
Examples of biopsies
Fine needle
Core needle
Surgical biopsy
87
What happens during a biospy?
Small tissue sample is removed and examined
88
What are the risks of a biopsy?
Procedure may cause cancer cells to break off and spread
89
What are the basic allopathic treatments for cancer?
SurgeryChemoRadiation
90
What are the conventional treatment approaches?
CurativePalliative
91
What is curative care?
Treatment used to resolve the malignancy
92
What is palliative care?
Focuses on reducing symptom severity rather than 'curing'
Quality of life
93
Examples of cancer surgery
Mastectomy
Prostatectomy
Orchiectomy
94
What is a mastectomy?
Removal of breast
95
What is a prostatectomy?
Removal of prostate gland
96
What is a orchiectomy?
Removal of the testes
97
What does radiotherapy do?
Affects cells which divide most rapidly - cancer and healthy cells
Causes loss of reproduction & Induces apoptosis
98
Examples of radiotherapy
External beam
Internal beam
Systemic beam
99
What is external beam radiotherapy?
Beams generated from outside the patient
100
What is internal beam radiotherapy?
Higher dose of radiation released from within a body cavity Probe used (cervical, colorectal)| Also known as Brachytherapy
101
What is systemic beam radiotherapy?
Radioactive material enters the blood to reach cells all over the body
102
What are the adverse effects of radiotherapy?
Bone marrow depression* => immunocompromised Burns => inflammation ulceration of skin
Hair loss Gut ulceration (diarrhoea, bleeding)
Sterility
Fatigue Fibrosis| *leads to aplastic anaemia with pancytopenia
103
What kind of natural support can be given during radiotherapy?
Exercise*Rest/relaxation (good sleep and stress management)Creams/gels for skin irritation| *reduces fatigue
104
What is chemotherapy?
Chemical agents destructive to malignant cells
105
What does chemotherapy do?
Targets rapidly dividing cells - cancerous and healthy
106
What does chemotherapy interfere with?
Protein synthesis
DNA replication
107
What are the adverse effects of chemotherapy?
Bone marrow depression Diarrhoea Vomiting Nausea
Hair loss
Organ damageCancer
108
Examples of drug treatments in cancer
Hormones
Biologic response modifier Analgesics
109
Example of hormone drug treatment in cancer
Tamoxifen
110
What does tamoxifen do?
Blocks oestrogen receptors
111
What is an adverse effect of tamoxifen?
Induces menopause
112
Example of an analgesic
Opioid analgesic - morphine
(acts on CNS)
113
What complementary therapies can be used to support cancer?
```Nutrition - high antioxidant, high anti-inflammatory, high fibre, whole plant foods, omega-3, 7-9 portions fruit/vegMedicinal mushrooms*Amygdalin (B17) => cyanide in cancer cellsHerbsAcupunctureHomeopathy```| *beta glucans immune modulating, anti-cancer properties
114
What is 'cured' from cancer?
5 years without reoccurrence
115
Why is cancer hard to diagnose?
Some cancers only present clinically once disease is very advanced
116
What are the different categories of cancer?
Carcinomas
Sarcomas
Leukaemias
Over 200 types of cancer
117
What are carcinomas?
Cancers forming in epithelial tissue
118
Where can carcinomas be found?
Skin
Mouth
Nose
Throat
Respiratory tract
Lung
Breast
Prostate
Stomach
119
What are sarcomas?
Cancers forming in connective tissue
120
Where can sarcomas be found?
Bone
Cartilage
Muscle
Tendons
121
What are leukaemias?
Cancers found in blood and bone marrow
Abnormal leukocytes travel through bloodstream NOT solid tumours
