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Module 4 > Oral Cancer > Flashcards

Oral Cancer Flashcards

(100 cards)

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1
Q

What does hypertrophy mean?

A

Increase in cell size

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2
Q

What does hyperplasia mean?

A

Increase in cell number

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3
Q

What does atrophy mean?

A

Reduction in cell size by loss of cell substance

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4
Q

What does hypoplasia mean?

A

Reduced size of an organ that never fully developed to normal size

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5
Q

What does metplasia mean?

A

Reversible change in which one adult cell type is replaced by another adult cell type

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6
Q

What does dysplasia mean?

A

Abnormal growth

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7
Q

What does neoplasia mean?

A

New growth

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8
Q

In adult tissues what is the size of cell population determined by?

A

The rates of cell proliferation, differentiation and death by apoptosis

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9
Q

What is meant by the term apoptosis?

A

Programmed cell death

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10
Q

What are the 2 main classifications of tumours?

A

Behaviour
Histogenesis

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11
Q

What are the 2 types of behaviour tumours?

A

Benign
Malignant

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12
Q

What is a prognosis?

A

Prediction of the probable course and outcome of a disease.
Appropriate treatment and estimated survival

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13
Q

What does a cancer prognosis involve?

A

Tumour type
Tumour grade
Tumour stage

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14
Q

What classification is used for staging malignant tumours?

A

TNM

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15
Q

What does TNM classification stand for?

A

T- extent of primary tumour
N - absence or presence and extent of regional lymph node metastasis
M - describes the abscence or presence of distant metastasis

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16
Q

What is distant metastasis?

A

Cancer that has spread from the original (primary) tumour to distant organs or distant lymph nodes

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17
Q

Define the term oral cancer

A

The general term given to the variety of malignant tumours that develop in the mouth

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18
Q

What is the most common tumour that counts for 90% of all cancers of the mouth?

A

Squamous cell carcinoma

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19
Q

What area of the mouth is concerned when talking about mouth cancer?

A

Anterior (2/3) of the tongue

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20
Q

What area of the mouth is concerned when talking about oropharyngeal cancer?

A

Posterior (1/3) of the tongue

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21
Q

What is the largest risk factor for mouth cancer?

A

Tobacco

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22
Q

What is the second largest risk factor for mouth cancer?

A

Alcohol

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23
Q

What age group does oral cancer mostly effect?

A

> 55

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24
Q

If you smoke >21 cigarettes and consume over 7 ounces of alcohol per day how much does your risk of developing mouth cancer increase by?

A

24%

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25
How does alcohol contribute to mouth cancer?
It causes thinning of the overlying mucosa making it more permeable for the carcinogens to enter the epithelial cells
26
If you smoke <10 cigarettes a day what is your risk compared to a non smoker of developing cancer?
2.5 x
27
If you smoke <20 cigarettes a day what is your risk compared to a non smoker of developing cancer?
5.0 x
28
If you smoke >20 cigarettes a day what is your risk compared to a non smoker of developing cancer?
5.5 x
29
If you quit smoking how long does it take for your relative risk to fall down to the same as someone who has never smoked?
20 years
30
Why does smoking cause cancer?
Contains the chemicals nitrosamines and acrolein (mutagen, carcinogen?
31
What is an example of a cultural habit associated with an increased risk of mouth cancer?
In Asia a lot of the population use betel nuts
32
What is oral submucous fibrosis?
abnormal collagen deposition
33
What does excessive alcohol consumption do to the metabolic pathway for oxidation of ethanol?
Slows it down, preventing acetaldehyde from converting to acetate
34
What is the recommended alcohol consumption per week in units?
14
35
How long does it take the body to eliminate 1 unit of alcohol?
1 hour
36
How can a poor diet contribute to mouth cancer?
Insufficient levels of supplements such as iron can cause the mucosa to become thinner making it more permeable for carcinogens
37
What is the known carcinogen in alcohol?
Ethanol is broken down into acetaldehyde
38
What is the third largest risk factor for mouth cancer?
Infection of HPV (Human Papilloma Virus)
39
What are the 5 types of HPV?
Alpha Beta Gamma Mu Nu
40
Which type of HPV most commonly effects the oral mucosa?
Beta
41
Which high risk HPVs are associated with mouth cancer?
HPV16 abd HPV18
42
What group does HPV belong to?
Papovavirus group
43
What does oncogenic mean?
causing development of a tumour or tumours
44
What early genes does HPV consist of?
E1-E7
45
What late genes does HPV consist of?
L1 and L2
46
What early genes give HPV its ocogenic properties and why?
E6 and E7 because they target the tumour suppressor genes and knockout their function
47
Why does HPV target cells which are capable of dividing?
Because the virus wants to take over the genetic regulation and production of proteins of the cell
48
Which protein does E7 interact with to inactivate the human tumour suppressor gene product?
The retinoblastoma protein (pRB)
49
Which protein does E6 bind to for the destruction by the ubiquitin pathway?
p53
50
What are the 2 main benign oral HPV lesions?
Papilloma Condylomata
51
What is the most common malignant oral HPV lesion?
Cancer - Squamous Cell Carcinoma (SCC)
52
Does mouth cancer generally give patients symptomatic or asymptomatic lesions?
Asymptomatic
53
What can happen to the teeth within a cancerous lesion?
They can become mobile
54
What does it mean for an area of the mouth to be indurated?
Hard and rubbery to touch
55
What percentage of oropharyngeal cancers are HPV related?
Up to 80%
56
What are the 2 main risk factors behind HPV?
Number of sexual partners Weakened immune system
57
What are the 3 HPV vaccines?
Quadrivalent Gardasil Bivalent Cervarix Nonvalent Gardasil
58
What is the Epstein-Barr Virus (EBV)?
A type of Herpes virus
59
What does EBV most commonly cause?
Infectious mononucleosis
60
What is infectious mononucleosis more commonly known as?
Glandular fever (kissing disease)
61
What is a common oral symptom of a HIV positive patient?
Oral candidiasis
62
What is Kaposi's sarcoma?
A rare type of cancer that affects the skin, mouth and occasionally the internal organs
63
What are usually the first symptoms of Kaposi's sarcoma?
Red, purple or brown patches, plaques or nodules on the skin
64
Where is commonly effected by UV Light as a risk of mouth cancer?
Lower lip
65
Approximately 20% of mouth cancers have HPV within tumour cells, which HPV does this tend to be?
HPV16
66
What is the commonest oral lesion with a viral aetiology?
Papilloma
67
What is the known national screening programme for oral cancer?
There isnt one
68
What are the 3 types of prevention classified into?
Primary Secondary Tertiary
69
Define primary prevention and what is the role of the clinician here?
Prevents a disease from developing Giving risk factor education - e.g. smoking/alcohol consumption
70
Define secondary prevention and what is the role of the clinician here?
To detect disease while it is localised or 'early' Screening the oral cavity - looking for what is normal/abnormal
71
Define tertiary prevention and what is the role of the clinician here?
to mitigate the morbidity from established disease and to improve quality of life maintaining oral health and remaining dentition after patients have been treated/undergoing treatment. Also giving advice regarding risk factors
72
What are the 3 screening programme types?
Mass Selective Opportunistic
73
What screening programme is used in dentistry?
Opportunistic
74
For a screening programme to be successful what must it be high in?
Sensitivity and Specificity
75
How is sensitivity calculated?
True Positive/TP+False Negative
76
How is specificity calculated?
True Negative/TN+FP
77
What % of specify and sensitivity in a screening programme is acceptable
80 or more
78
What is the best way to screen for oral cancer?
Conventional oral examination
79
What is the name of the only study to have shown benefit of screening oral cancer?
Cochrane Review
80
What does OPMD stand for?
Oral potentially malignant disorders
81
Name a common OPMD
Lichen planus
82
What is meant if something is homogeneous?
uniform/normal in colour, content, texture
83
Are white or red lesions more worrying?
Red
84
what sites in the mouth are at the highest risk for developing mouth cancer?
FOM and lateral borders of tongue
85
What does leukoplakia mean?
clinical term that means a white patch, isn't easily removed with gauze, no obvious risk factors (a white patch of unknown cause)
86
What is the clinical term used to describe red lesions of an unknown cause
Erythroplakia
87
What is meant by endophytic?
Inwards growing
88
What is meant by exophytic?
Outwards growing
89
When can cancers become painful?
When they are secondarily infected or when they invade nerves
90
What is meant by a perineurial spread?
Cancerous cells that have invaded the nerves
91
What is meant by a vascular invasion?
When cancerous cells have invaded the blood supply
92
How is the size of a lesion recorded?
In T sizes
93
How big is a T1 lesion?
<2cm
94
How big is a T2 lesion?
2-4cm
95
How big is a T3 lesion?
4-6cm
96
How big is a T4 lesion?
>6cm or if it involves bone
97
What should you do if you spot a suspicious lesion?
Photograph /document in notes Eliminate trauma Review Refer using urgent pathways
98
What is sensitivity of a screening programme telling you?
The proportion of the population who are correctly classified as having the disease
99
What is the specificity of a screening programme telling you?
The proportion of the population correctly classified as disease-free
100
When examining a patients lymph nodes what are you looking for?
Symmetry Soft non tender lymph nodes Palpate all anatomical sites of lymph nodes Skin moves freely over the nodes they are not attached think about anatomical drainage from the mouth to the nodes of the neck Symmetrical salivary glands

Module 4 (9 decks)

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