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Semester 2-PP > Session 10-Neoplasia 4 > Flashcards

Session 10-Neoplasia 4 Flashcards

1
Q

Which carcinomas account for over half of cancers in the UK?

A

Breast
Lung
Prostate
Bowel

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2
Q

Which malignant neoplasms are more common in children younger than 14?

A

Leukaemia
Central nervous system tumours
Lymphoma

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3
Q

Which factors are considered when determining which individuals will have a favourable outcome for malignant neoplasms?

A 
Age
General health 
Tumour site
Tumour type
Grade
Tumour stage
Availability of effective treatments
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4
Q

What is tumour stage a measure of?

A

Malignant neoplasm’s overall burden

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5
Q

What does T refer to in TNM staging system?

A

Size of primary tumour and typically expressed as T1 through to T4

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6
Q

What does N stand for in the TNM staging system?

A

Extent of regional node metastasis (lymphatics) from N0 to N3

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7
Q

What does M refer to in the TNM staging system?

A

Extent of distant blood-borne metastatic spread eg M0 or M1

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8
Q

Describe stage I of cancer

A

Early local disease

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9
Q

Describe stage II of cancer

A

Advanced local disease (ie N0, M0)

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10
Q

Describe stage III of cancer

A

Regional metastasis (ie any T, N1 or more, M0)

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11
Q

Describe stage IV of cancer

A

Advanced disease with distant metastasis (ie any T, any N and M1)

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12
Q

What is the staging system used for lymphoma?

A

Ann Arbor staging

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13
Q

Describe the stages of the Ann Arbor staging system

A

Stage I - lymphoma in single node region
Stage II - two separate regions on one side of diaphragm
Stage III - spread to both sides of diaphragm
Stage IV - involvement of one or more extra-lymphatic organs such as bone marrow or lung

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14
Q

Which staging system is used for colorectal carcinoma?

A

Dukes

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15
Q

Describe the stages of the Dukes staging system

A

Dukes’ A - invasion into but not through bowel
Dukes’ B - invasion through bowel wall
Dukes’ C - involvement of lymph nodes
Dukes’ D - distant metastases

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16
Q

What does tumour grade describe?

A

Degree of differentiation of neoplasm

17
Q

What does the Bloom-Richardson grading system assess?

A

Tubule formation
Nuclear variation
Number of mitoses

18
Q

How can cancer be treated?

A 
Surgery
Radiotherapy
Chemotherapy
Hormone therapy
Treatment targeted to specific molecular alterations
19
Q

When is adjuvant treatment given?

A

After surgical removal of primary tumour to eliminate subclinical disease

20
Q

When is neoadjuvant treatment given?

A

To reduce size of primary tumour prior to surgical excision

21
Q

How does radiation therapy kill proliferating cells?

A

By triggering apoptosis or interfering with mitosis

22
Q

Why is radiotherapy given in fractionated doses?

A

To minimise normal tissue damage

23
Q

How does radiotherapy (eg x ray) kill rapidly dividing cells?

A

High dosage causes either direct or free-radical induced DNA damage that is detected by cell cycle check-points, triggering apoptosis

24
Q

What are the four classes of chemotherapy agents?

A

Antimetabolites
Alkylating and platinum-based drugs
Antibiotics
Plant-derived drugs

25
Q

How do antimetabolites work?

A

Mimic normal substrates involved in DNA replication

26
Q

How do alkylating and platinum-based drugs work?

A

Cross-link two strands of DNA helix

27
Q

Which cancer does cisplatin treat?

A

Testicular

28
Q

How do antibiotics work?

A

Inhibits DNA topoisomerase (needed for DNA synthesis)

Causes double-stranded DNA breaks

29
Q

How do plant-derived drugs work?

A

Block microtubule assembly and interferes with mitotic spindle formation

30
Q

What is the problem with chemotherapy?

A

Kills body’s own rapidly proliferating cells - hair follicles, GI cells, bone marrow -> hair loss, GI upset and marrow suppression

31
Q

How is hormone therapy used to treat breast cancer?

A

Selective oestrogen receptor modulators (SERMs) such as tamoxifen bind to oestrogen receptors, preventing oestrogen from binding

32
Q

How does Trastuzumab (Herceptin) work?

A

1/4 of breast cancers have gross over-expression of HER-2 gene and Herceptin blocks Her-2 signalling

33
Q

How does Imatinib work?

A

Chronic myeloid leukaemia shows chromosomal rearrangement creating abnormal ‘Philadelphia’ chromosome in which oncogenic fusion protein (BCR-ABL) is encoded. Imatinib inhibits fusion protein

34
Q

Give examples of drugs that block immune checkpoints

A

Nivolumab

Ipilimumab

35
Q

What do tumour markers allow?

A

Monitoring of cancer burden

36
Q

Give examples of tumour markers

A
  • Hormones
  • Oncofetal antigens
  • specific proteins
  • mucins/glycoproteins
37
Q

Why is cancer screening important?

A

Attempt to detect cancers as early as possible when chance of cure is highest

38
Q

What are the problems with cancer screening?

A
  • lead time bias
  • length time bias
  • over diagnosis

Semester 2-PP (13 decks)

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