(SYNOPTIC) Cancer Metastases Flashcards
(46 cards)
What is a metastasis?
- Primary cancer can spread to other areas of the body.
- Secondary involvement = metastases
- Cells in metastasis resemble those in primary tumour.
What are the main routes of metastatic spread?
(1) Lymphatic system
- spreads to lymph nodes elsewhere.
(2) Haematogenous spread
- via blood
(3) Transcoelomic
- through body walls into abdominal/ chest cavities
What is the process of carbohydrate interactions in disease pathways of metastatic cancers?
(1) Leukocyte captures chemo-attractants
(2) Leukocyte rolls
(3) Rolling slows
(4) Leukocyte adhesion to endothelium
(5) Transmigration + release of chemo-attractants into tissue
What is lymphatic spread?
Follows lymphatic system
Lymphadenopathy
What is lymphadenopathy?
Spread and growth of cancer cells/ reactive hyperplasia
What is haematagenous spread?
Spread of metastases via circulatory system
Veins more readily invaded than arteries
What is transcoelomic spread?
Spread of metastases across peritoneal cavity
Often associate with fluid buildup
Name two types of cancer metastases that have arisen from transcoelomic spread?
(1) Ovarian cancer - across peritoneum
(2) Lung cancer - across pleural cavity
State the likely location of cancer metastases based on the location of the primary cancer.
Bladder
- Bone
- Liver
- Lung
State the likely location of cancer metastases based on the location of the primary cancer.
Breast
- Bone
- Brain
- Liver
- Lung
State the likely location of cancer metastases based on the location of the primary cancer.
Colon
- Liver
- Lung
- Peritoneum
State the likely location of cancer metastases based on the location of the primary cancer.
Kidney
- Adrenal gland
- Bone
- Brain
- Liver
- Lung
State the likely location of cancer metastases based on the location of the primary cancer.
Lung
- Adrenal gland
- Bone
- Brain
- Liver
- Other lung
State the likely location of cancer metastases based on the location of the primary cancer.
Melanoma (skin)
- Bone
- Brain
- Liver
- Lung
- Skin
- Muscle
State the likely location of cancer metastases based on the location of the primary cancer.
Ovary
- Liver
- Lung
- Peritoneum
State the likely location of cancer metastases based on the location of the primary cancer.
Prostate
- Adrenal gland
- Liver
- Bone
- Lung
How are metastases diagnosed?
- CT Scans
- X-ray
- Tumour markers
- Biopsy
- Cytology
What is the pharmacological symptomatic treatment of bone metastases?
Bisphosphonates
To reduce calcium
As bone metastases are often linked to hypercalcaemia
How is spinal cord compression, due to bone metastases, treated?
Dexamethasone with PPI cover
Radiotherapy to bone
Pain relief + laxatives
What is the pharmacological treatment of brain metastases?
Dexamethasone + PPI
Often causes seizures - anti-epileptics
What is the pharmacological treatment of lung metastases?
Dexamethasone + PPI
Salbutamol to open airways (if required)
May require tranexamic acid to reduce bleeding
What is the pharmacological treatment of liver metastases for symptomatic relief?
Dexamethasone
- useful for pain
Drain ascites
What is primary chemotherapy resistance?
Intrinsic resistance to chemotherapy, regardless of drug exposure
What is acquired chemotherapy resistance?
Natural selection of tumour cells that are sensitive to chemotherapy drug die, but this does not affect the tumour as a whole
