Week 4 Flashcards
(102 cards)
1
Q
carcinogenesis
A
accumulates mutations leads to abnormal appearance & behavior
2
Q
carcinoma-in-situ (stage 0 / pre-cancer)
A
carcinoma that has not invaded basement membrane
3
Q
3 germ layers
A
ectoderm (outer), mesoderm (middle), endoderm (inner)
4
Q
what are ectoderms
A
epithelium, nervous tissue
5
Q
what are mesoderms
A
epithelium, connective, muscle tissues
6
Q
what are endoderms
A
epithelium
7
Q
where do most cancers develop in
A
epithelial cells
8
Q
exceptions to benign tumors
A
melanoma, mesothelioma
9
Q
asbestos leads to
A
mesothelioma
10
Q
alcohol leads to
A
head, neck, liver, oesophageal cx
11
Q
diet leads to
A
stomach, colorectal cx
12
Q
hepatitis B/C leads to
A
liver cx
13
Q
liver fluke leads to
A
cholangiocarcinoma
14
Q
HPV leads to
A
head, neck, cervical cx
15
Q
UV leads to
A
skin cx, melanoma
16
Q
BRCA1/2 mutation leads to
A
breast cx
17
Q
RB1 mutation leads to
A
retinoblastoma
18
Q
APC mutation leads to
A
colorectal cx
19
Q
NF1 mutation leads to
A
neurofibromatosis
20
Q
implications of carcinoma-in-situ
A
histological diagnosis, screening, insurance
21
Q
mechanism of metastasis
A
- detaching from neighbouring cells
- invaded other tissue layers
- penetrate blood / lymphatic vessels
- escape from vessels
- establish & growth at new site
22
Q
mechanism of metastasis sites
A
first-pass organ, favored sites,
vascular organs
23
Q
common sites of metastasis
A
lungs, liver, brain, bones, adrenals, left supraclavicular lymph nodes
24
Q
colorectal cx leads to
A
liver cx
25
prostate cx leads to
bone cx
26
patterns of metastases
orderly (colorectal, cervical)
random (breast & lung)
27
general symptoms of cx
pain, bleeding, obstruction / compression fracture
28
symptoms of breast cx
hard lump, nipple discharge, bleeding, skin ulceration
29
skin ulceration of breast cx is indicative of __
late stage
30
symptoms of lung cx
cough, SOB, hemoptysis
31
symptoms of colorectal cx
rectal bleeding, change in bowel habits, constipation, diarrhoea
32
mass screening
breast, cervical, colorectal cx
33
high risk screening
breast, colorectal, liver cx
34
wilson's criteria for screening includes
disease
- must be latent & important health problem
test
- available, cheap, reliable
treatment
- available, cheaper if detected earlier
35
breast cx screening
mammogram
36
colorectal cx screening
FOBT, colonoscopy
37
liver cx screening
alpha-fetoprotein (AFP), US liver
38
cervix cx screening
Pap smear
39
rationale of staging
prognosis, treatment intent & modality
40
colorectal type of staging
Duke's
41
thymoma type of staging
masaoka
42
testicular cx type of staging
Marsden
43
SCLC type of staging
limited & extensive staging
44
what is the gold standard of investigation diagnosis
histology
45
clinical investigation for diagnosis
CT, MRI, PET
46
tumor markers for investigation
CEA, CA19-9, alpha-FP, CA125, CA15-3
47
types of biopsy
core biopsy, fine needle aspirate (FNA)
48
conditions when treatment is initiated without histological confirmation
emergency, difficult to access / patient not fit, germ cell tumor markers, hepatocellular carcinoma
49
elevated germ cell tumor markers
beta-hCG, alpha-FP, LDH
50
hepatocellular carcinoma is indicative of __
underlying liver cirrhosis
51
what germ cell tumor marker indicates hepatocellular carcinoma
alpha-FP
52
what tumor marker indicates prostate cx
PSA
53
most common CT-PET scan
FDG-PET
54
radioactive tracer in CT-PET is tagged to __
glucose; increased uptake in metabolically active tissues
55
CT-PET scan has lower sensitivity for __
brain, liver, urinary tract
56
MRI allows for greater visualization of ___
brain, CNS, liver, pelvic organs, joints
57
examples of pelvic organs
prostate, rectum, uterus/cervix
58
downsides of MRI scan
longer scan time, noisy, expensive, claustrophobic, issues with implants & pacemakers
59
pre-treatment scans for potential disease complications
blood tests, heart scan, lung function, renal scan
60
what is the treatment of most cancers
surgery
61
what is the radical intent of treatment
to cure
62
what is the palliative intent of treatment
relieve symptoms, delay complications, prolong life
63
3 types of radical treatment
definitive, neoadjuvant, adjuvant
64
definitive radical treatment
primary treatment without which cure is not possible
65
neoadjuvant radical treatment
before definitive treatment to facilitate it
66
adjuvant radical treatment
after definitive treatment to reduce risk of recurrence
67
surgery is defined as __
complete resection of many solid tumors
68
principle of oncological resection
resect all tumors including regional lymph nodes of adequate margins & en-bloc
69
R0 resection
resect all tumors (gross & microscopic)
70
R1 resection
incomplete resection (microscopic)
71
R2 resection
incomplete resection (gross)
72
second most effective cx treatment
radiotherapy
73
principle of radiotherapy
irradiate tumors including regional lymph nodes within 1 field
74
radiotherapy indications
1. definitive treatment
2. neoadjuvant & adjuvant settings
- improve resectability
- reduce risk of local occurence
3. palliation
- pain, bleeding, obstruction, impending #
75
on electromagnetic spectrum, what has shortest wavelength
x-rays
76
on electromagnetic spectrum, what has longest wavelength
radiowaves
77
external beam radiotherapy involves use of __
photons, electrons, protons
78
brachytherapy is a __ radioactive source
sealed
79
radionuclides is a __ radioactive source
unsealed
80
radiotherapy involves the use of __
ROS to damage DNA and cause mitotic cell death
81
in early responding tissues, expression of damage appears __
early
82
lag time of early & late side effects
early = from 2 weeks
late = >3 months after end of RT
83
incidence of early & late side effects
early = most will experience
late = most will not experience
84
outcome of early & late side effects
early = reversible
late = irreversible
85
systemic therapy indications
1. curable cx
2. neoadjuvant/adjuvant setting
3. palliative treatment in metastatic setting
86
types of systemic therapy
cytotoxic chemotherapy, hormonal therapy, targeted therapy, immunotherapy
87
common toxicities of cytotoxic chemotherapy
alopecia, nausea & vomitting, diarrhoea / constipation, bone marrow suppression
88
what cx are hormonally driven
breast, prostate, uterine
89
side effects of hormonal therapy
menopausal symptoms, CVS, osteoporosis
90
targeted therapy includes __
1) structure = small molecules, monoclonal antibodies
2) target / action = tyrosine kinase inhibitors, anti-angiogenic, apoptosis-inducing
91
benign tumors ends with __
-oma
92
malignant tumors ends with __
-carcinoma
93
tumor of connective tissue ends with __
-sarcoma
94
metathesis
malignant cells do not adhere to each other & often break loose from the mass, infiltrating into adjacent tissue
95
blood tests for cancer
low Hb & EPO count
96
systemic effects of cx
1. weight loss
2. anemia
3. severe fatigue
4. effusions
5. frequent infections
6. paraneoplastic syndrome
97
paraneoplastic syndrome
Tumour cells release
substances that affect neurological function or blood clotting, or may have hormonal effects
98
tumor seeding
Spread of cancer cells in body fluid or along membranes, usually in body cavity
99
tumor staging includes __
size of tumor, involvement of regional lymph nodes, spread of tumor
100
radiotherapy is most effective in __
rapidly dividing radiosensitive cells
101
chemotherapy involves the use of __
combo of 2-4 antineoplastic drugs
- antimitotics
- antimetabolites
- alkylating agents
- antibiotics
102
glucocorticoids are used to __
reduce mitosis, inflammation, swelling
increase EPO count, appetite, well being
