11. Neoplasia IV - Incidence, Prognosis and Treatment Flashcards
What cancers have the best prognosis?
Testicular
Melanoma
Breast
What cancers have the poorest prognosis?
Pancreatic
Lung
Oesophageal
Define tumour grading
Measure of how well or poorly differentiated the tumour is
Define tumour staging
Measure of how much tumour there is and how far it has spread
What categories does TNM staging analyse?
T - size - 1-4
N - nodes - 0-2
M - metastasis - 0-1
What does a tumour have to have to be measured as a stage 4 cancer on the TNM scale?
It has to have metastasised
What is the difference between a neoplasm measured as stage 1 and another as stage 2 on the TNM scale?
Size of the tumour
What staging is used to stage a lymphoma?
Ann Arbor
Describe the 4 stages in Ann Arbor scaling
Stage 1 - lymphoma in single node region
Stage 2 - lymphoma in 2 separate regions but on same side of diaphragm
Stage 3 - lymphoma has spread to both sides of the diaphragm
Stage 4 - disseminated involvement of one or more extra lymphatic organs
What is Duke’s staging used for?
Colorectal carcinoma
What are the 4 stages of Duke’s staging?
A - invasion into but not through the bowel
B - invasion through the bowel wall
C - involvement of lymph nodes
D - distant metastasis
How are tumours graded?
G1 - G4
G1 being well differentiated
G4 being poorly differentiated
How are breast carcinomas graded?
Bloom Richardson
What factors does bloom Richardson grading take into account?
Tubule formation
Nuclear variation
Rate of mitosis
Name the 5 main treatments of cancer?
Surgery Radiotherapy Chemotherapy Hormone therapy Treatment targeted to specific molecular alteration
What is adjuvant treatment?
Treatment given after surgical removal of a tumour to eliminate sub clinical disease
What is neoadjuvant treatment?
Treatment given to reduce the size of a tumour prior to surgical excision
Why is radiation given in fractionated doses in radiation therapy?
To minimise the damage done to the normal tissues while still killing the cancerous cells
What are antimetabolites?
Chemotherapy form that acts as a mimic for substrates used in DNA replication to prevent it occurring
What are alkylating and platinum based drugs such as cisplatin?
Chemotherapy drugs that cross link the strands of DNA
Name 2 types of hormone therapy and what cancers they are used in
Tamoxifen - breast cancer
Androgen blockade - prostate cancer
Name 2 oncogenes that can be targeted in therapy
Philadelphia chromosome
HER-2
What can be tumour markers be useful for?
Monitoring tumour burden
Checking treatment efficacy
Follow up to check for recurrence
Name some tumour markers
HCG
Oncofetal antigens
Specific proteins such as prostate specific antigen
Mucins such as CA125
Name 3 types of bias that can occur due to screening
Lead time bias
Length bias
Over diagnosis
Name four of the most common cancer locations
Breast
Lung
Prostate
Bowel
