16 Neoplasia 4 Flashcards
What are the most common cancer types (UK)?
Breast, lung, prostate, bowel (account for over 53%)
What are the most common cancer types in children under 14 yrs?
Leukaemias, CNS tumours, lymphomas
What are the survival rates for each of the following:
Testicular cancer:
Melanoma:
Breast:
Pancreatic:
Lung:
Oesophageal:
Testicular cancer: 98%
Melanoma: 90%
Breast: 87%
Pancreatic: 3%
Lung: 10%
Oesophageal: 15%
What factors do we consider when deterinign which individuals will have a favourable outcome for malignant neoplasms?
Age
Health status
Site
Type
Grade
Stage
Treatment
What is ‘tumour stage’ a measure of?
Overall burden of malignant neoplasm
What is the TNM staging system?
Commonest method of cancer staging (globally standardised)
How does the TNM staging system work?
T= size of primary tumour (T1-T4)
N= extent of regional node metastasis (N0-N3)
M= extent of distant metastatic spread (M0/M1)
How is TNM staging converted to I-IV staging?
What is ‘Ann Arbor’ staging?
Staging for lymphoma :
Stage 1: Lymphoma in single node region
Stage 2: 2 separate regions on 1 side of diaphragm
Stage 3: spread to both sides of diaphragm
Stage 4: diffuse/disseminated involvement of 1+ extra-lymphatic organs eg bone marrow/lungs
What is Dukes’ staging used for?
Colorectal Carcinoma :
A: invasion into but not through bowel
B: invasion through bowel wall
C: Lymph node involvement
D: Distant metastasis
What does ‘tumour grade’ describe?
degree of differentiation of neoplasm
G1-G4
G1=Well differentiated
G4= Undifferentiated/ anaplastic
(eg used for squamous cell carcinoma and colorectal carcinoma)
What is the ‘modified Bloom-richarson’ system used to grade?
Breast carcinoma
–> assesses:
- Tubule formation
- Nuclear variation
- Number of mitoses
How can cancer be treated? (in general terms)
- Surgery
- Radiotheraphy
- Hormone therapy
- Chemotherapy
- Treatment targeted to specific molecular alterations
What is adjuvent treatment? (of cancer)
Treatment given after surgical removal of primary tumour to elimnate subclinical disease
What is neoadjuvant treatment?
Given to reduce size of primary tumour prior to surgical excision
How does radiation therapy work? (as cancer treatment)
Kills proliferating cells:
- triggers apoptosis
- interferes with mitosis
How is radiotherapy administered?
- Focused on tumour, surrounding tissue= shielded.
- Given in fractionated doses - to minimise damage
- X-rays/other ionisng radiation used
High dosage- damages DNA- detected by cell- trigger apoptosis
What are the different classes of chemotheraphy drugs? (4)
Antimetabolites: Eg Fluorouracil (mimic normal substrates involved in DNA replication)
Alkylating and platinum-based drugs: Eg Cyclophosphamide (cross-link two DNA strands of helix)
Antibiotics: Eg doxorubicin (inhibits enzyme required for DNA synthesis)
Plant-derived: Eg vincristine (block microtubule assembly and spindle formation)
Give an examples of hormone therapy used to treat malignant tumours.
1) Hormone receptor-positive breast cancer- SERMs(Selective estrogen receptor modulators) eg TAMOXIFEN- prevents oestrogen binding
2) Prostate cancer- Androgen blockade
What are Trastuzumab (Herceptin)and Imatinib(Gleevec)?
Drugs targeting specific oncogenes.
Herceptin: Blocks Her-2 signalling- Breast cancer
Imatinib: inbits oncogene- Chronic myeloid leukaemia
How do Nivolumab and Ipilimumbab function?
Block immune checkpoints in cancer cell cycle
What are tumour markers and what can they allow us to measure?
Substance released by cancer cells into circulation.
Monitor cancer burden
Give examples of ‘TUMOUR MARKERS’.
- Hormones: HCG- released by testicular tumours
- Oncofetal antigens
- Specific proteins
- Mucins/glycoproteins
What national screening programmes are there currently for cancer in the UK?
Cervical, breast, bowel
