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2 Pathological Processes > 16 Neoplasia 4 > Flashcards

16 Neoplasia 4 Flashcards

1
Q

What are the most common cancer types (UK)?

A

Breast, lung, prostate, bowel (account for over 53%)

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2
Q

What are the most common cancer types in children under 14 yrs?

A

Leukaemias, CNS tumours, lymphomas

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3
Q

What are the survival rates for each of the following:

Testicular cancer:

Melanoma:

Breast:

Pancreatic:

Lung:

Oesophageal:

A

Testicular cancer: 98%

Melanoma: 90%

Breast: 87%

Pancreatic: 3%

Lung: 10%

Oesophageal: 15%

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4
Q

What factors do we consider when deterinign which individuals will have a favourable outcome for malignant neoplasms?

A

Age

Health status

Site

Type

Grade

Stage

Treatment

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5
Q

What is ‘tumour stage’ a measure of?

A

Overall burden of malignant neoplasm

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6
Q

What is the TNM staging system?

A

Commonest method of cancer staging (globally standardised)

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7
Q

How does the TNM staging system work?

A

T= size of primary tumour (T1-T4)

N= extent of regional node metastasis (N0-N3)

M= extent of distant metastatic spread (M0/M1)

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8
Q

How is TNM staging converted to I-IV staging?

A
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9
Q

What is ‘Ann Arbor’ staging?

A

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

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10
Q

What is Dukes’ staging used for?

A

Colorectal Carcinoma :

A: invasion into but not through bowel

B: invasion through bowel wall

C: Lymph node involvement

D: Distant metastasis

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11
Q

What does ‘tumour grade’ describe?

A

degree of differentiation of neoplasm

G1-G4

G1=Well differentiated

G4= Undifferentiated/ anaplastic

(eg used for squamous cell carcinoma and colorectal carcinoma)

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12
Q

What is the ‘modified Bloom-richarson’ system used to grade?

A

Breast carcinoma

–> assesses:

  • Tubule formation
  • Nuclear variation
  • Number of mitoses
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13
Q

How can cancer be treated? (in general terms)

A
  • Surgery
  • Radiotheraphy
  • Hormone therapy
  • Chemotherapy
  • Treatment targeted to specific molecular alterations
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14
Q

What is adjuvent treatment? (of cancer)

A

Treatment given after surgical removal of primary tumour to elimnate subclinical disease

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15
Q

What is neoadjuvant treatment?

A

Given to reduce size of primary tumour prior to surgical excision

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16
Q

How does radiation therapy work? (as cancer treatment)

A

Kills proliferating cells:

  • triggers apoptosis
  • interferes with mitosis
17
Q

How is radiotherapy administered?

A
  1. Focused on tumour, surrounding tissue= shielded.
  2. Given in fractionated doses - to minimise damage
  3. X-rays/other ionisng radiation used

High dosage- damages DNA- detected by cell- trigger apoptosis

18
Q

What are the different classes of chemotheraphy drugs? (4)

A

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)

19
Q

Give an examples of hormone therapy used to treat malignant tumours.

A

1) Hormone receptor-positive breast cancer- SERMs(Selective estrogen receptor modulators) eg TAMOXIFEN- prevents oestrogen binding

2) Prostate cancer- Androgen blockade

20
Q

What are Trastuzumab (Herceptin)and Imatinib(Gleevec)?

A

Drugs targeting specific oncogenes.

Herceptin: Blocks Her-2 signalling- Breast cancer

Imatinib: inbits oncogene- Chronic myeloid leukaemia

21
Q

How do Nivolumab and Ipilimumbab function?

A

Block immune checkpoints in cancer cell cycle

22
Q

What are tumour markers and what can they allow us to measure?

A

Substance released by cancer cells into circulation.

Monitor cancer burden

23
Q

Give examples of ‘TUMOUR MARKERS’.

A
  1. Hormones: HCG- released by testicular tumours
  2. Oncofetal antigens
  3. Specific proteins
  4. Mucins/glycoproteins
24
Q

What national screening programmes are there currently for cancer in the UK?

A

Cervical, breast, bowel

2 Pathological Processes (12 decks)

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