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BioMed S2 > 17. Oncology - Types of cancers > Flashcards

17. Oncology - Types of cancers Flashcards

1
Q

Lung Cancer: peak incidence

A

60-70 yrs

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2
Q

Lung Cancer: epidemiology

A

More common in men - 3:1

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3
Q

Lung Cancer: 5 year survival rate

A

15%

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4
Q

Lung Cancer: secondary to which cancers?

A

Colorectal
Prostate

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5
Q

Lung Cancer: aetiology

A

90% - due to smoking*
COPD

* can be from passive smoking

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6
Q

Lung Cancer: signs and symptoms

A 
Dry and persistent cough
Dyspnoea 
Chest pain (later stage)
Weight loss (later stage)
Voice hoarseness
Haemoptysis * 
Wasting of hands (apical tumours compress nerves to hands)
Clubbing of fingernails

*Blood in sputum

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7
Q

Lung Cancer: diagnostics

A

X-ray
CT scan
FBC
Sputum culture

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8
Q

Colorectal Cancer: peak incidence

A

Common over 50 yrs old

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9
Q

Colorectal Cancer: metastasis locations

A

Liver
Lungs
Brain
Bone

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10
Q

Colorectal Cancer: 5 year survival rate

A

93% (stage 1)
3% (stage 4)

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11
Q

Colorectal Cancer: aetiology

A

Strong link with diet high in non-organic meat, low fibre, lack of vit D
Polyps
Family history

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12
Q

Colorectal Cancer: signs and symptoms

A

Fluctuating bowel habits (constipation/diarrhoea)
Blood (and mucus) in stools
Abdominal pain (usually left side)
Anaemia (due to blood loss)

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13
Q

Colorectal Cancer: diagnostics

A 
Colonoscopy, biopsy
Stool analysis (occult blood and M2PK - tumour marker found in stools)
Blood test (CEA*, inflammatory markers, low Hb)

Carcinoembryonic Antigen, tumour marker

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14
Q

Breast Tumours: characteristics

A

Cysts or fibroadenomas
Most breast lumps are benign
Benign tumours - mobile, smooth, regular borders (different from malignant mass)
Fibrocystic breast disease - breast pain, tender masses, nodules - usually pre-menstrual

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15
Q

Breast Cancer: pathophysiology

A

Ductal or lobular
Endogenous/exogenous oestrogens*
Breast cancer cells contain receptors that hormones or other proteins bind to that promote tumour growth
Oestrogen receptors - 80%
Also progesterone and epidermal growth factor receptors
If none of these receptor types present, the cancer is triple negative (15% cases)

*oestrogen is a growth stimulate

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16
Q

Breast Cancer: aetiology

A

Family history and age
Genetic mutations in BRCA1 or BRCA2
Obesity - increase of IGF-1 and oestrogen
Regular alcohol intake and smoking
Oestrogen excess - early menarche/late menopause/OCP/HRT
Aluminium/parabens* - mimic oestrogen
BPA (in plastics) - mimics oestrogen

*in antiperspirants and deodrants

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17
Q

Breast Cancer: signs and symptoms

A 
Asymptomatic usually
Painless, unilateral fixed lump
Overlying skin changes e.g. dimpling, orange peel appearance
Inverted/discharging nipple
Enlarged axillary lymph nodes
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18
Q

Breast Cancer: diagnostics

A

Mammography
Thermography

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19
Q

Breast Cancer: complications

A

Metastatic spread via lymphatics

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20
Q

Breast cancer: Treatment

A

Radiotherapy, chemotherapy, surgery.
Hormonal therapy: If oestrogen positive — tamoxifen (blocks oestrogen receptors). This can cause hot flushes, joint pains, osteoporosis, DVT and sleep irregularities.

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21
Q

Ovarian Cancer: epidemiology

A

Mostly affects women over 40 yrs

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22
Q

Ovarian Cancer: aetiology

A

Family history and age
Genetic mutations in BRCA1 or BRCA2
Oestrogen excess - early menarche/late menopause/OCP/HRT
Infertility/never given birth
Poor lifestyle: exercise, smoking, obesity
Diet rich in animal fats
Talcum powder used between legs

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23
Q

Ovarian Cancer: signs and symptoms

A

Early stage asymptomatic
Vague abdominal discomfort/bloating
Abdominal mass with pelvic pain, ascites
75% present with advanced disease
Later: change in bowel habits

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24
Q

Ovarian Cancer: diagnostics

A

Ultrasound
CT/MRI
Blood test: CA-125

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25
Q

Ovarian Cancer: 5 year survival rate

A

38%
Most lethal gynaecological malignancy

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26
Q

Cervical Cancer: epidemiology

A

Most common in young women - 25-35 yrs

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27
Q

What percentage of female cancers does cervical cancer form?

A

20% of all cancers

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28
Q

Cervical Cancer: aetiology

A

Persistent HPV infection (strains 16 & 18 cause 70%)
Sexual behaviour (multiple partners, younger age)
Smoking
COCP

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29
Q

Cervical Cancer: signs and symptoms

A

Non-specific symptoms
Abnormal vaginal bleeding (inter-cycle bleeding, after intercourse)
Vaginal discharge
White/red patches on cervix

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30
Q

Cervical Cancer: diagnostics

A

Screening - detects 30% - smear test
Biopsy
MRI/CT scan

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31
Q

Cervical Cancer: allopathic treatment

A

Brachytherapy (internal radiotherapy)
Chemo-radiotherapy
Surgery - hysterectomy (preferred up to stage 2)

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32
Q

Liver Cancer: types of

A

Primary - if from liver cirrhosis
Secondary - if spread from elsewhere

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33
Q

Liver Cancer: aetiology

A

Associated with liver cirrhosis
Alcohol, toxins = necrosis = chronic inflammation and cell proliferation (turnover)
Hepatitis B/C = viral integration into host genome affecting DNA

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34
Q

Liver Cancer: signs and symptoms

A 
In advanced stages:
Jaundice
Ascites
Hepatomegaly
Pruritus (itchy skin)
Bleeding oesophageal varices (secondary to portal hypertension)
Loss of appetite
Feeling very full after eating
Nausea/vomiting
Pain or swelling in the abdomen
Fatigue and weakness
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35
Q

Liver Cancer: allopathic treatment

A

Surgery - transplant

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36
Q

Liver Cancer: epidemiology

A

More common in men
Peak around 60

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37
Q

Gastric Cancer: epidemiology

A

Male 55 yrs+
2nd highest cause of cancer-related death in the world
Highest in Korea and Japan (diet)

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38
Q

Gastric Cancer: areas affected/percentages

A

50% affects pylorus
25% affects lesser curvature

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39
Q

Gastric Cancer: aetiology

A

Smoking
H. pylori infection
Diet rich in salted, pickled and smoked foods (N-nitroso compounds)
Low food/veg diet

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40
Q

Gastric Cancer: signs and symptoms

A

Early stages - persistent indigestion, frequent burping, heartburn, feeling full quickly when eating, bloating, abdominal discomfort

Advanced stages - black blood in stools
Loss of appetite, weight loss, tiredness, anaemia, jaundice

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41
Q

Gastric Cancer: diagnostics

A

Stool analysis (blood*)
Endoscopy
Biopsy
Tumour markers - CEA, CA 19-9

black, tarry

42
Q

Gastric Cancer: allopathic treatment

A

Gastrectomy
Chemo/radiotherapy

43
Q

Oesophageal Cancer: aetiology

A 
Chronic irritation
Alcohol
Smoking
GORD and Barrett's oesophagus
Obesity
Low fruit/veg diet
Age
44
Q

Oesophageal Cancer: signs and symptoms

A

Few early symptoms, obstruction may occur later*
Dysphagia (difficulty swallowing)
Extreme weight loss
Melaena (blood in stools)

Obstruction can reach 75% before it’s noticed

45
Q

Pancreatic Cancer: pathophysiology

A

Most arise from the exocrine cells
Less common from the endocrine cells

46
Q

Pancreatic Cancer: metastatic percentage

A

Approx 60% metastatic at diagnosis

47
Q

Pancreatic Cancer: aetiology

A

Cause is unknown
Risks include age, smoking, family history
Diabetes, chronic pancreatitis, H. pylori

48
Q

Pancreatic Cancer: signs and symptoms

A 
Asymptomatic early on
Epigastric pain, radiating to back
Unexplained weight loss
Fatigue
Jaundice (bilirubin can't get out)
Nausea after eating
Glucose intolerance
49
Q

Pancreatic Cancer: allopathic treatment

A

Surgery
Chemotherapy
Radiotherapy

50
Q

Prostate Cancer: epidemiology

A

The most common cancer in men
Generally 50+ yrs

51
Q

Prostate Cancer: aetiology

A

Obesity
Diet - high meat consumption (esp. chargrilled), dairy and saturated fats, refined sugars
Ethnicity - black men at highest risk
Genetics - BRCA1/2

52
Q

Prostate Cancer: signs and symptoms

A 
Obstructed/poor urinary flow
Increased urinary frequency
Intermittent urine flow and dribbling of urine
Nocturia
Haematuria
Back pain can indicate bone metastases

Same urinary symptoms as BPH

53
Q

Prostate Cancer: diagnostics

A

Elevated PSA
Digital rectal exam
Biopsy

54
Q

Prostate Cancer: allopathic treatment

A

Radiotherapy
Androgen deprivation therapy
Chemotherapy
Surgery (removal) - 50% never recover urinary/erectile function

55
Q

Bladder Cancer: epidemiology

A

More common in men - 2:1
70-80 yr group

56
Q

Bladder Cancer: where does it originate?

A

Originates from transitional epithelial cells in bladder

57
Q

Bladder Cancer: aetiology

A

Smoking - carcinogens pool in bladder and induce mutations
Chronic cystitis
Increasing age
Catheterisation

58
Q

Bladder Cancer: signs and symptoms

A

Painless haematuria (90%)
Increased urine frequency & urgency
Dysuria
Bone metastases (with pain in spine)

59
Q

Bladder Cancer: allopathic treatment

A

Transurethral resection
Cystectomy

60
Q

Testicular Cancer: epidemiology

A

Young men (15-35 yrs)

61
Q

Testicular Cancer: aetiology

A

Higher risk if undescended testes
Family history

62
Q

Testicular Cancer: signs and symptoms

A

Hard, painless, unilateral mass
Dragging sensation
Dull ache
Metastastises to bone, brain, lungs, liver

63
Q

Skin Cancer: prognosis

A

Visible, generally easily detectable
Develops slowly - good prognosis

64
Q

Skin Cancer: typical locations for moles

A

Usually arises on head, neck or back

65
Q

Skin Cancer: epidemiology

A

Most common in fair-skinned people, 40+
Becoming more prevalent
Highest rate of recurrence

66
Q

Skin Cancer: what to look out for

A 
Asymmetry
Border
Colour
Diameter
Evolving
67
Q

What is the most common skin cancer?

A

Basal cell carcinoma

68
Q

What is the second most common skin cancer?

A

Squamous cell carcinoma

69
Q

Who is more likely to develop melanoma?

A

Women, 30-50 yrs

70
Q

What is the 5 year survival rate for melanoma?

A

80%

71
Q

Basal cell carcinoma: signs and symptoms

A

Raised, smooth, pearly bump on sun-exposed skin
Sometimes small blood vessels can be seen within the tumour
Crusting and bleeding in the centre

72
Q

Squamous cell carcinoma: signs and symptoms

A

Red, scaling thickened nodule/patch
Some are firm hard nodules with central necrosis = ulcer/bleeding

73
Q

Melanoma: signs and symptoms

A

Brown/black lesions
Change in size, colour, elevation of a mole or new mole

74
Q

Bone Tumours: definition

A

Can be malignant or benign
Most commonly secondary tumour

75
Q

What is osteosarcoma?

A

Malignant bone tumour

76
Q

Who is most likely to be affected by primary osteosarcomas?

A

Teenagers

77
Q

Where are osteosarcomas most likely to form?

A

Typically occur around the knee or humerus

78
Q

Bone Tumours: signs and symptoms

A

Worsening pain that becomes unremitting
Wake patient at night
Systemic symptoms - weight loss, malaise, fatigue, night sweats

79
Q

Brain Tumours: types of

A

High grade - rapid growth tumours
Low grade - lower growth tumours

80
Q

Example of high grade brain tumour

A

Mostly gliomas (common type is astrocytoma)
glioblastomas (immature cells)

81
Q

Example of low grade brain tumours

A

Meningiomas
Pituitary tumours

82
Q

Brain Tumours: epidemiology

A

Most common 50-70 yrs

83
Q

Where do malignant brain tumours usually metastasise from?

A

Metastatic 10x more common than primary
* Lung
* Breast
* Stomach
* Prostate

84
Q

Brain Tumours: aetiology

A

Mobile phone use

85
Q

Brain Tumours: signs and symptoms

A

Morning headaches, increasing in frequency
Nausea, vomiting, seizures
Uneven pupils, double vision
Papilloedema - bulging of optic nerve

86
Q

Lymphoma: definition

A

Malignancy of lymphatic cells

87
Q

Types of lymphoma

A

Non-Hodgkin’s lymphoma
Hodgkin’s lymphoma

88
Q

Non-Hodgkin’s lymphoma: epidemiology

A

5 times more common
Peak age - 50+ and children/young adults

89
Q

Hodgkin’s lymphoma: epidemiology

A

Peak age 20-35
Also paediatric

90
Q

Which cells are involved in lymphomas?

A

B-lymphocytes

91
Q

Lymphoma: aetiology

A 
EBV - found in 50% of patients with Hodgkin's
HIV
General immunosuppression
Pesticides/herbicides
Chemo/radiotherapy
92
Q

Lymphoma: signs and symptoms

A

Enlarged and asymptomatic lymph node in neck
Chest discomfort*, cough
Dyspnoea
Drenching night sweats, fever, weight loss
Lymphadenopathy
Hepatomegaly, splenomegaly

*can be created by enlarged thymus

93
Q

Lymphoma: diagnostics

A

Biopsy of lymph node - surgical/fine needle
Blood tests - raised ESR, leukocytosis, lymphopenia, anaemia, HIV testing

94
Q

Leukaemia: definition

A

Bone marrow cancers characterised by over-production of leukocytes

95
Q

Leukaemia: pathophysiology

A

Over-proliferation in leukocytes results in supressed RBC production (=anaemia) and suppressed platelet production (=thrombocytopenia)

96
Q

Acute leukaemias: characteristics

A 
All ages
Rapid onset
More aggressive
Immature (blast) cells
Anaemia/thrombocytopenia prominent
97
Q

Chronic leukaemias: characteristics

A 
Usually adults
Gradual onset
More mature
Differentiated cells
Lymph node enlargement/splenomegaly prominent
98
Q

Leukaemia: Signs and symptoms

A 
Anaemia symptoms
Malaise
Frequent infections
Fever, weight loss
Easy bleeding/bruising
Splenomegaly - excess haemolysis causes spleen to enlarge
Lymph node enlargement
99
Q

Leukaemia: diagnostics

A

Bone marrow biopsy
Blood test - FBC and blood film

100
Q

Leukaemia: allopathic treatment

A

Chemotherapy
Bone marrow transplant
Radiotherapy
Relapse is common

101
Q

Leukaemia: types

A

Four types of leukaemia:
1. Acute myelogenous leukaemia (AML)
2. Acute lymphocytic leukaemia (ALL)
3. Chronic myeloid leukaemia (CML)
4. Chronic lymphocytic leukaemia (CLL)

BioMed S2 (34 decks)

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