cancer

Question 1

what is the most common type of cancer in women

Answer 1

Breast

Question 2

what is the most common type of cancer in men

Answer 2

prostate

Question 3

what are the 5 changes that can occur to allow cancer to grow and spread

Answer 3

• uncontrolled cell growth
• loss of natural apoptosis
• decreased cellular differentiation
• ability to invade surrounding tissue
• ability to establish in atypical environments

Question 4

what mutations cause genetic instability in cancer

Answer 4

• overexpression of oncogenes
• faulty tumour supressor genes
• chemicals/ free radicals and other carcinogens can cause genetic instability
• viruses and bacteria can also cause cancer e.g HPV in cervical cancer or h.pylori in stomach cancer

Question 5

what does epigenetics mean

Answer 5

changing the activity of genes by altering how compact or relaxed the DNA is.

e.g methlylation= dna more compact so reduced gene expression

Question 6

what are liable cells

Answer 6

cells where tumours frequently occur because they continually go through the cell cycle and mutations usually occur during the S phase of the cell cycle

Question 7

what are stable cells

Answer 7

cells which typically inhibit the G0 phase of the cell cycle but can be stimulated to enter into cell division

Question 8

what is histopathology

Answer 8

a microscopic examination of tissue (a biopsy) which finds out what type of cancer it is

Question 9

what is a low grade cancer

Answer 9

cancer where cells look more like normal cells. They are slower growing

Question 10

what is a high grade cancer

Answer 10

cancer where cells look less like normal cells. They grow very quickly

Question 11

what are the 3 ways in which metastasis can occur

Answer 11

• direct invasion
• through the lymphatic system
• through the blood stream

Question 12

what are the generic symptoms/presentation of cancer

Answer 12

• lumps
• unexplained bleeding
• weight loss

Question 13

what are the 4 ways in which cancer can be diagnosed

Answer 13

• x-ray
• biopsy
• biomarkers
• CT/ PET scan

Question 14

when would surgery be used during cancer treatment

Answer 14

• to remove primary tumour
• during palliative care (to remove symptoms of metastasis/ incurable disease)
• together with other treatment

Question 15

when would radiotherapy be used during cancer treatment

Answer 15

• Neoadjuvant ( to reduce tumour before surgery)
• Adjuvant (with surgery and or chemotherapy)
• Palliative (to relieve symptoms of metastasis or incurable disease)

Question 16

what is the aim of radical radiotherapy

Answer 16

to cure cancer

Question 17

Name some types of radiotherapy

Answer 17

• x-ray, electron, proton
• stereotactic radiosurgery (SRS)
• Total body irradiation (TBI)
• liquid radioiodine (you ingest this)
• Selective internal radiation therapy (SIRT. radiation injected into veins)
• Intracavity (inserted into body cavity)
• insterstital (permanentyl inserting a radiocative source into a tumour)

Question 18

what are the typical side effects of radiotherapy

Answer 18

• alopecia
• nausea + vomiting
• skin reactions
• indigestion
• bladder/bowel changes
• fibrosis
• breathlessness

Question 19

why does radiation cause side effects

Answer 19

because radiation is not selective so often affects other healthy/ non-cancerous cells

Question 20

how do you manage skin reactions caused as a side effect of radiotherapy

Answer 20

treatment depends on how severe the skin reactions ( red, dry, itchy are)
grade 1: moisturiser
grade 2-: moisturiser +hydrocortisone
grade 3: moisturiser and dressings. stop hydrocortisone if skin is broken
grade 4: consult team

Question 21

how do you manage mucositis and other oral side effects of radiotherapy

Answer 21

• good oral hygiene: soft toothbrush, brush twice daily, don’t smoke, stay hydrated
• can also use sodium chloride or sodium bicarbonate

Question 22

how do you manage nausea and vomiting as a side effect of radiotherapy

Answer 22

how you manage nausea + vomiting depends on the site of radiotherapy.

• High risk radiotherapy: use 5-HT3 receptor anatagonist 24 hours before and after radiotherapy
• moderate risk: use ondansetron STAT or metoclopramide
• low risk: no prophylaxis

Question 23

what are the 4 systemic anti-cancer therapies

Answer 23

• cytotoxic chemotherapy e.g capecitabine
• targeted agents (e.g getfitnib, cetuximab)
• immunotherapy (nivolumab)
• CART-T (chimeric antigen receptor t-cell)

Question 24

what are the general side effects of chemotherapy

Answer 24

• nausea + vomiting
• Mucositis (also known as stomatitis)
• GI disturbance (constipation or diarrhoea)
• Peripheral neuropathy (damage to nerves)
• Alopecia
• Fatigue