cancer Flashcards

Question

Histology of Colorectal cancer

Answer 1

Histology Adenocarcinoma Preceded by adenomatous polyp

Answer 2

Risk factors Carriers of one adenoma larger than 1 cm Risk increases if multiple adenomas present Prevalence of adenomas detected during colonoscopy parallels incidence of colon cancer Alcohol consumption Tobacco smoking Ulcerative colitis and Crohn’s disease Higher for young age at diagnosis and presence of dysplasia Diabetes Cholecystectomy Women: cancers of endometrium, ovary, breast-due to shared hormonal or dietary factors Cancer of the colon Hereditary rare conditions First degree relative of colon cancer patients high intake of meat and smoked, salted, or processed foods

Answer 3

``` Primary prevention Increased physical activity Avoidance of overweight and obesity Reduce alcohol intake Quitting smoking No routine recommendation of aspirin ``` Secondary prevention Removal of adenomas via flexible colonoscopy

Answer 4

Vitamin D Aspirin NSAIDS Hormone therapy in menopause and other female hormones (OC)

Answer 5

``` Surveillance Flexible colonoscopy for adenomas Faecal occult blood Detection of adenoma Low specificity To a lesser extent-low sensitivity Sigmoidoscopy for distal colon Current recommendations Individuals over 50 Annual faecal occult blood testing OR one colonoscopic examination ( not need to be repeated for 10 years if results are normal) ```

Answer 6

Genetic factors Carriers of mutations of several high-penetrance and low frequency genes BRCA1, BRCA2, PTEN, TP53 High risk breast cancer Defined as inherited breast cancer syndrome Cumulative lifetime risk in carriers >50%, but rare in most populations except the AshKenazi Jews Moderate risk Group of low penetrance and low frequency DNA repair genes Similarities and differences in risk profiles between TNBC and ER+ breast cancer Similar risk factors BMI Lack of physical activity Breast density

Answer 7

Causes and risk factors Endogenous hormones Oestradiol concentrations in post-menopausal women; not so distinct in pre-menopausal Gender Less than 1% occur in men Risk factors: conditions involving high oestrogen levels Gonadal dysfunction Alcohol abuse Obesity Genetics: BRCA2 mutations more common than BRCA1 in male familial breast cancers Little evidence for geographic and interracial variations Fibrocystic disease and fibroadenoma Not pre-neoplastic Share with breast cancer epithelial proliferation, linked to hormonal alterations History of breast cancer in a first degree relative Role of family history related to low penetrance genes associated with hormonal metabolism and regulation, and DNA damage and repair

Answer 8

TNBC triple negative: Decreased risk | ER+: Increased risk

Answer 9

TNBC triple negative: Positively associated | ER+: Inversely associated

Answer 10

TNBC triple negative: No association | ER+: Modestely association

Answer 11

TNBC triple negative: No association | ER+: Risk factor

Answer 12

TNBC triple negative: Protective | ER+ : Risk factor

Answer 13

Primary Control of weight gain especially in post menopausal women ``` Secondary Mammography Effective in patients >50 years. Not well demonstrated for <50 Breast self examination No proven reduction in mortality ```

Answer 14

Protective factors | Physical exercise

Answer 15

high risk areas Squamous cell carcinoma (SqCC) Decreasing incidence Adenocarcinoma of lower oesophagus On the rise

Answer 16

``` Prevention SqCC Avoidance of smoking Reduction in alcohol drinking Improved diet Increased consumption of fresh fruits and vegetables Adenocarcinoma Avoidance of smoking Control of obesity Increased physical activity Treatment of reflux ```

Answer 17

Adenocarcinoma Lower third of oesophagus Increasing incidence among white people and high social classes Preneoplastic Barret’s oesophagus-columnar metaplasia of epithelium Main risk factor: persistent reflux oesophagitis Overwight Lack of physical activity Tobacco smoking Salty foods Protective factor: high intake of fruits and vegetables

Answer 18

``` Risk factors and causes 90% SqCC from tobacco smoking and alcohol drinking in HICs Smoking Quitting smoking reduces the risk Smoking black tobacco, high-tar, hand-rolled cigarettes, pipes, chewing tobacco Snuff use Genetic factors Genes responsible for keratosis palmaris and plantaris(tylosis) Mycotoxins and N-nitroso compounds Eating Bracken fern Ionizing radiation Radiotherapy for breast cancer ```

Answer 19

Risk factors and causes Diet rich in foods from animal origin and poor in vitamins and fibre Low intake of fresh fruits and vegetables Low intake of fish High intake of red meat and processed meat Plummer-Vinson syndrome Sideropenic dysphagia Deficit of iron, riboflavin, and other vitamins Coeliac disease Nutritional deficiencies Family history of oesophageal cancer

Answer 20

``` Normal characteristics Amenable to surgery Minor symptoms Fatal Compression Difficult area for surgery Production of hormones ```