cancer Flashcards
what is cancer?
a disease caused by cells divide uncontrollably and spread into surrounding tissues
what is a neoplasm (tumour)?
**uncontrolled cell proliferation leading to a mass or nodule **
how are neoplasms classified?
- benign - localised, wont spread, patient will usually survive - but there are exceptions
- malignant - aggresive, can invade other structures, can spread via metastasis
compare uncontrolled / controlled cell proliferation
- controlled - hyperplasia
- uncontrolled - neoplasia - leading
how are malignant neoplasms/ tumours classfied?
- primary tumour - growing at the site at which the tumour began
- secondary tumour/metastasis - a tumour that has spread
what are the most common types of primary malignancies?
- carcinoma - malignant neoplasms of epithelial structures
- lymphoma - malignant neoplasms arising from wbcs’s or lymphoid tissue
- sarcoma- malignant neoplasms arising from connective tissue
how do benign neoplasms present?
- lump- slow growing
- bleeding - sometimes
- pain
- mass effect - eg benign ovarian tumours can sometimes cause GIT obstruction
- a lot of benign tumours are incidental findings - found when something else is being investigated
what is an example of a benign neoplasm which may not be cured by surgery?
a benign tumour in the CNS
what are examples of malignant neoplasm?
- carcinoma - epithelial tissue
- lymphoma - lymphoid tissue
- melanoma - skin tissue
- sarcoma - connective tissue
- others - eg brain tumours CNS, germ cell tumours
what is the most common type of cancer in women?
breast
what is the most common cancer in men?
prostate
what are examples of environmental factors that cause cancer?
- infectious agents
- smoking
- alcohol
- dietary factors
- obesity
- oestrogen exposure
- carcinogens - eg UV radiation
what are examples of cancers that can happen as a result of inherited factors?
- colonic carcinoma
- breast carcinoma
- melonma
what are protooncogenes?
normal genes that produce proteins that regulate proliferation
what are oncogenes?
- a mutated form of proto-oncogenes
- they promote autonomous cell growth in cancer cells
what are tumour suppressor genes?
- genes that encode a protein that acts to regulate cell proliferation and division
what are the effects of carcinogens on protooncogene and tumour suppressor genes?
- carcinogens alter the protooncogene and therefore alter its activity on cell proliferation and cause cancer
- they also can inactivate tumour suppressor genes therby reducing their suppressive effects on cell growth and thereby allowing tumours to develop
how is cancer diagnosed?
- doctor will take history and physical exam
- radiology - imaging
- patients will be sent for a tissue sample - eg biopsy, fluid sample, fine needle aspiration (needle placed into organ eg thyroid gland)
what is dysplasia?
abnormal cells present within a tissue but not involving the entire thickness of the tissue
what is cancer in situ?
- abnormal cells involving the entire thickness of the tissue BUT they dont extend beyond the tissue itself
what is invasive cancer?
- abnormal cells extending into surrounding tissue
what is a carcinoma?
- malignant tumour of epithelium
- can be divided into in situ or invasive
- eg inner lining of GIT, lungs etc
how are carcinomas classified?
- squamous cell carcinoma - eg of the skin and lung
- adenocaricnoma - glandular epithelium eg colon rectal cancer
- urothelial cell carcinoma - arises from the urothelial cells of the bladder
- basal cell carcinoma - arise from the basal cells of the squamous epithelium of the skin
- undifferentiated - tumours where we cant determine what the cell of origin was
what are the clinical presentations of a primary malignant neoplasm (hasnt spread yet)?
- mass - eg cancer of the breast
- bleeding eg hemoptysis - lung cancer, melena (blood in stool), PV (vagina) bleeding - gynacological
- loss of function- eg pathological fracture due to bone tumour
what does prognosis mean?
a medical term for predicting the likelihood of a disease
where are examples of sites in the body in which metastasis occurs?
- lymph nodes
- lungs
- bone
- liver
- brain
what are examples of metastatic effects?
- jaundice- yellowing of skin
- bone pain or fracture
- cerebral stroke
- pneumonia
- lymphadenopathy - eg when breast cancer spreads to the axillary lymph nodes - results in a nodule under the arm
what are the 3 main routes in the body in which cancer can spread?
- direct - to adjacent structures
- lymphatic
- blood vessel - eg colorectal can spread to liver via veins
compare stage vs grade of tumour
- stage - how far the tumour has spread
- grade - what does the tumour look like - eg low grade would look like the normal cells in that area
what is the international TNM classification?
what is T, N& M
- T- tumour size/spread
- N- nodes
- M- metastasis?
what does the treament of malignant neoplasms involve?
- surgery
- radiotherapy
- immunotherapy
- chemotherapy
- targeted therapy eg herceptin used to treat HER2 positive breast carcinomas
what is a sarcoma?
malignant tissue of connective tissue
rare tumours - eg primary bone tumours
what are malignant melanomas?
- malignant tumours in the melanocytes in the dermis of the skin
- can occur in the skin, anal margin, eye or very rarely in the oesophagus
what are the physiotherapy issues related to malignancy?
POST OP
* patients can develop** pneumonia** after surgery
*** mobility issues **following surgery
* **stroke **- patient may have cerebrovascural events
* breast cancer patients - who get their axillary lymph nodes removed - they may develop lymphodema and need physio help
* patients who have had bone tumours - may have had to get a **limb amputation **
