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4th Yr - CMS 1 > Cancer > Flashcards

Cancer Flashcards

1
Q

what is cancer ?

A

Uncontrolled new growth of tissue
which is non-physiological (not being controlled by normal homeostatic mechanisms) and has the
capacity to infiltrate, invade and spread from it’s point of origin, having a detrimental effect on the affected patient

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2
Q

who gets cancer ?

A

1 in 2 of the population
375,000 cases per year.
Deprivation 20% more likely
Risk factors
Genetics
Behaviour eg. smoking, diet
common for older ppl

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3
Q

why is cancer important?

A
  • very common= 1 in 2 of the population
  • £6bn per year in UK
  • 6% of NHS budget
  • 50% of people with cancer will die
  • 40% of cases are preventable
    eg. modifying Risk factors, or Screening couldve been done
  • Many cancer survivors do not return to work
  • Risk of unemployment is 37% higher following cancer diagnosis
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4
Q

how do people know they have cancer ?

A
  • Symptoms are non-specific
  • Need a high index of suspicion
  • Persistent symptoms must be taken seriously
  • Pain, lumps, weight loss, lymphadenopathy late features = late features
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5
Q

what are the big 4 ?

A
  • 200 different types of cancer
  • 50% of them = breast, prostate, lung and bowel
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6
Q

what is the Kaplan Meier survival estimate ?

A

used to determine survival and outcomes in medical research and clinical studies

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7
Q

in what context is the Kaplan Meier survival estimate particularly helpful?

A

in the comparison of treatments, allowing researchers to assess and compare the survival rates of different tx groups over time

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8
Q

what does the Kaplan Meier survival estimate for cancer ?

A
  • allows for prognosis assessment
  • compared stage 1 2 3 4 of cancer in the diagram
  • stage 1 disease - 5 years survival is 80%
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9
Q

what is the quality of life scale ?

A
  • we do not only want to look at survival but also how well pts return to normal life
  • asks q’s like= have you lost weight, have you gone back to work?, can you dress yourself properly, anxiety/ depression.
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10
Q

how do pts with cancer get help?

A

GP
hospital
dentists
pharmacists

MDT = coordinates pts tx
surgeons, oncologists, pathologists, radiologists
nurses, therapists

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11
Q

how do MDT’s work ?

A
  • meet every week
  • discuss all new cancer diagnoses
  • results following tx
  • waiting times, workloads, results are audited
  • published with comparison with rest of uk
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12
Q

what are some barriers for pts and why would they be unlikely to ask for help ?

A
  1. may not have symptoms
  2. may not feel ill
  3. may not seek help until cancer is advanced
  4. poorer survival rate
  5. poorer QOL
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13
Q

what are the signs and symptoms of cancer ?

A

Lump in the breast
Lump in the axilla
Nipple bleeding/discharge
Men can get breast cancer too

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14
Q

what are the signs and symptoms of lung cancer ?

A

Persistent cough
Heamoptysis
Abnormal Xray
Finger clubbing
Supraclavicular lymph node
Weight loss
Fatique
shortness of breath
bleeding whilst coughing

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15
Q

what are the signs and symptoms of prostate cancer ?

A

Urinary problems
Frequency
Hesitancy
Nocturia
Urgency
waking up at night
Retention
Check PSA
Examine prostate

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16
Q

what are some signs and symptoms of colorectal cancer ?

A
  1. Unintentional weight loss
  2. Change in bowel habit
  3. Rectal bleeding
  4. Abdominal pain
  5. Positive FIT test
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17
Q

what is screening?

A

testing of a population AT RISK of a disease

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18
Q

what are the advantages of screening ?

A

aim to identify asymptomatic cases or ppl with pre malignant disease

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19
Q

what are the disadvantages of screening ?

A

increase the rate of detection

20
Q

what are the Wilson and juggler principles for screening ?

A

improve outcomes, survival and QOL

21
Q

how do we screen for breast cancer ?

A
  • mammography
  • 50-70 yrs
  • every 3 yrs
22
Q

how do we screen for colorectal cancer ?

A
  • 60-75 yrs
  • faecal immunochemical test
  • every 2 years
23
Q

how do we test for lung cancer ?

A
  • CT scan
  • 50-80 yrs
  • smokers
24
Q

how do we screen for prostate cancer ?

A
  • PSA test
  • but can raised from the things like vigorous activity
25
Q

how do we screen for cervical cancers ?

A
  • smear tests
  • age 25-64
26
Q

what are the steps in the management of cancers ?

A
  1. 2WW referral
  2. Direct to “2ww coordinator”
  3. Seen and examined within 2 weeks
  4. If +ve diagnosis: staging complete and treatment plan within 31 days
  5. Start treatment withint 62 days
    14:31:62 day pathway.
  6. Audited and published. Fines for Trusts that do not meet dates.
27
Q

what is TNM?

A

tumour, nodes (regional), and metastases (distant) in cancer staging

28
Q

what differentiates T1-4 diagnosis?

A
29
Q

what differentiates N0-3 diagnosis?

A
  1. N0: No regional lymph node involvement.
  2. N1: Involvement of nearby regional lymph nodes.
  3. N2: More extensive regional lymph node involvement.
  4. N3: Extensive regional lymph node involvement, often indicating advanced
30
Q

what differentiates M1 M0 diagnosis?

A
  1. M0: No distant Metastases; the cancer has not spread to distant organs or tissues.
  2. M1: Distant Metastases present; the cancer has spread to other organs or distant sites in the body.
31
Q

what is the group stage ? 1-4?

A

a way of bringing the elements of TNM to give you one stage

32
Q

in cancer management that is the role of MDT ?

A

involves various healthcare professionals collaborating to devise and implement an effective tx plan

33
Q

what is the primary goal of surgery in cancer management ?

A
  • Remove primary tumour with an adequate margin to ensure complete excision.
  • remove involved lymph nodes
  • reconstruction
34
Q

what are some forms of tx alongside surgery ?

A
  1. radiotherapy
  2. external beam
  3. implant - brachytherapy
35
Q

what are the challenges associated w/ radiotherapy ?

A
  1. Limited dose: There is a limit to the radiation dose that can be safely administered to avoid damage to healthy tissues.
  2. Can only treat once: Radiotherapy is often limited to a specific number of sessions or a single course of treatment.
  3. Radiation reaction: Adverse reactions can occur in response to radiation, affecting both cancerous and healthy tissues.
  4. Mucositis: Inflammation and ulceration of the mucous membranes, commonly occurring in areas exposed to radiation.
  5. Osteoradionecrosis: Death of bone tissue in the radiation field, particularly relevant in head and neck cancer treatments.
36
Q

how is chemotherapy often use din conjunction with radiotherapy ?

A

Chemotherapy is often used in combination with radiotherapy to enhance the effectiveness of treatment, a therapeutic approach known as chemoradiotherapy.

or can used on its own

37
Q

what are some of the side effects of chemo?

A
  1. Toxicity: Chemotherapy drugs can have toxic effects on both cancer cells and healthy cells.
    - Hair loss: Chemotherapy can lead to hair loss, a common side effect due to the impact on rapidly dividing cells, including hair follicles.
    - Nausea: Chemotherapy may cause nausea and vomiting as part of its side effects.
    - Weight loss: Patients undergoing chemotherapy may experience weight loss due to various factors, including nausea and changes in appetite.
    - Fatigue: Chemotherapy-induced fatigue is a common and often persistent side effect.
    - Effects on blood: Chemotherapy can affect blood cell production, leading to conditions like anemia, neutropenia, and thrombocytopenia.
38
Q

In cancer management, what is the role of immunotherapy?

A

a type of cancer treatment that utilizes the body’s own immune system to recognize, attack, and destroy cancer cells.

39
Q

How does immunotherapy differ from traditional cancer treatments like chemotherapy and radiotherapy?

A

Immunotherapy differs from traditional treatments like chemotherapy and radiotherapy by targeting the immune system rather than directly attacking the cancer cells. It aims to enhance the body’s natural defenses against cancer.

40
Q

What is the role of anti-resorptive medications in cancer management?

A

eg. bisphosphonates and RANK-L inhibitors like denosumab, are used in cancer management to reduce bone turnover and mitigate bone-related complications.

41
Q

Why is it important for individuals receiving anti-resorptive medications to be dentally fit?

A

to minimize the risk of medication-related complications, particularly in the context of dental procedures.
- Caution with extractions

42
Q

In cancer management, what is the role of hormone therapy?

A
  • altering hormone levels in the body to slow down or inhibit the growth of hormone sensitive tumours
43
Q

How is hormone therapy commonly used in the context of breast cancer and prostate cancer?

A

aims to reduce levels of testorone to block its effects as prostate cancer growth is often stimulated by this hormone

44
Q

5 year survival?

A

cost of follow up
benefit if follow up

45
Q

what is my role as a dentist?

A
  1. Champion healthy living
  2. Smoking, alcohol, diet
  3. Be aware of red flag signs
  4. Signpost patients to GP
  5. Champion screening
  6. Oral Health promotion

4th Yr - CMS 1 (29 decks)

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