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Cancer Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what is the main way cancer develops?

A

genetic predisposition mixed with environmental factors gives uncontrolled proliferation and a cancer forms

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2
Q

what are some systemic features of cancer?

A

cachexia
ectopic hormone production - PTH hypercalcaemia, or ACTH - cushings disease
parneoplastic syndromes - neurological/dermatomyocitis, venous thromboses

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3
Q

techniques for diagnosis of cancer?

A

imaging - CT/MRI

fibre optic techniques - endoscopy/bronchoscopy/biopsy

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4
Q

what are some staging techniques for cancer diagnosis?

A

TNM - tumour node metastases - clarify prognosis, survival, defines tx
Ann arbor - lymphoma staging
Dukes ABCD - colorectal carcinomas

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5
Q

what is the main action of chemotherapy?

A

interferes with cellular replication by targeting DNA or cell division

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6
Q

side effects effect rapid dividing cells such as?

A

GI or oral mucosa
bone marrow
hair
reproductive cells

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7
Q

chemo is often a combination of agents, why is this better?

A

different modes of action
less chance of resistance
less toxicity

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8
Q

how is chemo used combined with or as an adjuvent to surgery?

A

pre surgery - reduce tumour load

post surgery - reduce sub clinical disease

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9
Q

what cancers can a course of chemo cure?

A

hodgkins lymphoma
testicular teratoma
acute childhood leukemia

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10
Q

chemo can be used as a contribution to care and to prolong life expectancy in what cancers?

A

small cell carcinoma of the lung
breast carcinoma
adult leukemia
ovarian cancer

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11
Q

chemo can be used as palliation in what cancers?

A

GI tract
non small cell lung cancer
cervical carcinoma
squamous carcinomas of the head and neck

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12
Q

what are some general short term side effects of chemo?

A

nausea
vomiting
diarrhea
alopecia

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13
Q

what are some short term side effects of chemo caused by bone marrow suppression?

A
  1. neutropenia - high infection risk, least wbc’s 7-9 days after chemo, oral infections
  2. thrombocytopenia = bleeding tendancies
  3. anaemia
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14
Q

what long term side effects can chemo cause?

A

impaired fertility
teratogenic
cancer - leukemia
organ damage - pulmonary fibrosis, cardiomyopathy, neuropathy

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15
Q

how can chemo be used as hormone therapy?

A

in breast and prostate cancers

non curative

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16
Q

how does radiotherapy work?

A

affects rapidly dividing cells - targeted to specific areas

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17
Q

how is radiotherapy delivered?

A

externally - linear accelerator

internal - implant/systemic - taken up by specific organs e.g strontium by bone, iodine 131 by thyroid

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18
Q

what are some short term side effects of radiotherapy?

A 
oral mucositis
diarrhea 
nausea
tired
hair loss
bm suppression
sunburn
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19
Q

what are some long term effects of radiotherapy?

A 
osteoradionecrosis
xerostomia
skin ulcers
fibrosis
bowel stenosis
secondary malignancies
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20
Q

what are some novel therapies in cancer treatment?

A
  1. immunotherapy -vaccines, cytokines
  2. angiogenesis inhibitors
  3. signal inhibitors - specific inhibition of mutated proteins
  4. gene therapy - insert correct functioning versions of damaged genes
  5. phototherapy - tumour takes up dye, killed by laser
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21
Q

what is the aetiology of lung cancer?

A

biggest killer/poor outlool/almost totally avoidable

90% due to smoking, can also be caused by passive smoking

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22
Q

local signs of lung cancer?

A

cough/chest pain/breathless/chest infections

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23
Q

where can lung cancer metastasise to?

A

bones
brain
liver

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24
Q

what are some systemic signs of lung cancer?

A

cachexia

hormonal - high calcium/low sodium

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25
Q

how is lung cancer diagnosed?

how is it treated?

A

CXR/CT/bronchoscopy/sputum cytology

surgery/chemo/radio/laser

26
Q

what is the 5yr survival for lung cancer?

can it be screened for?

A

10%

screening under investigation

27
Q

what is the aetiology of colorectal cancer?

A

disease of western lifestyle, 2nd most common cause of death, partially preventable

28
Q

risk factors in lifestyle that contribute to colorectal cancer development?

A

diet high in fat and low in fibre
familial - genes
inflammatory bowel disease

29
Q

what are local signs of colorectal cancer?

A

anaemia
altered bowel habits
acute abdomen

30
Q

where can colorectal cancer metastasise to?

A

liver
lungs
ascites

31
Q

what is a systemic sign of colorectal cancer?

A

cachexia

32
Q

how is colorectal cancer diagnosed?

how is it treated?

A

sigmoid/colonoscopy, barium swallow

surgery, radiotherapy, chemotherapy

33
Q

what is the survival like for colorectal cancer?

can it be screened for?

A

90% 5 yr survival stage I,

34
Q

what is the aetiology of breast cancer?

A

1 in 12 women
no 1-2 in women
relatively young pts

35
Q

risk factors of breast cancer?

A

familial - genes

hormonal - no children/early periods/late menopause/no breastfeeding/HRT

36
Q

what are local signs of breast cancer?

A

puckering, pain, discharge, lump

37
Q

where can breast cancer metastasise to?

A

bone
brain
liver

38
Q

what are some systemic signs of breast cancer?

A

cachexia

hypercalcaemia

39
Q

how is breast cancer diagnosed?

how is it treated?

A

mammogram/tissue diagnosis - fine needle aspiration/biopsy

surgery/chemo/radio/hormonal - osetrogen inhibition

40
Q

how is breast cancer screened for?

A

mammograms every 3 years for women 50-70yrs

self exams promoted

41
Q

aetiology of prostate cancer?

A

1 in 3 men

80% of 80 + yr olds

42
Q

local signs of prostate cancer?

A

detected on pr exam
confused with normal urinary changes in elderly
found at operation for urinary symptoms

43
Q

where can prostate cancer metastasise to?

A

bone

lungs

44
Q

how is prostate cancer diagnosed?

how is it treated?

A

biopsy/prostate specific antigen

surgery/radio/hormonal - inhibit testosterone

45
Q

how to screen for prostate cancer?

A

look for prostate specific antigen

46
Q

aetiology of oseophageal cancer?

risk factors?

A

increasing frequency
poor outlook
- smoking/alcohol/reflux

47
Q

local signs of oseophageal cancer?

A

dysphagia
pain
anaemia

48
Q

where can oseophageal cancer metastasise to?

A

lymphadenopathy

liver

49
Q

systemic signs of oseophageal cancer?

A

cachexia

50
Q

how is oseophageal cancer diagnosed?

how is it treated?

A

endoscopy/barium swallow

surgery/radio/laser/endoscopic dilation

51
Q

survival rate of oseophageal cancer?

can it be screened for?

A
52
Q

aetiology of stomach cancer?

A

reducing frequency

risks with Hpylori, prev gastrectomy, age, smoking

53
Q

what are local signs of stomach cancer?

A

local fullness, vomitting, pain, anaemia

54
Q

where can stomach cancer metastasise to?

A

lymph nodes, liver, ascites

55
Q

how is stomach cancer diagnosed?

how is it treated?

A

endoscopy

surgery/radiotherapy/chemotherapy

56
Q

what is the survival rate of stomach cancer?

how can it be screened for?

A
57
Q

aetiology of cerebral cancers?

A

10% of all tumours - 60% primary, 40% secondary

58
Q

what are some local signs of a cerebral cancer?

A

focal defecit - limb weakness, cranial nerve palsy
impaired co ordination
headache - raised intracranial pressure, local invasion
seizures
endocrine effects

59
Q

how are cerebral cancers diagnosed?

how are they treated?

A

CT, MRI

surgery, radiotherapy, steroids, anti epileptics, hormone blocking medications

60
Q

prognosis of cerebral tumours?

A

prognosis depends on site

CMS (42 decks)

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