Cancer Flashcards
what is the main way cancer develops?
genetic predisposition mixed with environmental factors gives uncontrolled proliferation and a cancer forms
what are some systemic features of cancer?
cachexia
ectopic hormone production - PTH hypercalcaemia, or ACTH - cushings disease
parneoplastic syndromes - neurological/dermatomyocitis, venous thromboses
techniques for diagnosis of cancer?
imaging - CT/MRI
fibre optic techniques - endoscopy/bronchoscopy/biopsy
what are some staging techniques for cancer diagnosis?
TNM - tumour node metastases - clarify prognosis, survival, defines tx
Ann arbor - lymphoma staging
Dukes ABCD - colorectal carcinomas
what is the main action of chemotherapy?
interferes with cellular replication by targeting DNA or cell division
side effects effect rapid dividing cells such as?
GI or oral mucosa
bone marrow
hair
reproductive cells
chemo is often a combination of agents, why is this better?
different modes of action
less chance of resistance
less toxicity
how is chemo used combined with or as an adjuvent to surgery?
pre surgery - reduce tumour load
post surgery - reduce sub clinical disease
what cancers can a course of chemo cure?
hodgkins lymphoma
testicular teratoma
acute childhood leukemia
chemo can be used as a contribution to care and to prolong life expectancy in what cancers?
small cell carcinoma of the lung
breast carcinoma
adult leukemia
ovarian cancer
chemo can be used as palliation in what cancers?
GI tract
non small cell lung cancer
cervical carcinoma
squamous carcinomas of the head and neck
what are some general short term side effects of chemo?
nausea
vomiting
diarrhea
alopecia
what are some short term side effects of chemo caused by bone marrow suppression?
- neutropenia - high infection risk, least wbc’s 7-9 days after chemo, oral infections
- thrombocytopenia = bleeding tendancies
- anaemia
what long term side effects can chemo cause?
impaired fertility
teratogenic
cancer - leukemia
organ damage - pulmonary fibrosis, cardiomyopathy, neuropathy
how can chemo be used as hormone therapy?
in breast and prostate cancers
non curative
how does radiotherapy work?
affects rapidly dividing cells - targeted to specific areas
how is radiotherapy delivered?
externally - linear accelerator
internal - implant/systemic - taken up by specific organs e.g strontium by bone, iodine 131 by thyroid
what are some short term side effects of radiotherapy?
oral mucositis diarrhea nausea tired hair loss bm suppression sunburn
what are some long term effects of radiotherapy?
osteoradionecrosis xerostomia skin ulcers fibrosis bowel stenosis secondary malignancies
what are some novel therapies in cancer treatment?
- immunotherapy -vaccines, cytokines
- angiogenesis inhibitors
- signal inhibitors - specific inhibition of mutated proteins
- gene therapy - insert correct functioning versions of damaged genes
- phototherapy - tumour takes up dye, killed by laser
what is the aetiology of lung cancer?
biggest killer/poor outlool/almost totally avoidable
90% due to smoking, can also be caused by passive smoking
local signs of lung cancer?
cough/chest pain/breathless/chest infections
where can lung cancer metastasise to?
bones
brain
liver
what are some systemic signs of lung cancer?
cachexia
hormonal - high calcium/low sodium
how is lung cancer diagnosed?
how is it treated?
CXR/CT/bronchoscopy/sputum cytology
surgery/chemo/radio/laser
what is the 5yr survival for lung cancer?
can it be screened for?
10%
screening under investigation
what is the aetiology of colorectal cancer?
disease of western lifestyle, 2nd most common cause of death, partially preventable
risk factors in lifestyle that contribute to colorectal cancer development?
diet high in fat and low in fibre
familial - genes
inflammatory bowel disease
what are local signs of colorectal cancer?
anaemia
altered bowel habits
acute abdomen
where can colorectal cancer metastasise to?
liver
lungs
ascites
what is a systemic sign of colorectal cancer?
cachexia
how is colorectal cancer diagnosed?
how is it treated?
sigmoid/colonoscopy, barium swallow
surgery, radiotherapy, chemotherapy
what is the survival like for colorectal cancer?
can it be screened for?
90% 5 yr survival stage I,
what is the aetiology of breast cancer?
1 in 12 women
no 1-2 in women
relatively young pts
risk factors of breast cancer?
familial - genes
hormonal - no children/early periods/late menopause/no breastfeeding/HRT
what are local signs of breast cancer?
puckering, pain, discharge, lump
where can breast cancer metastasise to?
bone
brain
liver
what are some systemic signs of breast cancer?
cachexia
hypercalcaemia
how is breast cancer diagnosed?
how is it treated?
mammogram/tissue diagnosis - fine needle aspiration/biopsy
surgery/chemo/radio/hormonal - osetrogen inhibition
how is breast cancer screened for?
mammograms every 3 years for women 50-70yrs
self exams promoted
aetiology of prostate cancer?
1 in 3 men
80% of 80 + yr olds
local signs of prostate cancer?
detected on pr exam
confused with normal urinary changes in elderly
found at operation for urinary symptoms
where can prostate cancer metastasise to?
bone
lungs
how is prostate cancer diagnosed?
how is it treated?
biopsy/prostate specific antigen
surgery/radio/hormonal - inhibit testosterone
how to screen for prostate cancer?
look for prostate specific antigen
aetiology of oseophageal cancer?
risk factors?
increasing frequency
poor outlook
- smoking/alcohol/reflux
local signs of oseophageal cancer?
dysphagia
pain
anaemia
where can oseophageal cancer metastasise to?
lymphadenopathy
liver
systemic signs of oseophageal cancer?
cachexia
how is oseophageal cancer diagnosed?
how is it treated?
endoscopy/barium swallow
surgery/radio/laser/endoscopic dilation
survival rate of oseophageal cancer?
can it be screened for?
aetiology of stomach cancer?
reducing frequency
risks with Hpylori, prev gastrectomy, age, smoking
what are local signs of stomach cancer?
local fullness, vomitting, pain, anaemia
where can stomach cancer metastasise to?
lymph nodes, liver, ascites
how is stomach cancer diagnosed?
how is it treated?
endoscopy
surgery/radiotherapy/chemotherapy
what is the survival rate of stomach cancer?
how can it be screened for?
aetiology of cerebral cancers?
10% of all tumours - 60% primary, 40% secondary
what are some local signs of a cerebral cancer?
focal defecit - limb weakness, cranial nerve palsy
impaired co ordination
headache - raised intracranial pressure, local invasion
seizures
endocrine effects
how are cerebral cancers diagnosed?
how are they treated?
CT, MRI
surgery, radiotherapy, steroids, anti epileptics, hormone blocking medications
prognosis of cerebral tumours?
prognosis depends on site
