Cancer Flashcards
1
Q
what is hyperplasia?
A
increase in the number of cells
2
Q
when does hyperplasia occur?
A
in response to a stimulus
3
Q
when does hyperplasia regress?
A
when the stimulus is removed
4
Q
what is hypertrophy?
A
increase in cell size
5
Q
what is atrophy?
A
loss of cell size or number
6
Q
when does atrophy occur?
A
with the withdrawal of a stimulus
7
Q
what two things can atrophy be?
A
hormonal or mechanical
8
Q
what is metaplasia?
A
reversible change from one mature cell type to another
9
Q
what does metaplasia occur in response to?
A
injury
10
Q
what is neoplasia?
A
new growth without a stimulus
11
Q
what are the three types of neoplastic growth?
A
benign
premalignant
malignant
12
Q
what do benign growths not have?
A
any malignant potential
13
Q
describe a premalignant growth
A
dysplastic but still benign as there is no invasion
14
Q
what is the closest a growth can be to malignancy whilst still being benign?
A
carcinoma in-situ
15
Q
what is malignancy?
A
growth that has invaded and has metastatic potential
16
Q
who gets screened for colonic cancer?
A
patients with positive FOB tests
17
Q
what is the gold standard for colonic cancer screening?
A
optical colonoscopy
18
Q
what does radical treatment mean?
A
treatment with curative intent
19
Q
what is the aim of radical treatment?
A
to eradicate a tumour, often at the expense of side effects
20
Q
what does palliative treatment mean?
A
non-curative
21
Q
what is the aim of palliative treatment?
A
to improve symptoms or prolong life
22
Q
what is adjuvant treatment?
A
treatment done after surgery
23
Q
what is the aim of adjuvant surgery?
A
reducing risk of recurrence
24
Q
what is neo-adjuvant treatment?
A
treatment done before surgery
25
what is the aim of neoadjuvant treatment?
to shrink a tumour before surgical removal
26
name four descriptors of treatment endpoint
overall survival
disease free survival
progression free survival
local control
27
what is overall survival?
the patients time alive
28
what is disease free survival?
time without any symptoms or signs of cancer
29
what is progression free survival?
the time living with cancer that is not getting worse
30
what is local control?
time without recurrence or progression at a specific tumour site
31
name four non surgical treatment modalities
external beam radiotherapy
brachytherapy
radionuclide therapy
systemic anti cancer therapy
32
how does radiotherapy cause cancer cell death?
radiation causes a double strand break in DNA that prevents cell division, resulting in cell death
33
what is brachytherapy?
chips with radiation inserted into a patient
34
name three things included in systemic anti cancer therapy (SCAT)
cytotoxic chemotherapy
targeted therapy
immunotherapy
35
name three chemotherapy agents
alkylating agents
taxanes
anthracyclines
36
how do alkylating agents work?
attach an alkyl group to DNA
37
how do platinum salts work?
DNA cross linking
38
how do anti metabolites work?
interfere with RNA/DNA growth
39
how do taxanes work?
mitotic inhibitors
40
how do anthracyclines work?
interfere with enzymes for DNA copying
41
how does topoisomerase work?
prevents DNA strands from unwinding
42
what unit is a radiotherapy prescription given in?
grays (Gy)
43
what is Gy the unit of?
absorbed dose
44
what are targeted agents?
monoclonal antibodies
45
what monoclonal agent can be used to treat some breast cancers?
Herceptin/Trastuzumab
46
what does Herceptin target?
HER2
47
what are the three broad groups that most cancers fall under?
epithelial
mesenchymal
haematological
48
what is the term for epithelial malignancy?
carcinoma
49
who is more likely to get carcinoma, children or the elderly?
the elderly
50
what is carcinoma progression characterised by?
local growth
51
what two ways does a carcinoma spread?
haematogenous and lymphatic orutes
52
where is lymphatic spread to in colorectal cancer?
local lymph nodes in the mesentery
53
where is lymphatic spread to in testicular cancer?
para-aortic lymph nodes
54
where do lung cancers metastasise to via the blood?
bone
brain
adrenal glands
the liver
55
where do GI malignancies commonly spread to in the blood?
the liver
56
where does prostate cancer spread in the blood?
anywhere
57
what are mesenchymal tumours called?
sarcomas
58
what is a benign tumour of smooth muscle called?
leiomyoma
59
what is a benign tumour of skeletal muscle called?
rhabdomyoma
60
what is a benign tumour of fat called?
lipoma
61
what is a benign tumour of bone called?
osteoma
62
what is a benign tumour of cartilage called?
chondroma
63
what is a benign tumour of blood vessels called?
haemangioma
64
what is a benign tumour of nerves called?
neuroma
65
what is a malignant tumour of smooth muscle called?
leiomyosarcoma
66
what is a malignant tumour of skeletal muscle called?
rhabdomyosarcoma
67
what is a malignant tumour of fat called?
liposarcoma
68
what is a malignant tumour of bone called?
osteosarcoma
69
what is a malignant tumour of cartilage called?
chondrosarcoma
70
what is a malignant tumour of blood vessels called?
angiosarcoma
71
what is a malignant tumour of nerves called?
malignant peripheral nerve sheath called (MPNST)
72
are sarcomas common or rare?
rare
73
what is the defining feature of sarcoma progression?
local growth
74
what type of spread is very rare in a sarcoma?
lymphatic spread
75
describe the morphology of a sarcoma cell
spindle cell
| very long tapered shape
76
can haematological tumours metastaised?
no
77
what is a lymphoma?
tumour like masses in lymph nodes
78
what is crucial in haematological tumours?
FBC
79
what is a brain tumour often called?
glioma
80
what are lesions in the brain considered to be until proven otherwise?
metastases
81
where do primary brain tumours metastasise to?
nowhere, they can't cross the blood brain barrier
82
what does TNM stand for?
tumour size
lymph node involvement
metastasis
83
what does Tis stand for?
tumour in situ
84
what does tumour in situ mean?
the tumour is contained within the lamina propria
85
what does T1 mean?
the tumour has invaded the submucosa only
86
what does T2 mean?
the tumour has invaded the muscularis propria and has not extended beyond it
87
what does T3 mean?
the tumour has invaded into the subserosa but not into the serosa or any adjacent tissues
88
what does T4 mean?
the tumour has directly invaded other organs or structures
89
what does NX mean?
lymph nodes cannot be assessed
90
what does N0 mean?
no regional lymph node metastasis
91
what does N1 mean?
metastasis to 1-3 nearby lymph nodes
92
what does N2 mean?
metastasis to four or more regional nodes
93
what does M0 mean?
no metastasis
94
what does M1 mean?
metastasis to distant tissues, including lymph nodes
95
what stage is a tumour with T1N1M0?
III A
96
what stage is a tumour with T2N2M0?
III C
97
what stage is a tumour with T2N0M1?
IV
98
describe the TNM score for a stage I cancer?
T1/2
N0
M0
99
describe the TNM score for a stage II A cancer?
T3
N0
M0
100
describe the TNM score for a stage II B cancer?
T4
N0
M0
101
describe the TNM score for a stage III A cancer?
T1/2
N1
M0
102
describe the TNM score for a stage III B cancer?
T3/4
N1
M0
103
describe the TNM score for a stage III C cancer?
T ANY
N2
M0
104
describe the TNM score for a stage IV cancer?
T ANY
N ANY
M1
105
what staging system can be used for bowel cancer?
duke's staging
106
describe duke's stage A bowel cancer
confined to the bowel wall with no lymph node metastases
107
describe duke's stage B bowel cancer
local spread out of the bowel wall with no lymph node metastasis
108
describe duke's stage C bowel cancer
lymph node metastasis
109
describe duke's stage D bowel cancer
metastatic disease
110
what is the prognosis for stage A bowel cancer?
95%
111
what is the prognosis for stage B bowel cancer?
85%
112
what is the prognosis for stage C bowel cancer?
60%
113
what is the prognosis for stage D bowel cancer?
8%
114
what does PSA stand for?
prostate specific antigen
115
what is PSA?
a protein produced only by the prostate
116
what is prostatism?
a collection of symptoms including urinary hesitation and difficulty in emptying the bladder
117
what causes the symptoms of prostatism?
enlargement of the prostate which narrows or completely closes the urethra
118
what are two possible causes of prostatism?
prostate cancer
| benign prostate hyperplasia (BPH)
119
what should be measured in people with prostatism?
PSA
120
what is a normal range for PSA?
0-4
121
what are differentials of high PSA?
prostate cancer
| benign prostate hyperplasia
122
what examination can be done to differentiate between BPH and prostate cancer?
PR exam, BPH feels smooth while prostate cancer feels rough
123
besides PSA and PR exam, what other test needs to be done to diagnose prostate cancer?
biopsy
124
name two enzymes that are raised in muscle damage
CK
| AST
125
name four enzymes that are raised in liver damage
ALT
AST
ALP
GGT
126
name four enzymes that are raised in heart damage
troponin
CK
AST
LDH
127
name two enzymes that are raised in pancreas damage
amylase
| lipase
128
name an enzyme that is raised in bone damage
ALP
129
what is the normal range for alkaline phosphatase?
30-130
130
name two types of cells that contain ALP?
hepatocytes
| osteoblasts
131
what does high alkaline phosphatase in a cancer patient suggest?
metastasis to either the liver or bone
132
what test can be done to determine whether raised ALP is due to liver or bone pathology?
GGT, if elevated it is liver pathology
133
which type of pleural effusion is more likely to be caused by malignancy?
exudate
134
what is the reference interval for calcium?
2.10-2.55
135
what is the most important thing to measure in someone with raised calcium?
PTH
136
what does it mean if someone has high calcium and high PTH?
the high PTH is what is causing the high calcium, as PTH stimulates calcium production when levels are low
137
what is PTHrP?
PTH related protein
138
is PTHrP seen upon measuring PTH?
np
139
what may be causing high calcium in a patient whose PTH levels are normal?
PTHrP
140
what do oncogenes do?
promote cell division
141
what do tumour supressors do?
stop cell division
142
what do DNA repair genes do?
repair DNA damage
143
what do drug metabolism genes do?
metabolise carcinogens
144
name four types of genes that are involved in cancer
oncogenes
tumour suppressor genes
DNA repair genes
drug metabolism genes
145
what is a driver mutation?
a mutation that drives carcinogenesis
146
what is a passenger mutation?
an incidental mutation that develops because the tumour is unstable
