Cancer Flashcards
Give the intrinsic risk factors for cancer
Genetic makeup Increased age Immune system Chronic irritation Endogenous exposure to hormones
Give the extrinsic risk factors for cancer
Environment
Infectious agents
Diet
What ratio of people does cancer affect
1 in 2 in a lifetime
How many cancer cases can be prevented?
4 in 10
What is the main risk factor for cancer?
Increasing age
What are the 4 most common cancers?
Breast
Prostate
Lung
Bowel
Which scan exposes the patient to the worst dose of radiation?
CTPA
What is the radiation dose of CTPA equivalent to?
750 Xrays
Name some common metastatic sites
Lymph nodes Bone Liver Lungs Brain
How do cancers metastasise?
Lymphatic system
Blood system
Which cancers commonly spread to the brain?
Lung
Brain
Melanoma
Which cancers commonly spread to the liver?
Bowel
Breast
Lung
Which cancers commonly spread to the bone?
Lung
Breast
Prostate
In what different ways do cancers present?
Primary - lump, pain, bleeding. Direct local spread causing compression/invasion of adjacent structures
Spread to draining lymph nodes - lump, pain, lymphoedema - compression/invasion of adjacent structures
What are some symptoms due to metastatic disease
General non specific symptoms - cachexia, fatigue, malaise, fever, itch
or specific to location
What symptoms indicate bony mets
Pain, pathological fractures, spinal cord compression, hypercalcaemia
What symptoms indicate liver mets
Pain, early satiety, easy bruising, jaundice
What symptoms indicate lung mets
SoB, cough, haemoptysis
What symptoms indicate brain mets?
Confusion, nausea, headache, motor/sensory symptoms, fits
What is cancer staging?
Investigations to determine the extent of local spread of primary tumour and presence of distant metastasis
What does the cancer staging imaging depend on?
The specific cancer
What is required for a lymphoma cancer staging?
USS, CT, MRI, PET-CT, bone marrow biopsy +/- lumbar puncture for CSF
Why is cancer staging done?
To estimate prognosis and help plan treatment
Describe the TNM staging
Tumour/node/metastases
Tumour size
Involvement of regional lymph nodes
Presence of metastases
Describe the FIGO staging
International federation of gynaecology and obstetrics
All gynae tumours
Describe Dukes staging for colorectal cancer
A,B,C - unfortunately too simple, use TNM instead
What influences cancer treatment decisions?
Cancer factors - Histology, stage, grade, ER status, HER2 status for breast cancer, is it curable?
Patient factors - frailty, location, patient wishes
Which cancer is alpha FP and hCG raised in?
Testicular/germ cell
Which cancer is CEA raised in?
Colorectal cancer
Which cancer is CA125 raised in?
Ovarian cancer
Which cancer is CA19-9 raised in?
Pancreatic
Which cancer is CA15-3 raised in?
Breast
Which cancer are paraproteins raised in?
Myeloma
Which cancer is calcitonin raised in?
Medullary thyroid
Which cancer is alpha fetoprotein raised in
Hepatocellular
