Cancer + Genetics + Markers Flashcards
What are carcinoma
Cancer that begins in epithelial tissue
- Adenocarcinoma
- SCC
- TCC
- Small cell
What are adenocarcinoma
Glandular epithelium
- Stomach
- Intestine
What are SCC
Affects squamous epithelium
- Cervix
- Anus
- Head and neck
- Skin
What are TCC
Uroepithelium
- Renal pelvis
- Ureter
- Bladder
What is a sarcoma
Begins in mesenchyme
- Bone
- Caritlage
- Fat
- Muscle
- Blood vessels
What is leukaemia / lymphoma
Leukaemia - starts in blood forming tissue e.g. marrow
Lymphoma - begin in cells of immune system
What are germ cell tumour
Originate from germ cells in testis or ovaries
- Seminoma
- Non seminoma
How does cancer spread
Direct
Lymphatic to regional LN - follow vascular
Haematenous
Trans-coleomic ( across body cavity e.g. pleura -> peritoneum -> pericardium)
Staging of cancer
TNM = most common
T1-4
NO-1
MO - 1
When does MDT management plan occur
After historical Dx and staging
After pathological Dx
Relevant TNM stage assigned
What type of treatment in cancer
Local
Regional
Systemic
Local Rx
Aim at anatomical target
Surgical resection
RT
Regional Rx
Aimed at Rx draining nodal region
Surgical resection + RT of nodes
Systemic Rx
Effect on distant mets
4 types described later
Most common cancers UK
Breast Lung Colorectal Prostate Bladder NHL Melanoma Stomach Oesopahgus Pancreas
Most common cause of cancer death
Lung Colorectal Breast Prostate Pancreas Oesophagus Stomach Bladder NHL Lymphoma
What is Li Fraumeni
AD mutation in p53 suppressor gene
Causes high incidence of sarcoma/. leukaemia
When do you suspect
Sarcoma <45
1st degree relative with sarcoma <45 + another family member with malignancy <45 or sarcoma at any age
What is BRCA 1 and 2 linked with
BRCA 1 - breast and ovarian
BRCA 2 - prostate, breast and ovarian
What is Lynch syndrome / HNPCC
AD mutation
Develop colonic and endometrial cancer at younger age
How do you identify Lynch
3+ family confirmed colorectal (1+ 1st degree)
2 successive generation
1+ colon <50
FAP excluded
What is Gardner’s syndrome / FAP
AD mutation of APC gene causing
- Multiple colonic polyp
- Skull osteoma
- Thyroid cancer
- Epidermoid cyst
If Dx with FAP what happens
Colectomy to reduce risk of colon cancer
Aflatoxin produced by Aspergillus
Liver HCC
Aniline dyes
Bladder TCC
Asbestos
Mesthelioma
Bronchial
Nitrosamine
Oesophageal
Gastric
Vinyl chloride
Hepatic angiosarcoma
What type of tumour markers can you get
Monoclonal Ab
Tumour antigen
Enzymes
Hormones
Monoclonal AB
Ca125
Ca 19-9
Ca 15-3
Ovarian
Pancreatic
Breast
Tumour antigen PSA AFP hCG CEA S-100 Bombesin
PSA = prostatic AFP = HCC or teratoma hCG = testicular / germ cell CEA = colorectal S-100 = melanoma / schwanomma Bombesin = SCLC / gastric / neuroblastoma
Calcitonin
ADH
Medullary thyroid
SIADH - lung cancer
What are useful tumour markers for monitoring
AFP and HCG in testicular / germ
CEA in colorectal
CA125 in ovarian
