cancer lecture Flashcards
What is prevalence?
Proportion of a population with a condition at a given time
Is incidence?
The portion of a population developing a condition in a given time
What is hyperplasia?
An increasing number of cells
What is hypertrophy?
An increase in the size of cells
What is metaplasia?
Reversible replacement of one cell type for another cell type
What is dysplasia?
Disordered cellular development which is still reversible but once it gets to you neoplasia it is not reversible.
What are benign cancers of epithelial origin?
Adenoma which is a benign tumour formed from the glandular structures of epithelium.
Papilloma which is a benign tumour at the epithelium and appears as a nipple like structure.
What is a malignant tumour of epithelial origin called?
Carcinoma
What does stromal origin mean?
the tissue forming the ground substance, framework, or matrix of an organ, as opposed to the functioning part or parenchyma.
what are the different types of benign stroll disease?
Haemangioma- A haemangioma is a collection of small blood vessels that form a lump under the skin.
Leiomyoma- also known as fibroids, is a benign smooth muscle tumor that very rarely becomes cancer
Rhabdomyoma- a benign tumor of striated muscle. Rhabdomyomas may be either “cardiac” or “extra cardiac”
What are malignant cancer of stromal origin?
Haemangiosarcoma
Leiomyosarcoma
Rhabdomyosarcoma
What is the association between human grade and differentiation?
- the higher the grade the less well differentiated the tumour
- well differentiated
- moderately differentiated
- poorly differentiated (anapaestic)
how can you tell if a tumour is less well differentiated?
- increase in nuclear staining
- atypical mitosis
- increase nuclear to cytoplasm ratio
what is TNM staging?
Tumour size (T1 to T4)
Nodes (N0 to N3) N0- no lymph nodes N1- regional small lymph nodes N2- in between n3- more distant and numerous lymph nodes
Metastasis (M0 or M1)
- M0- no distant metastasis
- M1- distant metastasis to other organs
what is the staging criteria used for colorectal cancer?
dukes
-Dukes’ A,B,C or D.
A=The cancer is in the inner lining of the bowel
B=The cancer has grown through the muscle layer of the bowel.
C= The cancer has spread to at least 1 lymph node close to the bowel.
D=The cancer has spread to another part of the body, such as the liver, lungs or bones
what criteria is used to stage melanoma?
Breslow’s thickness measure of how deeply a melanoma tumor has grown into the skin. The tumour thickness (depth) is usually measured from the top of the tumour to the deepest tumour cells
what are the hallmarks of cancer?
- sustained proliferative signals
- evasion of growth suppression
- avoidance of immune destruction
- replicative immortality
- tumour promoting inflammation
- invasion and metastasis
- angiogenesis
- genome instability
what are the different mechanisms by which cancer can spread?
- direct
- lymphatic
- haematological
- transcoelemic- (via the peritoneum)
how are carcinomas mainly spread?
lymphatic
how are sarcomas mainly spread?
haematological
what is the tumour marker for prostate cancer?
- PSA- prostatic specific antigen
- also elevated in BPH prostatitis, UTI, catheterisation
what is the tumour marker for bowel cancer?
CEA- carcinoembryonic antigen
- Also elevated in smokers, cirrhosis, IBD
what is the tumour marker for ovarian cancer?
Ca 125
- Also elevated in peritoneal malignant disease, endometriosis
what is the tumour maker that is elevated in pancreatic and Hillary malignancy?
Ca 19-9
what marker is alpha-fetoprotein?
Hepatocellular cancer and germ cell testicular tumour
what’s the C1-5 cytology score?
C0 Inadequate sample
C1 Normal tissue
used to categorise FRNAC- fine needle aspiration cytology
C2 Abnormal but definitely benign
C3 Abnormal but probably benign
C4 Abnormal but probably malignant
C5 Abnormal but definitely malignant
what is neoadjuvant therapy?
Downstage tumour to enable resection
what is is adjuvant therapy?
used tromp up after surgery
what are the key features of basal cell carcinoma?
- Most common common skin cancer
- Associated with sun exposure
- Rarely metastasise but invade locally
- Pearly rolled edge
- Central ulceration
- Telangectasia- spider veins
what are squamous cell carcinoma associations?
UV light
Immunosuppression
Chronic ulceration
Bowen’s disease
what are features of squamous cell carcinoma?
- Ulcerated nodule
- Erythematous
- Friable bleeding
(bleeds when touched) - Metastasises to local - lymph nodes
what are risk factors for melanoma?
Fair skin and redheads
UV light
Family history
Albinism
how does breslows thickness relate to mortality in melanoma?
<1.5mm has >80% 5 year survival
>4mm has <50% 5 year survival
what is the scoring systemised to grade prostatic cancer?
- gleason grading
- The Gleason Score ranges from 1-5 and describes how much the cancer from a biopsy looks like healthy tissue (lower score) or abnormal tissue (higher score). Most cancers score a grade of 3 or higher
what are treatment options for localised prostatic tumour?
Localized (30%) Attempt cure Radical prostatectomy Radical radiotherapy Brachytherapy Localised (70%) watchful waiting
what is the management for metastasised prostatic cancer?
- androgen withdrawal
- Sub capsular orchidectomy
( the removal of the tissue from the lining of the testicles where testosterone is made) - Spine radiotherapy
what is the response and survival like for interventions in metatsiatic prostate cancer?
median response - 2 yrs
mean survival - 3.5 yrs
what type of cancer is renal cancer?
adenocarcinoma
what are environmental risk factors for renal cancer?
tobacco, asbestos urban dwelling
what are genes that predispose to renal cancer?
genes (VHL), APKD
what is the presentation of renal cancer?
30% - incidental finding
60% - haematuria, pain, +/- mass
what are treatment options for renal cancer?
Radical surgery
- Laparoscopic/partial nephrectomy/robotic/open
± adrenal gland
± lymphadenectomy
Alternative
- Embolisation
(a minimally invasive procedure performed by interventional radiologists, in which the blood supply to masses or vessels which are causing symptoms in a patient is cut off, relieving the symptoms the patient experiences)
- Cryosurgery / ablation
where does transitional cell carcinoma affect?
Occurs anywhere in renal tract Urethra Bladder Ureter Renal pelvis
what does transitional cell carcinoma present with?
Haematuria (micro/macro)
Irritative bladder symptoms
what can be used to treat superficial transitional cell carcinoma?
- resection
- Bacillus Calmette-Guerin or BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer
what is used to treat invasive T2, T3 carcinoma?
resection followed by radiotherapy
what is the treatment for metastatic/ T4 disease?
- Platinum based chemotherapy
- palliation
what is a predisposing factor for testicular cancer?
maldescent of testicles
also more common in scandinavians
what is the prognosis for testicular cancer?
95% ten year survival
at what age do people get testicular cancer?
20-40
what are the different stages for testicular cancer?
Stage 1 - Confined to testis
Stage 2 - Para-aortic nodes
Stage 3 - Nodes above the diaphragm
Stage 4 - Extranodal disease
what are the different microscopic appearances of testicular tumours?
Seminoma- germ cell tumour
Teratoma- tumor made up of several different types of tissue, such as hair, muscle, teeth, or bone.
Lymphoma- lymph tumour
what is the treatment of testicular cancer?
stage 1:
surveillance and radiotherapy
stage 2:
radiotherapy and chemotherapy
what are the serum markers for testicular cancer?
AFP – teratomas
ßHCG – teratomas and seminomas
