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cancer lecture Flashcards

1
Q

What is prevalence?

A

Proportion of a population with a condition at a given time

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2
Q

Is incidence?

A

The portion of a population developing a condition in a given time

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3
Q

What is hyperplasia?

A

An increasing number of cells

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4
Q

What is hypertrophy?

A

An increase in the size of cells

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5
Q

What is metaplasia?

A

Reversible replacement of one cell type for another cell type

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6
Q

What is dysplasia?

A

Disordered cellular development which is still reversible but once it gets to you neoplasia it is not reversible.

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7
Q

What are benign cancers of epithelial origin?

A

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.

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8
Q

What is a malignant tumour of epithelial origin called?

A

Carcinoma

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9
Q

What does stromal origin mean?

A

the tissue forming the ground substance, framework, or matrix of an organ, as opposed to the functioning part or parenchyma.

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10
Q

what are the different types of benign stroll disease?

A

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”

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11
Q

What are malignant cancer of stromal origin?

A

Haemangiosarcoma
Leiomyosarcoma
Rhabdomyosarcoma

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12
Q

What is the association between human grade and differentiation?

A
  • the higher the grade the less well differentiated the tumour
  • well differentiated
  • moderately differentiated
  • poorly differentiated (anapaestic)
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13
Q

how can you tell if a tumour is less well differentiated?

A
  • increase in nuclear staining
  • atypical mitosis
  • increase nuclear to cytoplasm ratio
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14
Q

what is TNM staging?

A

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
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15
Q

what is the staging criteria used for colorectal cancer?

A

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

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16
Q

what criteria is used to stage melanoma?

A

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

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17
Q

what are the hallmarks of cancer?

A
  • sustained proliferative signals
  • evasion of growth suppression
  • avoidance of immune destruction
  • replicative immortality
  • tumour promoting inflammation
  • invasion and metastasis
  • angiogenesis
  • genome instability
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18
Q

what are the different mechanisms by which cancer can spread?

A
  • direct
  • lymphatic
  • haematological
  • transcoelemic- (via the peritoneum)
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19
Q

how are carcinomas mainly spread?

A

lymphatic

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20
Q

how are sarcomas mainly spread?

A

haematological

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21
Q

what is the tumour marker for prostate cancer?

A
  • PSA- prostatic specific antigen

- also elevated in BPH prostatitis, UTI, catheterisation

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22
Q

what is the tumour marker for bowel cancer?

A

CEA- carcinoembryonic antigen

- Also elevated in smokers, cirrhosis, IBD

23
Q

what is the tumour marker for ovarian cancer?

A

Ca 125

- Also elevated in peritoneal malignant disease, endometriosis

24
Q

what is the tumour maker that is elevated in pancreatic and Hillary malignancy?

A

Ca 19-9

25
Q

what marker is alpha-fetoprotein?

A

Hepatocellular cancer and germ cell testicular tumour

26
Q

what’s the C1-5 cytology score?

A

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

27
Q

what is neoadjuvant therapy?

A

Downstage tumour to enable resection

28
Q

what is is adjuvant therapy?

A

used tromp up after surgery

29
Q

what are the key features of basal cell carcinoma?

A
  • Most common common skin cancer
  • Associated with sun exposure
  • Rarely metastasise but invade locally
  • Pearly rolled edge
  • Central ulceration
  • Telangectasia- spider veins
30
Q

what are squamous cell carcinoma associations?

A

UV light
Immunosuppression
Chronic ulceration
Bowen’s disease

31
Q

what are features of squamous cell carcinoma?

A
  • Ulcerated nodule
  • Erythematous
  • Friable bleeding
    (bleeds when touched)
  • Metastasises to local - lymph nodes
32
Q

what are risk factors for melanoma?

A

Fair skin and redheads
UV light
Family history
Albinism

33
Q

how does breslows thickness relate to mortality in melanoma?

A

<1.5mm has >80% 5 year survival

>4mm has <50% 5 year survival

34
Q

what is the scoring systemised to grade prostatic cancer?

A
  • 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
35
Q

what are treatment options for localised prostatic tumour?

A 
Localized (30%)
Attempt cure
Radical prostatectomy
Radical radiotherapy
Brachytherapy
Localised (70%)
watchful waiting
36
Q

what is the management for metastasised prostatic cancer?

A
  • androgen withdrawal
  • Sub capsular orchidectomy
    ( the removal of the tissue from the lining of the testicles where testosterone is made)
  • Spine radiotherapy
37
Q

what is the response and survival like for interventions in metatsiatic prostate cancer?

A

median response - 2 yrs

mean survival - 3.5 yrs

38
Q

what type of cancer is renal cancer?

A

adenocarcinoma

39
Q

what are environmental risk factors for renal cancer?

A

tobacco, asbestos urban dwelling

40
Q

what are genes that predispose to renal cancer?

A

genes (VHL), APKD

41
Q

what is the presentation of renal cancer?

A

30% - incidental finding

60% - haematuria, pain, +/- mass

42
Q

what are treatment options for renal cancer?

A

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
43
Q

where does transitional cell carcinoma affect?

A 
Occurs anywhere in renal tract
Urethra
Bladder
Ureter
Renal pelvis
44
Q

what does transitional cell carcinoma present with?

A

Haematuria (micro/macro)

Irritative bladder symptoms

45
Q

what can be used to treat superficial transitional cell carcinoma?

A
  • resection

- Bacillus Calmette-Guerin or BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer

46
Q

what is used to treat invasive T2, T3 carcinoma?

A

resection followed by radiotherapy

47
Q

what is the treatment for metastatic/ T4 disease?

A
  • Platinum based chemotherapy

- palliation

48
Q

what is a predisposing factor for testicular cancer?

A

maldescent of testicles

also more common in scandinavians

49
Q

what is the prognosis for testicular cancer?

A

95% ten year survival

50
Q

at what age do people get testicular cancer?

A

20-40

51
Q

what are the different stages for testicular cancer?

A

Stage 1 - Confined to testis
Stage 2 - Para-aortic nodes
Stage 3 - Nodes above the diaphragm
Stage 4 - Extranodal disease

52
Q

what are the different microscopic appearances of testicular tumours?

A

Seminoma- germ cell tumour

Teratoma- tumor made up of several different types of tissue, such as hair, muscle, teeth, or bone.

Lymphoma- lymph tumour

53
Q

what is the treatment of testicular cancer?

A

stage 1:
surveillance and radiotherapy

stage 2:
radiotherapy and chemotherapy

54
Q

what are the serum markers for testicular cancer?

A

AFP – teratomas

ßHCG – teratomas and seminomas

surgery (10 decks)

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