Cancer part 1

Question 1

Characteristic if a benign tumour

Answer 1

Low rate of mitosis and growth
Few obvious spindles
Highly differentiate
Often encapsulated
Low invasiveness
No metastasis
No ectopic hormone production

Question 2

Characteristic if a malignant tumour

Answer 2

High rate of mitosis and growth
Numerous obvious spindles
Low differentiation
Irregular edges
Invasive
Metastasis
Ectopic hormone production

Question 3

What type of damage is caused by a benign tumour

Answer 3

Space of occupying lesion
Pressure on sunrrouding tissue, vessels and ducts

Question 4

Damage caused by Malignant tumour

Answer 4

SOL (space of occupying lesion)
Pressure on surrounding tissues, vessels, ducts and nerves
Loss of differentiated function
Acquisition of other functions - ectopic hormone secretion
Local invasiveness
Metastasis

Question 5

How is tumour progression classified

Answer 5

Grading systems

Staging system

Question 6

What are the levels of the grading systems and what do they mean

Answer 6

Grade 1: Highly differentiated
Grade 2: 50-75% differentiated
Grade 3: 25-50% differentiated
Grade 4: 0-25% differentiated

Question 7

How is the Gleason grade system calculated

Answer 7

By adding the two most common grades together

Question 8

What is the scale for the Gleason grade design

Answer 8

1-10

Question 9

Explain the staging system

Answer 9

overall progress of the cancer reflecting size of the original in situ tumour, its invasiveness and the extent of metastasis

So is broken down into smaller systems
-Tumour size(TNM system): 0-4
-Nodal involvement: 0-4

Question 10

What is the TNM system

Answer 10

A global standard for cancer staging

Question 11

What are the generalised outline for a tumour.

Answer 11

Stage 1:- T1 N0 M0
Stage 2:- T2 N1 M0
Stage 3:- T3 N2 M0
Stage 4:- T4 N3 M1

Question 12

What is angiogenesis

Answer 12

When the tumour progression is slow and is accelerated by the improvement of oxygen and nutrients supply

Provide route for metastasis

Removal of acid metabolites

Question 13

What is metastasis

Answer 13

The process by which the primary tumour travels through the tissues and blood vessels and reinvades a new location

Question 14

What are the modes of therapy for Cancer

Answer 14

Surgery

Radiotherapy

Hormonal therapy

Immunotherapy

Cytotoxic chemotherapy

Question 15

When is surgery used to treat cancer

Answer 15

> When there is a week defined solid tumour
Non-vital regions
Non-mutilating
Resection or reconstruction possible
- liver/gut

Question 16

When is radiotherapy normally used

Answer 16

> More diffuse, but local tumours
Vital organ/region - head and neck, CNS
Adjuvant therapy - post mastectomy
Palliative

Question 17

When is Hormonal therapy normally used

Answer 17

> Tumours arising from tissue which is normally under hormonal control

> not progressed too far

> not de-differentiated significantly and lost the original hormone receptors

Question 18

Name types of Immunotherapies

Answer 18

> Most modern drugs
Targeted monoclonal antibodies
Protein inhibitors
Tagged antibodies
Immune activation
Vaccines / targeted cells

Question 19

What is cytotoxic therapy used for

Answer 19

> Adjuvant therapy: eliminate cells not cleared by surgery or RT

> Neoadjuvant therapy: Pre-shrink tumour prior to surgery or RT

> Primary therapy: Used for dispersed tumours

> Indication therapy: For patients presenting with cancer to induce remission

> Salvage/Palliative therapy: Used to relieve symptoms

Question 20

Properties of cytotoxic therapy

Answer 20

> Little selective targeting with traditional CT agents

> Used based on differential rate

> Not targeted so many side-effects

> All rapid dividing cells can be effected

Question 21

What is the most common management plan used for cancer

Answer 21

Primary tumour
Radiation therapy
Adjuvant chemotherapy and hormonal therapy