Cancer Part 1 Flashcards
What is cancer?
Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymphatic system
More cancers in older populations. True or false?
True
lung cancer increases with the number of cigarettes smoked. True/false?
True
state the two classifications of tumour
Benign and malignant
State the features of Benign tumours
Low rate of mitosis and growth
Few obvious spindles
Highly differentiated
Often encapsulated
Low invasiveness
No metastasis
No ectopic hormone production
State the features of Malignant tumours
High rate of mitosis and growth
Numerous obvious spindles
Low differentiation
Irregular edges
Invasive
Metastasis
Ectopic hormone production
Facts about damage with a benign tumour
Space occupying lesion (SOL)
Pressure on surrounding tissues, vessels, ducts and nerves
Facts about damage with a malignant tumour
SOL- Space occupying lesion
Pressure on surrounding tissues, vessels, ducts and nerves
Loss of differentiated function
Acquisition of other functions - ectopic hormone secretion
Local invasiveness
Metastasis
List the two ways tumour progression can be classified?
The grading system
The staging system
Knowledge of how developed the tumour is guides the treatment. It also allows comparison between treatment strategies.
What does the grading system in tumour progression mean?
describes the extent to which the cells have de-differentiated away from the cell type of the tissue of origin.
Facts about Tumour grading system
Grade I - 75-100% - highly differentiated
Grade II - 50-75% differentiated
Grade III - 25-50% differentiated
Grade IV - 0-25% differentiated
State the grading system used in cancer
Gleason Grade system
1 is least aggressive, 5 is most aggressive
Gleason grade is calculated by adding two commonest grades together (range 2-10)
Low-grade cancers (6 or less) are usually slow-growing and less likely to spread.
A score of 7 is a moderate grade.
High-grade tumours (8–10) are likely to grow more quickly and are more likely to spread
What does staging system mean in Cancer?
overall progress of the cancer reflecting size of the original in situ tumour, its invasiveness and the extent of metastasis
Facts about the TNM staging system
Tumour size - T0, T1, T2, T3, T4
Nodal involvement - N0, N1, N2, N3, N4
Distant metastasis - M0, M1, M2, M3, M4
TNM is a global standard for cancer staging . True/false?
True
Knowledge of the cancer stage will guide the choice of the most appropriate treatment for an individual patient.
Describe staging in a typical breast cancer
Stage 1:- T1 N0 M0
Stage 2:- T2 N1 M0
Stage 3:- T3 N2 M0
Stage 4:- T4 N3 M1
Facts about tumour progression
Tumour progression is initially a slow process
Screening may identify precancerous lesion before they progress
What can accelerate tumour progression?
Angiogenesis
Improves tumour uptake of oxygen and nutrients
Removes acid metabolites
Provides a route whereby the tumour can metastasise
State the modes of cancer therapy
The usual modalities are
Surgery
Radiotherapy
Hormonal therapy
Immunotherapy
Cytotoxic chemotherapy
Surgical cancer therapy facts
Well-defined solid tumours
Non-vital regions
Non-mutilating
Resection or reconstruction possible - liver/gut
Radiotherapy in cancer facts
More diffuse, but local tumours
Vital organ/region - head and neck, CNS
Adjuvant therapy - post mastectomy
Palliative
Hormonal therapy in cancer facts
Tumours arising from tissue which is normally under hormonal control
not progressed too far
not de-differentiated significantly and lost the original hormone receptors
Biological targetting/immunotherapy facts
Most modern drugs
Targeted monoclonal antibodies
Protein inhibitors
Tagged antibodies
Immune activation
Vaccines / targeted cells
State the mode of cytotoxic therapy
Adjuvant therapy
Neoadjuvant therapy
Primary therapy
Induction therapy
Salvage or Palliative therapy
