Cancer Part 1 Flashcards

1
Q

What is cancer?

A

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

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2
Q

More cancers in older populations. True or false?

A

True

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3
Q

lung cancer increases with the number of cigarettes smoked. True/false?

A

True

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4
Q

state the two classifications of tumour

A

Benign and malignant

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5
Q

State the features of Benign tumours

A

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

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6
Q

State the features of Malignant tumours

A

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

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7
Q

Facts about damage with a benign tumour

A

Space occupying lesion (SOL)
Pressure on surrounding tissues, vessels, ducts and nerves

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8
Q

Facts about damage with a malignant tumour

A

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

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9
Q

List the two ways tumour progression can be classified?

A

The grading system
The staging system

Knowledge of how developed the tumour is guides the treatment. It also allows comparison between treatment strategies.

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10
Q

What does the grading system in tumour progression mean?

A

describes the extent to which the cells have de-differentiated away from the cell type of the tissue of origin.

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11
Q

Facts about Tumour grading system

A

Grade I - 75-100% - highly differentiated
Grade II - 50-75% differentiated
Grade III - 25-50% differentiated
Grade IV - 0-25% differentiated

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12
Q

State the grading system used in cancer

A

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

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13
Q

What does staging system mean in Cancer?

A

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

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14
Q

Facts about the TNM staging system

A

Tumour size - T0, T1, T2, T3, T4
Nodal involvement - N0, N1, N2, N3, N4
Distant metastasis - M0, M1, M2, M3, M4

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15
Q

TNM is a global standard for cancer staging . True/false?

A

True

Knowledge of the cancer stage will guide the choice of the most appropriate treatment for an individual patient.

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16
Q

Describe staging in a typical breast cancer

A

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

17
Q

Facts about tumour progression

A

Tumour progression is initially a slow process
Screening may identify precancerous lesion before they progress

18
Q

What can accelerate tumour progression?

A

Angiogenesis

Improves tumour uptake of oxygen and nutrients
Removes acid metabolites
Provides a route whereby the tumour can metastasise

19
Q

State the modes of cancer therapy

A

The usual modalities are
Surgery
Radiotherapy
Hormonal therapy
Immunotherapy
Cytotoxic chemotherapy

20
Q

Surgical cancer therapy facts

A

Well-defined solid tumours
Non-vital regions
Non-mutilating
Resection or reconstruction possible - liver/gut

21
Q

Radiotherapy in cancer facts

A

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

22
Q

Hormonal therapy in cancer facts

A

Tumours arising from tissue which is normally under hormonal control
not progressed too far
not de-differentiated significantly and lost the original hormone receptors

23
Q

Biological targetting/immunotherapy facts

A

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

24
Q

State the mode of cytotoxic therapy

A

Adjuvant therapy
Neoadjuvant therapy
Primary therapy
Induction therapy
Salvage or Palliative therapy

25
Q

Describe Adjuvant Cytotoxic chemotherapy

A

Eliminate residual cells not cleared by surgery/RT, and to minimise the risk of recurrence

26
Q

Describe neoadjuvant cytotoxic therapy

A

preshrink the tumour prior to surgery/RT,
a more complete/less mutilating resection

27
Q

Describe primary cytotoxic therapy

A

for dispersed tumours (lymphomas, leukaemias and secondary metastasis)

28
Q

Describe Induction cytotoxic chemotherapy

A

initial therapy for patients presenting with cancer to induce remission

29
Q

Describe salvage or Palliative Cytotoxic chemotherapy

A

all more appropriate therapies have failed, but low dose CT might relieve some symptoms

30
Q

Facts about cytotoxic therapy

A

little selective targeting with traditional CT agents
Use based on differential replication rate
Not really targeted, many side-effects occur
All rapidly dividing cells can be affected

31
Q

Facts about presentation and diagnosis in cancer

A

10^9 cells is the smallest tumour burden that is physically detectable
About 1 g or size of a small pea
Clinical symptoms first appear
Death usually with a burden of 10^12 cells - about 1 kg of tumour

32
Q

Facts about combined modalities in cancer

A

Most cancer management uses combined modalities, e.g. breast cancer
Primary tumour removed by surgery (mastectomy/lumpectomy)
Radiation therapy to remaining breast and/or axilla
Adjuvant chemotherapy and/or hormonal therapy to eradicate any microneoplastic disease