Cancer staging and treatment Flashcards
Cancer staging and treatment
There are four types of staging
- Clinical staging - imaging, tests, biopsies
- Pathologic staging - combines clinical staging with surgical results
- Post therapy - how much remains
- Re-staging - extent of disease if cancer comes back after treatment
Cancer staging and treatment
TNM staging
TNM staging:
- T describes the size of the tumour.
- N describes whether the cancer has spread to the lymph nodes and which nodes are involved. For example, N0 = no lymph nodes affected. N1 = 1–3 of the lymph nodes affected.
- M describes if the cancer has spread to another part of the body. For example, M0 means the cancer has not spread (metastasised) to other parts of the body.
- Once the T, N, and M are determined, they are combined, and an overall stage of 0, I, II, III, IV is assigned.
Cancer staging and treatment
Bladder cancer classification
Cancer staging and treatment
Prostate cancer staging
Cancer staging and treatment
Breast cancer staging
Cancer staging and treatment
Bowel cancer staging
Bowel Ca staging uses the Dukes staging system.
- Dukes’ A- The cancer is in the inner lining of the bowel, or it is slightly growing into the muscle layer
- Dukes’ B- The cancer has grown through the muscle layer of the bowel.
- Dukes’ C- The cancer has spread to at least 1 lymph node close to the bowel.
- Dukes’ D- The cancer has spread to another part of the body, such as the liver, lungs or bones
Cancer staging and treatment
Treatment
surgery
Depending on your type of cancer and how advanced it is, surgery can be used to:
1) Remove the entire tumour-surgery removes cancer that is contained in one area.
2) Debulk a tumour- surgery removes some, but not all, of a cancer tumour. Debulking is used when removing an entire tumour might damage an organ or the body. Removing part of a tumour can help other treatments work better.
3) Ease cancer symptoms- Surgery is used to remove tumours that are causing pain or pressure
Cancer staging and treatment
Treatment
Radiotherapy
Radiotherapy is used in >50% of cancer patients. It uses ionizing radiation to produce free radicals, which damage DNA. Normal cells are better at repairing this damage than cancer cells, so are able to recover before the next dose (or fraction) of treatment.
Cancer staging and treatment
Treatment
Chemotherapy
Chemotherapy is used to:
- Stop the spread of the cancer, lessen the chance it will return, or stop or slow its growth.
- Ease cancer symptoms by shrinking tumours that are causing pain or other problems.
When used with other treatments, chemotherapy can:
- Make a tumor smaller before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
- Destroy cancer cells that may remain after treatment with surgery or radiation therapy. This is called adjuvant chemotherapy.
- Help other treatments work better.
- Kill cancer cells that have returned or spread to other parts of your body.
Cancer staging and treatment
Treatment
Classification of cancer drugs
Alkylating agents:
- Antiproliferative drugs that bind via alkyl groups to DNA, eg cyclophosphamide, chlorambucil, busulfan.
Antimetabolites:
- Interfere with normal cellular metabolism of nucleic acids, eg methotrexate, 5-fl uorouracil.
Vinca alkaloids: ‘
- Spindle poisons’ which target mechanisms of cell division, eg vincristine,vinblastine.
Antitumour antibiotics:
- Vary in action (depending on type), eg dactinomycin, doxorubicin, mitomycin.
Cancer staging and treatment
Treatment
Immunotherapy
Monoclonal antibodies:
- Inhibit a specific targeted process, such as angiogenesis, (eg bevacizumab for renal cell carcinoma), or epidermal growth factor receptors (eg panitumumab and cetuximab).
- NB: over-expression of epidermal growth factor receptors correlates with poor prognosis in many cancers.
- Others: eg etoposide, taxanes, platinum compounds.
