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Patho Midterm 1 > Cancers > Flashcards

Cancers Flashcards

1
Q

What is a primary malignancy?

A

Cancer is first formed in that region [example. Cancer that is formed formed in the liver]

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2
Q

What is a secondary malignancy?

A

Cancer that is formed in a different area of the body and is spread to a different site [ex. cancer that is formed in the lungs but spreads to the liver]

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3
Q

What makes a secondary site ideal to metastasize?

A

If it is richly vascularized because blood circulation is needed to carry cancer cells to the secondary site and a if it is large because the cancer cells have room to grow.

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4
Q

What are the most common secondary sites for cancer?

A

Liver, lungs, bones, brain

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5
Q

Aside from the liver being large and richly vascularized, why are cancer cells easily spread to the liver?

A

The liver receives blood from many areas of the body from the hepatic portal system so cancer cells are easily spread to the liver.

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6
Q

What is the 4th leading cause of death from cancer?

A

Pancreatic cancer

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7
Q

What are the 2 types of primary hepatic tumours?

A
  1. Hepatocellular carcinoma

2. Cholangiocarcinoma

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8
Q

Over 90% of individuals die within one year after being diagnosed of this type of cancer.

A

Pancreatic cancer

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9
Q

80% of primary liver cancers are this type.

A

Hepatocellular carcinoma

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10
Q

Manifestations of hepatocellular carcinoma?

A

Insidious onset; it is masked by underlying liver disease

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11
Q

Where does hepatocellular carcinoma arise from?

A

hepatocytes

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12
Q

What is the etiology of hepatocellular carcinoma?

A

Etiology is associated with chronic liver disease and toxins.

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13
Q

How is hepatitis associated with hepatocellular carcinoma?

A

The viral DNA (from hepatitis) gets incorporated into the hepatocellular DNA, causing a mutation of the host cell’s genes.

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14
Q

List an example of an environmental toxin associated with hepatocellular carcinoma.

A

Arcenic

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15
Q

What are the treatment options for a patient with hepatocellular carcinoma?

A
  • poor prognosis -> usually advanced by the time it is diagnosed
  • partial hepatectomy
  • palliative chemo and radiation (comfort care)
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16
Q

Partial hepatectomy?

A

Resecting a portion of the liver

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17
Q

Where does Cholangiocarcinoma originate?

A

It originates in the bile duct epithelium, mutation of this tissue

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18
Q

What is cholangiocarcinoma associated with?

A

It is associated with chronic inflammation of duct epithelium (such as schistosomiasis)

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19
Q

Schistosomiasis?

A

A disease caused by parasitic flatworms

20
Q

Where are secondary hepatic metastatic tumors most commonly from?

A

The lungs, breast, colon

21
Q

Liver cancer manifestations?

A
  • manifestations of pre-existing chronic liver diseases
  • In those of liver disease: hepatomegaly, ascites, abdominal pain
  • anorexia, fever, weight loss
22
Q

Which cancer is known to have a very high mortality rate?

A

Pancreatic cancer

23
Q

Who is at higher risk of developing pancreatic cancer?

A

Men, smokers, black population

24
Q

What is considered to be a major factor contributing to pancreatic cancer and why?

A

Smoking because cigarette smoke has organ specific carcinogens. One or more is specific to the pancreas

25
Etiology of pancreatic cancer.
- smoking - age (over 50) - diabetes mellitus - chronic pancreatitis
26
Name the type of pancreatic cancer that is most common.
Mostly adenocarcinomas
27
Adenocarcinoma?
Duct epithelium
28
What are the manifestations of pancreatic cancer related to?
Mnfts are related to the mass of the tumor rather than the function of the pancreas.
29
Manifestations of pancreatic cancer.
Jaundice Abdominal pain Weight loss
30
Which diagnostics would you run to determine if your patient has pancreatic cancer?
- Imagining -> US and CT scan
31
Treatment for pancreatic cancer.
Pain management is key (supportive rather than curative) | Surgery for primary tumours.
32
Which cancer is an important cause of death from cancer
Colorectal cancer
33
Why is mortality declining for colorectal cancer?
The mortality rate is declining because we have better screening techniques that detect colorectal cancer earlier on -> we can intervene earlier (before it was normally detected late -> too late too cure)
34
Etiology for colorectal cancer?
- idiopathic - aging (greater than 50 yrs) - Familial risk (increases by 20%) - IBD - Familial adenomatous polyps - poor diet - aspirin
35
What kind of genetic trait is familial adenomatous polyps (colorectal CA)?
Autosomal dominant (rare) ; younger individuals under 40 develop these polyps
36
Why is poor diet linked to colorectal cancer?
Role of fat, refined carbohydrates)
37
In colorectal cancer, where is the tumour sitting?
The tumour isn't sitting in the lumen, it will be in the wall
38
What does the degree of staging depend on?
It depends on the layers of the wall impacted. Less layers=lower stage
39
Explain colorectal cancer: Stage one.
- limited to the mucosa and submucosa layer | - 90-95% 5 year survival rate
40
Explain colorectal cancer: Stage two
- Infiltration of the muscularis externa layer - no lymph node involvement - 70-85% 5 year survival rate
41
Explain colorectal cancer: Stage three
- invasion of serosa - mets to the lymph node - 40-60% 5 yr survival rate
42
Explain colorectal cancer: Stage four
- penetrates the serosa (has gone through the wall) - adjacent organs affected (SEEDING) - mets (distant metastasis) - poor prognosis
43
Manifestations of colorectal cancer?
- bleeding - alterations in bowel habits, diarrhea, and constipation - pain
44
Which tests would you run to diagnose a patient with colorectal cancer?
- digital rectal exam - fecal occult blood - barium enema - sigmoidoscopy, colonoscopy
45
What are the treatment options for a patient with colorectal cancer?
``` Surgical excision (depending on when it is detected) If the patient gets surgery, you can do pre-op radiation to shrink the tumour and post op chemo ```

Patho Midterm 1 (18 decks)

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