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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
Q

Etiology of pancreatic cancer.

A
  • smoking
  • age (over 50)
  • diabetes mellitus
  • chronic pancreatitis
26
Q

Name the type of pancreatic cancer that is most common.

A

Mostly adenocarcinomas

27
Q

Adenocarcinoma?

A

Duct epithelium

28
Q

What are the manifestations of pancreatic cancer related to?

A

Mnfts are related to the mass of the tumor rather than the function of the pancreas.

29
Q

Manifestations of pancreatic cancer.

A

Jaundice
Abdominal pain
Weight loss

30
Q

Which diagnostics would you run to determine if your patient has pancreatic cancer?

A
  • Imagining -> US and CT scan
31
Q

Treatment for pancreatic cancer.

A

Pain management is key (supportive rather than curative)

Surgery for primary tumours.

32
Q

Which cancer is an important cause of death from cancer

A

Colorectal cancer

33
Q

Why is mortality declining for colorectal cancer?

A

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
Q

Etiology for colorectal cancer?

A
  • idiopathic
  • aging (greater than 50 yrs)
  • Familial risk (increases by 20%)
  • IBD
  • Familial adenomatous polyps
  • poor diet
  • aspirin
35
Q

What kind of genetic trait is familial adenomatous polyps (colorectal CA)?

A

Autosomal dominant (rare) ; younger individuals under 40 develop these polyps

36
Q

Why is poor diet linked to colorectal cancer?

A

Role of fat, refined carbohydrates)

37
Q

In colorectal cancer, where is the tumour sitting?

A

The tumour isn’t sitting in the lumen, it will be in the wall

38
Q

What does the degree of staging depend on?

A

It depends on the layers of the wall impacted. Less layers=lower stage

39
Q

Explain colorectal cancer: Stage one.

A
  • limited to the mucosa and submucosa layer

- 90-95% 5 year survival rate

40
Q

Explain colorectal cancer: Stage two

A
  • Infiltration of the muscularis externa layer
  • no lymph node involvement
  • 70-85% 5 year survival rate
41
Q

Explain colorectal cancer: Stage three

A
  • invasion of serosa
  • mets to the lymph node
  • 40-60% 5 yr survival rate
42
Q

Explain colorectal cancer: Stage four

A
  • penetrates the serosa (has gone through the wall)
  • adjacent organs affected (SEEDING)
  • mets (distant metastasis)
  • poor prognosis
43
Q

Manifestations of colorectal cancer?

A
  • bleeding
  • alterations in bowel habits, diarrhea, and constipation
  • pain
44
Q

Which tests would you run to diagnose a patient with colorectal cancer?

A
  • digital rectal exam
  • fecal occult blood
  • barium enema
  • sigmoidoscopy, colonoscopy
45
Q

What are the treatment options for a patient with colorectal cancer?

A 
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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