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CLASP Cancer > CLASP Cancer > Flashcards

CLASP Cancer Flashcards

1
Q

What is hyperplasia?

A

An increase in cell number in response to a stimulus, which can lead to an increase in organ/tissue size

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2
Q

What is hypertrophy?

A

An increase in cell size due to an increase in demand

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3
Q

What is atrophy?

A

Decrease in cell size/number due to withdrawal of signals; hormonal/mechanical

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4
Q

What is metaplasia?

A

Reversible change from one mature cell type to another; usually in response to injury

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5
Q

What is neoplasia?

A

Growth without a stimulus

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6
Q

What are the four types of neoplasia in order of severity?

A

1) Benign neoplasia
2) Dysplasia (pre-malignant)
3) Carcinoma-in-situ (last step before malignancy)
4) Malignant

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7
Q

What is malignancy?

A

Autonomous growth that has invaded beyond its normal location and has metastatic potential

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8
Q

What cancers can result from obesity?

A

1) Oesophageal
2) Pancreatic
3) Liver
4) Colorectal
5) Breast + endometrial

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9
Q

What cancers can result from too much consumption of red/processed meat?

A

1) Colorectal

2) Stomach

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10
Q

How does breastfeeding relate to cancer?

A

Causes modest reduction in risk of ovarian, endometrial and breast cancers

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11
Q

How does beta-carotene relate to cancer?

A
  • Decreased risk if you get RDA

- Increased risk if high dose in tobacco users

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12
Q

What cancer can result from too much calcium and dairy consumption?

A

Prostate cancer

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13
Q

What cancer can result from too much alcohol?

A

1) Mouth (throat + oesophageal)
2) Stomach
3) Breast
4) Bowel
5) Liver

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14
Q

What is acrylamide?

A

Chemical found when starchy food is cooked until dark brown (coffee, burnt toast); limited evidence in relation to cancer

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15
Q

What are the four types of cancer?

A

1) Epithelial/carcinoma
2) Mesenchymal/sarcoma
3) Haematological
4) Neuroectoderm/melanoma

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16
Q

Who gets epithelial cancers/carcinomas?

A

Elderly people due to an accumulation of environmental risk factors; rare in children

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17
Q

What are the characteristics of epithelial cancers/carcinomas?

A
  • Local growth
  • Spread through hematogenous and lymphatic routes
  • Local lymph node involvement
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18
Q

What is the pattern of spread for colorectal cancer?

A

Lymphatic spread to local lymph nodes in mesentery + follow vascular supply

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19
Q

What is the pattern of spread of testicular cancer?

A

Spread to para-aortic lymph nodes

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20
Q

What are metastases commonly found in lung and breast cancers?

A
  • Bone
  • Brain
  • Adrenal
  • Liver
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21
Q

Where do GI malignancies metastasise?

A

Rarely to bone, mainly liver

22
Q

What is the pattern of spread of prostate cancer and melanoma?

A

Wide spread, metastases can be anywhere

23
Q

What are the characteristics of mesenchymal cancers/sarcomas?

A
  • Local growth, can get very big
  • Haematogenous spread, late and can disseminate widely with time
  • Lymphatic spread is very rare
24
Q

Describe the morphology of mesenchymal cancers

A
  • Spindle cell lesions
  • Elongated, tapered shape to cells
  • Solid, follow textbooks
  • Often associated with specific large translocations (FISH/karyotyping)
25
Q

What is Ewing’s sarcoma?

A

Rare cancer affecting bones/tissue around bones; genetically characterised by t(11, 22)

26
Q

What are the primary indicators of haematological cancer?

A
  • Large lymph nodes across areas which don’t fit with epithelial drainage
  • Diffuse orgnanomegaly (liver and spleen)
  • FBC crucial, malignant cells replace normal blood cells
27
Q

What is the morphology of haematological cancer?

A
  • Solid white masses
  • Cells resemble origin cells
  • Look very similar, not pleomorphic
  • Monotonous and clonal
28
Q

What are some features of neuroectoderm tumours?

A
  • Brain lesion, never benign as brain is compressed
  • No mets due to BBB
  • 3 grades, primary stay within the brain
29
Q

What are the symptoms of prostatism?

A

Urinary hesitation, difficulty in voiding, post-micturition dribbling

30
Q

How do you proceed with prostatism?

A

Measure PSA (prostate specific antigen)

31
Q

What are alkaline phosphatases?

A
  • Enzymes found in high amounts in bone and liver and released by osteoblasts which regard bone turnover
  • Measures in patients with previous cancers/suspected mestastases
32
Q

What are the local biochemical effects of an obstructed liver?

A
  • Bile duct blocked or obstructed due to malignancy
  • Decrease in bilirubin levels
  • Back pressure to liver
  • Abnormal liver enzymes
33
Q

Explain the serum ascites albumin gradient (SAAG)

A

Serum albumin - ascitic fluid albumin = value which correlates with pressure in portal circulation

34
Q

How to proceed in hypercalcaemia as a systemic tumour effect?

A
  • Measure parathyroid hormone PTH (may be responsible)

- Give IV fluid and biphosphonate (stops bone reabsorption)

35
Q

What are the 4 main types of cancer treatment?

A

1) Radical treatment
2) Palliative treatment
3) Adjuvant treatment
4) Neoadjuvant treatment

36
Q

Describe radical cancer treatment?

A

Curative intent; aims to eradicate a tumour, often at expense of treatment side effects

37
Q

Describe palliative cancer treatment?

A

Non-curative; aims to improve symptoms, length and quality of life, not at expense of significant side effects

38
Q

Describe adjuvant cancer treatment?

A

Post-op; aims to reduce risk of cancer recurrence

39
Q

Describe Neo-adjuvant cancer treatment?

A

Pre-op; aims to shrink a tumour before surgical removal

40
Q

What are the 4 cancer treatment end-points?

A

1) Overall survival
2) Disease-free survival
3) Progression-free survival
4) Local control

41
Q

What is progression-free survival?

A

Time living with cancer not getting worse

42
Q

What is local control in cancer end-points?

A

Time without recurrence/progression at a specific tumour site

43
Q

What are the main cytotoxic chemotherapy mechanisms?

A
  • Alkylating agents -> attach alkyl group to DNA
  • Platinum salts -> DNA cross-linking
  • Anti-metabolites -> interfere with DNA/RNA growth
  • Taxanes -> mitotic inhibitors
  • Anthracyclines -> interfere with DNA copying enzymes
  • Topoisomerase inhibitors -> prevent DNA strands unwinding
44
Q

What are some chemotherapy side effects?

A

Malaise, fatigue, lethargy, alopecia, nausea, diarrhoea, mucositis, (mouth ulcers), altered taste, haematological abnormalities, peripheral neuropathy, renal/liver impairment, nail changes, changes in fertility, menopause

45
Q

What is the mechanism behind radiotherapy?

A

Specific wavelengths (0.1 - 100 micron) cause a double-strand break in DNA and prevent cell division

46
Q

What are some acute radiotherapy toxicities (weeks)?

A

Fatigue, erythema/desquamation, head and neck [mucositis, pain and odynophagia], diarrhoea, N+V, cystitis, oesophagitis

47
Q

What are some late radiotherapy toxicities (months/years)?

A

Skin fibrosis/ulceration, dysphagia, bowel dysfunction, incontinence, bladder instability, pneumonitis (cough + dyspnoea), menopause, infertility and secondary cancer

48
Q

How is radiotherapy prescribed?

A
  • Prescribed in Grays (Gy), split into fractions, Mon-Fri is 5 fractions
  • Radical treatments 4-6 weeks, combines with chemo
  • Palliative treatments 8-30 Gy in 1-10 fractions
49
Q

How is cancer described in genetics?

A

Disease of mosaicism largely caused by post-zygotic mutations (due to imperfect DNA repair)

50
Q

How do oncogenes and tumour suppressors relate to cell division?

A
  • Oncogenes; switched on for cell division

- Tumour suppressors; switched on to stop cell division

51
Q

What is an association study?

A

Tests completed to identify if a certain polymorphism is associated with a disease

CLASP Cancer (2 decks)

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