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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
What is Ewing's sarcoma?
Rare cancer affecting bones/tissue around bones; genetically characterised by t(11, 22)
26
What are the primary indicators of haematological cancer?
- 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
What is the morphology of haematological cancer?
- Solid white masses - Cells resemble origin cells - Look very similar, not pleomorphic - Monotonous and clonal
28
What are some features of neuroectoderm tumours?
- Brain lesion, never benign as brain is compressed - No mets due to BBB - 3 grades, primary stay within the brain
29
What are the symptoms of prostatism?
Urinary hesitation, difficulty in voiding, post-micturition dribbling
30
How do you proceed with prostatism?
Measure PSA (prostate specific antigen)
31
What are alkaline phosphatases?
- 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
What are the local biochemical effects of an obstructed liver?
- Bile duct blocked or obstructed due to malignancy - Decrease in bilirubin levels - Back pressure to liver - Abnormal liver enzymes
33
Explain the serum ascites albumin gradient (SAAG)
Serum albumin - ascitic fluid albumin = value which correlates with pressure in portal circulation
34
How to proceed in hypercalcaemia as a systemic tumour effect?
- Measure parathyroid hormone PTH (may be responsible) | - Give IV fluid and biphosphonate (stops bone reabsorption)
35
What are the 4 main types of cancer treatment?
1) Radical treatment 2) Palliative treatment 3) Adjuvant treatment 4) Neoadjuvant treatment
36
Describe radical cancer treatment?
Curative intent; aims to eradicate a tumour, often at expense of treatment side effects
37
Describe palliative cancer treatment?
Non-curative; aims to improve symptoms, length and quality of life, not at expense of significant side effects
38
Describe adjuvant cancer treatment?
Post-op; aims to reduce risk of cancer recurrence
39
Describe Neo-adjuvant cancer treatment?
Pre-op; aims to shrink a tumour before surgical removal
40
What are the 4 cancer treatment end-points?
1) Overall survival 2) Disease-free survival 3) Progression-free survival 4) Local control
41
What is progression-free survival?
Time living with cancer not getting worse
42
What is local control in cancer end-points?
Time without recurrence/progression at a specific tumour site
43
What are the main cytotoxic chemotherapy mechanisms?
- 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
What are some chemotherapy side effects?
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
What is the mechanism behind radiotherapy?
Specific wavelengths (0.1 - 100 micron) cause a double-strand break in DNA and prevent cell division
46
What are some acute radiotherapy toxicities (weeks)?
Fatigue, erythema/desquamation, head and neck [mucositis, pain and odynophagia], diarrhoea, N+V, cystitis, oesophagitis
47
What are some late radiotherapy toxicities (months/years)?
Skin fibrosis/ulceration, dysphagia, bowel dysfunction, incontinence, bladder instability, pneumonitis (cough + dyspnoea), menopause, infertility and secondary cancer
48
How is radiotherapy prescribed?
- 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
How is cancer described in genetics?
Disease of mosaicism largely caused by post-zygotic mutations (due to imperfect DNA repair)
50
How do oncogenes and tumour suppressors relate to cell division?
- Oncogenes; switched on for cell division | - Tumour suppressors; switched on to stop cell division
51
What is an association study?
Tests completed to identify if a certain polymorphism is associated with a disease

CLASP Cancer (2 decks)

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