Clinical Oncology Flashcards
What are the differential diagnoses for a patient with a mass lesion?
Inflammatory lesion e.g. abscess, granuloma
Infectious (Leishmaniasis)
Haematoma
Cyst
What is the most common diagnostic method used for a mass lesion and what diagnostics does it tell you?
Fine needle aspiration- tells you the cell type, inflammation vs neoplasia, benign vs malignant
What are the three cell types found in tumours?
Round cells
Mesenchymal cells
Epithelial cells
What indicates a mass is malignant? (6)
Cellular Pleomorphism (different cell shapes)
Nuclear pleomorphism
Multinucleation
High Nucleus: Cytoplasm ratio
Mitotic figures
Increased cytoplasmic basophilia
If cytology is not diagnostic… what now?
Biopsy to look ay tissue architecture, invasion of surrounding tissues, blood vessels/ lymphatics, necrosis, tumour grade
What does Immunocytochemistry show us?
Type of antibodies and proteins in the mass- good for refining the diagnosis
What does the grade of a tumour depend on? (5)
Mitotic index
Degree of cellular differentiation
Amount of necrosis
Invasion of surrounding tissues
Invasion of vasculature/ lymphatics
What two grading systems are used to grade tumours?
Patnaik system- grade 1-3
Kiupel system- divided into low and high grade (no middle ground)
What do we mean by staging a cancer patient and how is this done?
assesses the extent of disease using imaging
[called the TNM system]
What is the first part of staging a tumour?
Hint- the T
Looks at size, mobility and gives it a grade T1, T2, T3 etc. based on those
What is the second part of staging a tumour?
Hint- the N
N= imaging of the internal nodes to decide if metastasis is present
N0 means the closest lymph node is clear of cancer cells
N1 means it is not clear
What is the last part of staging a tumour?
Hint- the M
M= Metastasis- uses imaging to scan the whole body and see if any other masses come from the same initial tumour
What is the WHO staging for Lymphoma?
classifies staging based on how many lymph nodes and lymph tissues are involved
What are paraneoplastic effects?
Give an example
an effect that occurs away from the tumour in distant parts of the body
e.g. hypercalcaemia can occur due to PTH-rp secretion
e.g. hypopglycaemia, thrombocytopenia
What are the three main treatment options for cancer in animals?
Surgery
Chemotherapy
Radiotherapy
When is surgery indicated as a cancer treatment?
for localised tumours such as carcinomas, sarcomas, mast cell tumours
[often in combination with radiation or chemo]
When is Radiation therapy indicated for cancer treatment?
With cancers that have a high risk of recurrence
With cancers where surgery would be too invasive e.g. nasal tumours
To shrink a tumour prior to surgery
When is Chemotherapy indicated?
For tumours that have high metastatic potential such as haematopoeitic tumours
Or when surgery/ radiotherapy is not possible
What can we do as supportive care for Cancer patients?
Nutritional support & Hydration via IV
Anticipate and treat adverse effects before they occur e.g. give gastric protectants, anti emetics and appetite stimulants
When would we give antibiotics with Chemotherapy?
if the chemotherapy causes neutropenia
