Common cancers, aetiology, clinical presentation and dental relevance

Question 1

Review the process of how a neoplasm starts

Answer 1

• Initiation: genetic injury
• Promotion: Stimulated proliferation of cells increasing the opportunity for further genetic injuries
• Progression: increased biological and clinical aggression of cells and accumulation of further genetic injuries

Question 2

State which cancer is common amongst 0-25 year olds

Answer 2

Leukaemia

Question 3

State which cancer is common amongst 25-49 year old females

Answer 3

Breast cancer

Question 4

State which cancer is common amongst 25-49 year old males

Answer 4

Melanoma

Question 5

State which cancer is common amongst 50-64 year old females

Answer 5

Breast cancer

Question 6

State which cancer is common amongst 50-64 year old males

Answer 6

Prostate cancer

Question 7

State which cancer is common amongst 65+ year olds

Answer 7

Colorectal cancer

Question 8

List the signs of lung cancer

Answer 8

• Coughing
• Chest pain
• Shortness of breath
• Wheezing
• Coughing up blood
• Feeling very tired all the time
• Weight loss with no known cause

Question 9

List the two types of lung cancer and state which is the more common of the two

Answer 9

Less common:
Small cell lung cancer

MOST common:
non- small cell lung cancer

Examples -
• Adenocarcinoma: begin in mucus producing cells
• Squamous cell carcinoma
• Large cell undifferentiated carcinoma

Question 10

List the signs of prostate cancer

Answer 10

• Frequent urination, particularly at night
• Pain on urination
• Blood in the urine or semen
• A weak stream
• Pain the back or pelvis (commonly metastasise to bone)
PSA test

Question 11

List the signs of breast cancer

Answer 11

• New lumps in the breast or under the arm
• Nipple sores, discharge
• Skin of the breast dimpling
• Rash or red swollen breasts

Question 12

Describe basal cell carcinoma and melanoma

Answer 12

• Basal cell carcinoma: most common, develops on body parts exposed to sun (head, neck, face, shoulder and back)
• Melanoma: 4th most common cancer diagnosed in Australia.

Question 13

Discuss how to self examine for skin cancer and its diagnosis

Answer 13

Self-examination for:
○ Asymmetry 
○ Border (uneven)
○ Colour 
○ Diameter (>6mm)
○ Evolving (growing) 

Diagnosis is confirmed through biopsy

Question 14

List types of head and neck cancer

Answer 14

• Verrucous carcinoma
• Minor salivary gland carcinoma
• Lymphomas
• Squamous cell carcinoma (>90%)

Question 15

Describe the features of a squamous cell carcinoma

Answer 15

○ Induration due to hypercellularity
○ Lymphadenopathy due to metastasis
○ Fungation and ulceration: tissue replacement and necrosis
○ Fixation: invasion into surrounding tissue

Question 16

Discuss the oral complications of cancer treatment

Answer 16

• Xerostomia
• Infection
• Oral mucositis
• Change of taste
• Increased caries risk
• Bleeding