Common Cancers and Staging Flashcards
What is the estimated number of new cancer cases in 2016? (aus)
130,466
72 thousand males/58 thousand females
Estimated number of deaths from cancer in 2016?
46,880
26 thousand males/20 thousand females
What is the chance of surviving at least 5 years after cancer?
67%
a little over 70% for RT treatments
What are the top 3 cancers? (american data)
breast cancer, lung cancer, prostate
For every 106 females diagnosed with breast cancer how many males are there?
1
What are the three most common sites to cause spinal cord compression?
breast, lung, prostate
metastasis to the cord
Treatment of breast cancer includes?
- Primary intervention- surgery
- Chemotherapy
- EBRT with the use of tangent fields
- Brachytherapy, IMRT/VMAT
What immobilisation equipment used for breast cancer?
- prone Breast board (patient lays prone, breast sits in aperture, allows easy position of pendulous breast)
- Made of carbon fibre or fibre glass so it doesn’t heat up
- knee bolster
- Wing board
- Supine
Does the size of breast tissue affect the risk of breast cancer? if so why?
Yes, studies indicate that the number of cells in the breast tissue can increase cancer risk. However there isn’t a direct correlation.
What contributes to Familial risk of breast cancer? (25-50% lifetime risk)
-Two first or 2nd degree relatives with breast or ovarian cancer
- Plus one or more of the following*
- additional relatives with breast/ovarian cancer
- onset of BC before 40
- bilateral breast cancer
- breast or ovarian cancer in the same woman
- ashkenazi jewish ancestry
- breast cancer in male relative
Genetic risks of cancer breast cancer?
Presence of the BRCA1, BRCA2 genes, p53mutation
Why do we need 2-2.5cm margin on the anterior aspect of the breast when using a tangential field?
Erythema (swelling), breathing,
Why is there a small amount of lung in the treatment field?
In order to encompass the curving aspect of breast (and therefore the entire breast) we must treat a small aspect lung
What is stage 1 of breast cancer?
Early disease: tumour confined to the breast (node-negative)
what is stage 2 of breast cancer?
Early disease: tumour spread to ipsilateral axillary node (node-positive)
What is stage 3 of breast cancer?
Locally advanced tumour: spread to superficial structures of the chest wall, involvement of ipsilateral internal mammary lymph nodes
What is stage 4 of breast cancer?
Advanced (or metastatic) disease present at distant sites such as bone, brain liver and lungs, and supraclavicular lymph node involvement
Cancer stages are based on what four characteristics?
- The size of the cancer
- is the cancer invasive or non-invasive
- lymph node involvement
- metastasis or not
What is the TNM?
The staging system based on the extent of the tumour (T) the spread to lymph nodes (N) and presence of metastasis (M)
What does the T category describe in the TNM system?
The original site of primary tumour
What does the N category describe in the TNM system?
describes whether or not the cancer has reached nearby lymph nodes
What does the M category describe in the TNM system?
Tells whether are distant metastases (spread of cancer to other parts of the body)
What does TX mean?
TX primary tumour can not be evaluated
what does N0 mean?
No evidence of primary tumour
What does Tis mean?
Carcinoma in situ (early cancer has not spread to neighbouring tissue)
what does T1-T4 mean?
Size and/ or extent of the primary tumour
what does NX mean?
Regional lymph nodes cannot be evaluated
what does N0 mean?
No regional lymph node involvement
what does N1-N3?
regional lymph node involvement (number and or extent of spread)
What does Mo mean?
No Distant metastasis cancer has not spread to other body parts
what does M1 mean?
Distant metastasis spread to other parts of body
What is T1a, T1b, T1c?
T1a=>1-5 mm primary tumour size
T1b=>5-10mm
T1c=>10-20mm
What is T2 and T3 size?
T2=>20-50 (still contained within the breast)
T3=>50mm
What is T4a?
Direct extent ion to chest wall
greater than 50cm
For a tumour to grow about 1 cubic cm takes how many years of normal cell division?
8 years
but cancer has high proliferation
What is the leading cause of cancer mortality throughout the world? (men and women)
Lung cancer
in america 87,260
rates are rising in women
How do we treat lung cancer? What are the OAR?
Multiple beams, 3 or 4 beams, Posterior oblique, lateral and anterior field,arc therapy
Spinal cord, heart, lung, vena cavam aorta
What are radiation therapy treatment options?
3DCRT-pallative IMRT DCAT VMAT SABR Cyberknife- robotic arm
What is 3DCRT?
3D conformal radiation Therapy
trying to get dose to conform around target, using multiple beams.
May use this for palliative by using just an ant and post beam, reduce the symptoms involved.
What is T1? (Lung cancer staging)
- Tumour 3cm or less, surrounded by lung and visceral pleura
- no evidence of invasion more proximal than lobar bronchus
What is T2? (lung cancer staging)
tumour more than 3cm
extends to hilar region but does not involve entire lung
What is T3? (Lung cancer staging)
tumour more than 7cm in one direction
What is t4? (lung cancer staging)
tumour with any size that invaded surrounding tissues and major vessels
What is M1a? (lung cancer staging)
Seperate tumour in contolatteral lobe
What is M1b? (lung cancer staging)
Distant metastasis (in extra thoracic organs)
What is M0 and M1? (lung cancer staging)
M0- no distant metastasis
M1- distant metastasis
Why is there less chance of survival for 15-20 year olds with lung cancer than older people?
Prostate cancer is more aggressive due to hormones in younger people
slow growing in older people and they may die due to other causes
What are the detection method for prostate cancer?
Digital rectal exam
Blood test- Prostate specific androgen
The only conclusive method is TRUS biopsy (trans rectal ultrasound)
