Diagnosis, staging and treatment of common cancers Flashcards
What is the risk of women developing cancer if they have BRCA1 and BRCA2 genes?
80% risk
What are the main non modifiable risk factors for breast cancer?
- Women have 100x greater risk
- Two of three are 55 years or older when diagnosed
- Higher risk if blood close relative have disease - double risk if immediate relative (85% who have family relative do not develop themselves)
- Dense breast tissue (more gland and less fat tissue)
- Period before 12 and menopause after age 55 - more periods
What are the modifiable risks for breast cancer?
- Parity: No children or child after age 30 - pregnant many times increases breast cancer risk
- Oral contraceptive pill: Increases risk - if stop for 10 years risk becomes the same
- Alcohol: 1.5x greater risk in regular drinkers
- Overweight /Obese especially if around abdomen
- Lack of exercise
- Combined hormone replacement therapy (oestrogen and progesterone) - oestrogen only seems to be fine.
- Breast feeding: Especially beneficial if lasts 1.5 to 2 years
What are the signs and symptoms of breast cancer?
- Often no signs
- More common: Lump, area of thickening/dimple in chest (looks like orange)
- Less common: Breast swelling and redness or an enlarged underarm lymph node
What might the diagnostic process be for breast cancer?
1) Showing signs and symptoms
2) Sent for mammography
3) Biopsy (cells drawn from needle)
4) Further diagnostic tests: Chest x-rays, ultrasound examination, MRI and bone scan.
Outline the stages of breast cancer?
Stage 0: Cancer cells remain inside breast duct
Stage l: Tumour 2cm or less and is confined
Stage llA: Cancer cells in axillary lymph nodes, tumour is 2cm or less and spread to lymph nodes, tumour 2-5cm and has not spread to lymph nodes
Stage lllB: Tumour 2-5cm and has spread to lymph nodes
Stage lllA: Cancer cells in axillary lymph nodes with cells sticking or to other structures OR cancer has moved beyond first lymphatic bed
Stage lllB: Any size tumour that has spread to chest wall and/or skin of breast. Cancer spread to lymph nodes near breastbone.
Stage lllC: Cancer has spread to lymph nodes above and below collarbone and to axillary lymph nodes and breastbone
Stage lV: Cancer has metastasised to other body parts
How is treatment for breast cancer carried out?
- Multi-disciplinary team - physicians, pathologists, surgeons, breast care nurses etc discuss best treatment
- Options: surgery, radiotherapy, chemotherapy, hormone treatment and biologicall targeted agents such as hereceptin - most have combination of at least two
What are the signs and symptoms of prostate cancer?
1) Difficulty passing urine
2) Inability to urinate
3) Passing urine often
4) Weak or interrupted urin flow
5) Pain when urinating
6) Blood in urine
7) Pain in lower backs, hips and upper thighs
What is the diagnostic process for prostate cancer?
1) Symptoms
2) Prostate specific antigen test
3) Rectal ultrasound examination
4) Bone scan can be requested to ensure cancer has not spread
What is the T staging for prostate cancer?
Tumour involvement
T1: Too small to feel or be seen on scans - discovered during needle biopsy after finding raised PSA
T2a: Tumour is in one half of one lobe of prostate
T2b: Tumour is in more than half one of lobes
T2c: Tumour in both lobes but still in prostate
T3a: Tumour has broken through capsule covering of prostate
T3b: Tumour has spread into seminal vesicles
T4: Tumour has spread to nearby organs such as rectum or bladder
What is the N and M staging for in prostate cancer?
Node involvement
N0: No cancer cells in the lymph nodes close to the prostate
N1: Cancer cells present in lymph nodes
Metastasis
M0: No cancer spread has been found outside prostate
M1: Cancer spread outside pelvis
M1a: There are cancer cells in lymph nodes outside pelvis
M1b: Cancer cells in bone
M1c: Cancer cells in distant organs or tissues
What is the treatment for prostate cancer?
1) Low risk is usually offered active monitoring
2) Intermediate risk are likely to be offered treatment with surgery to remove prostate
3) If broken through capsule - hormone treatment to suppress testosterone levels and halt tumour growth
What are the signs and symptoms of colon cancer?
- Early: Constipation, Diarrhoea (if continues longer than 3 weeks see doctor),
- Late: Lack of appetite, weight loss, bleeding from back passage
- Severe abdominal pain, anaemia caused by blood loss, weakness and tiredness - cancer of rectum typically causes bleeding from back passage
- Recurring waves of pain in lower abdomen - results in constipation, acute pain and vomiting if completely blocked - hospital visit required - complete blockage can result in gangrene.
