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YEAR 4 CANCER CARE > General Oncology > Flashcards

General Oncology Flashcards

1
Q

Top 10 cancers in the UK?

A
  1. Breast
  2. Lung
  3. Colorectal
  4. Prostate
  5. Bladder
  6. Non-Hodgkins Lymphoma
  7. Melanoma
  8. Stomach
  9. Oesophagus
  10. Pancreas
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2
Q

Most common causes of death from cancer in UK?

A
  1. Lung
  2. Colorectal
  3. Breast
  4. Prostate
  5. Pancreas
  6. Oesophagus
  7. Stomach
  8. Bladder
  9. Non-Hodgkins Lymphoma
  10. Ovarian
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3
Q

What is Aflatoxin and what cancer can it cause?

A
  • Produced by Aspergillus
  • Causes Hepatocellular carcinoma
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4
Q

What cancer can Aniline Dye cause?

A
  • Bladder- transitional cell carcinoma
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5
Q

What cancer can Asbestos cause?

A
  • Mesothelioma and bronchial carcinoma
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6
Q

What cancer can Nitrosamines cause?

A
  • Oesphageal and gastric cancer
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7
Q

What type of cancer can vinyl chloride cause?

A
  • Hepatic angiosarcoma
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8
Q

What is Li-Fraumeni Syndrome?

A
  • Autosomal dominant
  • Consists of germline mutation to p53 supressor gene
  • High incidence of maligancies esp sarcomas and leukaemias
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9
Q

When is Li-Fraumeni syndrome diagnosed?

A
  • Idividual develops sarcoma under 45 years
  • First degree relative diagnosed with any cancer below age 45 years and another family member develops malignancy under 45 years or sarcoma at any age
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10
Q

What is BRCA 1 and 2?

Where is it? Risk?

A
  • BRCA 1- chromosome 17
  • BRCA 2- chromsome 13
  • 60% risk of developing breast cancer
  • Associated with ovarian cancer- 55% BRCA 1 and 25% BRCA 2
  • BRCA 2 associated with prostate ca in men
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11
Q

What is Lynch syndrome?

A
  • Autosomal dominant
  • Develop colonic and endometrial ca at young age
  • 80% of affected individuals will get colonic and/or endometrial ca
    *
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12
Q

How to determine high risk individuals for Lynch syndrome?

A
  • Amsterdam criteria
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13
Q

Outline Amsterdam criteria

A

For lynch syndrome
* 3 or more family members with confirmed diagnossi of colorectal cancer- one of whom is a first degree relative of the other 2
* Two sucessive affected generations
* One or more colon cancers diagnsoed under age 50 years
* FAP has been excluded

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14
Q

What is Gardners Syndrome?

A
  • Autosomal dominant familial colorectal polyposis
  • Multiple colonic polyps
  • Extra-colonic disease incl: skull osteoma, thyroid cancer, epidermoid cysts
  • Mutation of APC gene located on chromosome 5
  • Desmoid tumours seen in 15%
  • Due to colonic polyps most pts will undergo colectomy
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15
Q

Association of CA 125?

A
  • Ovarian cancer
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16
Q

Association of CA 19-9

A

Pancreatic cancer

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17
Q

Association of CA 15-3

A

Breast cancer

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18
Q

Association of PSA?

A
  • Prostate carcinoma- not specific
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19
Q

Association of AFP

tumour antigen

A
  • Hepatocellular carcinoma
  • Teratoma
20
Q

Association of CEA?

A
  • Colorectal cancer
21
Q

Association of S-100

A
  • Melanoma
  • Schwannoma
22
Q

Association of Bombesin?

A
  • Small cell lung cancer
  • Gastric cancer
  • Neuroblastoma
23
Q

Modifiable RF for cancer?

A
  • Tobacco smoking
  • Excess weight
  • Physical exercise
  • Diet e.g. Red meat linked with colon cancer and Fibre- reducing colon cancer risk
  • Alcohol use
  • Unsafe sex practices e.g. for HPV spread for cervical ca or Hep B spread for hepatocellular carcinoma
  • Sun protection- skin cancer
  • Radiation
  • H.pylori
  • HIV
  • Environment e.g. dye factory- increased risk of bladder cancer
24
Q

Non-modifiable risk factors for Cancer?

A
  • Genetics e.g. BRCA 1, FAP etc
  • Age- older age
  • Gender e.g. laryngeal cancer is more in men
  • Race, e.g. caucasian more likely than asians
25
Q

Advice to prevent cancer?

health promotion

A
  • Encouraged to quit smoking
  • 150 mins of moderate intensity acitivity in a week
  • Reduce red and processed meat consumption
  • Increase dietary fibre
  • Only drink the recommended amout of alcohol
  • Wear suncream
  • Attend screening programmes
  • Encourage to check breasts and testes for lumps
26
Q

What are the screening programmes for cancer in the UK?

A
  • Bowel
  • Breast
  • Cervical
27
Q

Outline the Bowel cancer screening programme?

A
  • 60-74 years old
  • Every 2 years
  • Receive in the post and send off a stool sample
  • FIT test- checks for blood in the stool
  • Older than 74 can request bowel screening every 2 years by contacting bowel screening programme

Slowly trying to roll out to 50-59 as well so be aware

28
Q

Outline the Bowel cancer screening programme?

A
  • 60-74 years old
  • Every 2 years
  • Receive in the post and send off a stool sample
  • FIT test- checks for blood in the stool
  • Older than 74 can request bowel screening every 2 years by contacting bowel screening programme

Slowly trying to roll out to 50-59 as well so be aware

29
Q

Outline Breast screening programme?

A
  • 50-70 years old
  • Every 3 years
  • Mammography
  • Can still be tested after 70 but have to make an appointment
30
Q

What is the cervical cancer screening programme?

A
  • 25-49 years
  • Every 3 years
  • 49-64–> invited every 5 years
  • Spedulum procedure- tests for HPV
31
Q

What is screening and why do we do it?

A

What? A way of identifying apparently healthy peole who may have an increased risk of a particular condition

Why? Can find out conditions early to allow for further diagnostic tests. Can then be offered treatment (sooner = more effective), advice and support.

32
Q

Define lead-time bias

A

Early diagnosis of a disease falsely makes it look like people are surviving longer.

33
Q

What is length time bias?

A

Length time bias occurs when patients with less severe diseases are more likely to have them detected during screening. Length time bias leads us to think that it was the screening was responsible for higher survival rates (but the conditions picked up are just slower growing )

34
Q

What are oncogenes?

A
  • genes that can cause cancer
  • May be expressed at inappropriately high levels
  • Or mutated genes with have new properties
35
Q

What are tumour supressor genes?

A
  • Typically they inhibt parts of cell cycle- stop cel division, survival or other properties of cancer cells
  • May become mutated- this may result in uncontrolled cell division
36
Q

Neoplasm definition?

A
  • Abnormal growth of cells that persists after intitial stimulus is removed
37
Q

What is dysplasia?

A
  • pre-neoplastic alteration in which the cells show disordered organisations
  • Reversible
    *
38
Q

Pathophysiology of cancer?

A
  • Accumulated mutations in somatic cells
  • Mutations are caused by initiators – mutagenic agents
  • Promoters then cause cell proliferation
  • A tumour is formed by the clonal expansion of a single precursor cell that has incurred genetic damage
39
Q

What are the targets of cancer causing mutations?

A

*Growth promoting proto-oncogenes
* Growth inhibiting tumour suppressor genes
* Genes that regulate programmed cell death (apoptosis)
* Genes involved in DNA repair

40
Q

What happens if there is a mutation in Apoptosis regulating genes?

A
  • May acquire abnormalities that result in less cell death and enhanced survival of cells
41
Q

What happens if there is a mutation in DNA repair genes?

A
  • Loss of function mutations
  • Contribute indirectly to carcinogenesis
  • Impair ability of cell to recognise and repair non-lethal genetic damage in other genes
42
Q

How do tumours evade the host defence and prevent being destroyed?

A
  • Loss of reduced expression of histocompatibility antigens
  • Expression of certain factors that suppresses the immune system
  • Failure to produce tumour antigen
43
Q

How do you refer for pts with query cancer?

A

Via 2 week wait

44
Q

Examples of red flag symptoms that would worry you?

A
  • Bone marrow supression- anaemia, thrombocytopenia, leukopenia
  • B symptoms: fatigue, fever, night sweats, significant weight loss
  • Haemoptysis and chronic- lung cancer
  • Occult blood in stool, malaena- bowel cancer
  • bone pain- myeloma
  • Breast lumps
  • large and craggy prostate
  • Painless jaundice- panreatic cancer
  • Hepatomegaly- hepaotcellular carcinoma
45
Q

What are diagnostic procedures for cancer?

A
  • Blood tests
  • CT scans, PET scans
  • Biopsy- usually core or excision
  • Immunohisotfluroscopy
46
Q

Outline performance status?

A
  • 0- fully active, able to carry on all predisease performance without restriction
  • 1- Restricted in physically strenuous activity, but ambulatory and able to carry out work of a light and sedantary nature
  • 2- Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours
  • 3- capable of limited self care, confined to bed or chair more than 50% of waking hours
  • 4- completely disabled. Cannot carry on any self- care. Totally confined to bed or chair
  • Dead
47
Q

What are driver mutations?

A
  • genes encoding proteins cirtical to cancer cell frowth + survival
  • Loss of both copies of TSG required for disease

YEAR 4 CANCER CARE (22 decks)

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