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Year 4 Cancer Care and Haem > General Oncology Principles > Flashcards

General Oncology Principles Flashcards

1
Q

What are the three broad classifications of genetic mutations causing cancer?

A

Tumour Supressor
Proto- Oncogenes
DNA Repair

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2
Q

What are Tumour Supressor Genes?

A

Both need to be inactivated (recessive)
Can be germ line or acquired

Eg - P53 (involved in cell cycle regulation and maintaining integrity)

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3
Q

What are Proto- Oncogenes?

A

Functions become enhanced in carcinogenesis
Usually encodes growth factors, growth factor receptors and transcription factors
Only requires one mutation

Eg RAS (encodes GProtein for cellular signal transduction)

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4
Q

What are mutations of DNA repair?

A

Mutation of these accelerate mutations of tumour supressor and proto-oncogenes

Eg ATM gene (detects DNA damage, produces syndrome of ataxia telangiectasia)

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5
Q

What are BRCA1/2 genes?

A

Tumour Supressor genes

Carriers have a 55-85% lifetime risk

40% increase of Ovarian with BRCA1

Increased incidence of male breast/prostate/pancreas

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6
Q

What is the RB1 gene?

A

On chromosome 13 encoding a tumour Supressor gene

If both alleles are inactivated - Retinoblastoma

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7
Q

What is the APC gene?

A

Tumour Supressor on chromosome 5

Associated with FAP

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8
Q

What is the most important known carcinogen?

A

Smoking

Responsible for 90% of lung cancers

Synergistic effect on neoplasms caused by other things (eg alcohol)

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9
Q

Name four cancers that alcohol is particularly implicated in

A

H and N
Oesophageal (particularly squamous)
Breast Cancer
HCC

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10
Q

Diet can have a massive impact on the occurrence of Cancer. Give four cancers particularly related to obesity.

A

Endometrial
Post Menopausal Breast Cancer
Oesophageal Cancer
Colorectal

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11
Q

How can Colon Cancer risk be reduced with diet?

A

High levels of vegetable and fibre intake

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12
Q

What is the relation of Salt Fish in terms of cancer?

A

Increased incidence of Nasopharyngeal Cancer

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13
Q

What is the relation of Aflatoxin (found in corn, nuts, soybeans) and Cancer

A

Increased incidence of HCC

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14
Q

Viral infections play a significant role in initiating carcinogenesis but do require other factors. Name three carcinogenic viral infections

A

HPV
Hep B and Hep C
EBV

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15
Q

What two malignancies is EBV most associated with?

A

Hodgekins Lymphoma

Burkitt’s Lymphoma

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16
Q

Name a carcinogenic bacterial infection

A

H.Pylori

Strong association with Gastric Adenocarcinoma and a role in the development of gastric lymphoma

17
Q

Name a carcinogenic parasitic infection

A

Schistosomiasis

Associated with SCC of the bladder

18
Q

Name two Radiosensitivity Syndromes

A

Ataxia Telangiectasia

Blooms Syndrome

19
Q

Name three industrial exposures and their associated cancers

A

Napthylamines (Dye/Textile) - Bladder Cancer

Benzenes (Chemical/Rubber) - Haematological

Asbestos - Mesothelioma

20
Q

Give two examples of potentially carcinogenic pharmacological interventions

A

Therapeutic cancer treatments (Alkylating)

High dose diethylstilbestriol in pregnancy (causing clear cell carcinoma of female offspring)

21
Q

Describe three characteristic features of familial cancers

A

Unusually early age of tumour onset

Multiple/Bilateral Tumours

Familial Clustering (eg breast and ovary, uterus and colon)

22
Q

Cowden Syndrome is an Autosomal Dominant condition of Hamartomas and increased risk of cancers (breast, thyroid and uterine). Name three symptoms

A

Mucosal Cobblestone Papules
Acral Keratoses
Craniomegaly

23
Q

Gorlin Syndrome is a syndrome of increased BCC risk. Give two presenting features

A

Frontal Bossing

Palmar and Plantar Pits

24
Q

Neurofibromatoses is a syndrome of increased neural tumours . Give three presenting features

A

Café au Lait

Cutaneous Neurofibromas

Axillary Freckling

25
Q

Describe four implications of Familial Genetic Testing

A
  • May be negative but this doesn’t mean there isn’t a risk
  • Sometimes might just not have a clear result and will therefore require further testing
  • Positive result may cause feelings of guilt in affected family member
  • Affected person may discover they’re at risk of other cancers
26
Q

BRCA1/2 testing if offered if chance of identifying a mutation is >20% . Give three examples of this.

A

Two breast cancers in under 30y
Three breast cancers in under 40y
Four breast cancers in under 50y

27
Q

Bowel Cancer screening is done by testing sample for mismatch repair. Give three examples when this is done

A

One relative under 45y
Two relatives under 55y
Three relatives at any age

28
Q

How are the results from Bowel Cancer screening managed?

A

Moderate Risk- Colonoscopy at presentation and 55y

High Risk - 2 yearly colonoscopies from the age of 25

29
Q

What are the six hallmarks of cancer?

A 
Resisting cell death
Sustaining proliferative signalling
Evading growth suppressors 
Ability to invade and metastasise
Enabling replicative mortality
Inducing angiogenesis
30
Q

Define Tumour

A

Abnormal mass of tissue resulting from excessive cell division and evasion of apoptosis
Can be benign or malignant

31
Q

What is a benign growth?

A

Not Cancerous

Local problems (do not spread)

Don’t return once removed

32
Q

What is a malignant growth?

A

Cancerous

Can spread and invade other tissues

33
Q

What is Premalignant Dysplasia?

A

Dysfunctional cell growth and morphological changes in cell nuclei

Lose specific characteristics from tissue of origin

Classified by grade

34
Q

What is Metaplasia?

A

Reversible replacement of one cell type by another

Can be benign

35
Q

What is the difference between stage and grade?

A

Stage - How advanced the cancer is

Grade - Refers to Histological and pathological features of cells in a neoplasm

36
Q

There are three main types of biopsy: FNA, Core Biopsy and Surgical Biopsy. What is an FNA?

A

Negative pressure removes tissue with force

Deep tissue may require radiological guidance

37
Q

There are three main types of biopsy: FNA, Core Biopsy and Surgical Biopsy. What is an Core Biopsy?

A

Larger cylindrical core of tissue providing a larger sample

38
Q

There are three main types of biopsy: FNA, Core Biopsy and Surgical Biopsy. What is an Surgical Biopsy?

A

Incisional - removes parts of abnormal tissue

Excisional - removes entire area of abnormality (for curative intent)

39
Q

What are the seven principles of screening?

A
  • The cancer will be a major health problem
  • Will be more treatable of detected early
  • Should be acceptable to those eligible
  • Should be inexpensive
  • High sensitivity
  • High specificity
  • Screening reduces mortality

Year 4 Cancer Care and Haem (16 decks)

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