Imaging, Biopsy & Principles of treatment in Cancer - (Imaging) Flashcards
When staging a cancer upon diagnosis, does the staging change if new information regarding the cancer is provided?
- no, staging remains the same
- additional information is added to the initial staging
The TNM staging used in cancer relates to:
T = primary Tumour
N = local Nodal involvement
M - metastatic disease
How many stages of T are they typically?
1 - 6
2 - 4
3 - 3
4 - 2
1 - 6
- Tx = tumour cannot be measured
- T0 = tumour cannot be found
- T1-T4 = increases from T1 to T4
The TNM staging used in cancer relates to:
T = primary Tumour
N = local Nodal involvement
M - metastatic disease
How many stages of N are they typically?
1 - 6
2 - 5
3 - 4
4 - 3
2 - 5
- Nx = cancer in nearby lymph nodes cannot be measures
- N0 = no cancer in nearby lymph nodes
- N1-N3 = increasing number of local lymph node involvement
The TNM staging used in cancer relates to:
T = primary Tumour
N = local Nodal involvement
M - metastatic disease
How many stages of M are they typically?
1 - 6
2 - 5
3 - 4
4 - 3
4 - 3
- Mx = metastasis cannot be measured
- M0 = cancer has not spread to other body parts
- M1 = cancer has spread to other body parts
What is the staging process used in lymphoma (cancer of the lymph tissue)?
1 - TNM staging
2 - Nodal staging
3 - Ann Arbor staging system
4 - Dukes staging
3 - Ann Arbor staging system
- stage 1 = 1 lymph node region involved above diaphragm
- stage 2 = 2 lymph node regions involved above diaphragm
- stage 3 = 2 lymph node regions involved, one above and 1 below the diaphragm
- stage 4 = multiple lymph node regions affected and multiple organs
Prior to imaging some tests can be performed in a patient suspected of having cancer. Which of the following are cancer specific?
1 - FBC
2 - Blood chemistry test function
3 - Urinalysis
4 - Cytogenetic analysis
5 - Immunophenotyping
4 - Cytogenetic analysis
- genetic analysis of a tumour biopsy
5 - Immunophenotyping
- immunohistochemistry to diagnose specific cancer, stage, and monitor blood cancers disorders, identify tumour markers and antibodies to help personalise treatment
In the image we can see lymphoma, with spleen and lymph nodes in the hilum region of the lungs. What stage according to the Ann Arbor staging system would this be?
1 - stage 4
2 - stage 3
3 - stage 2
4 - stage 1
2 - stage 3
- lymph nodal involvement above and below diaphragm
Which of the following is most commonly use to stage cancers?
1 - ultrasound
2 - X-ray
3 - CT
4 - MRI
3 - CT
- MRI is good for local staging
What is commonly the 1st line imaging for thyroid nodules and potentially malignancy?
1 - ultrasound
2 - X-ray
3 - CT
4 - MRI
1 - ultrasound
Which imaging is flourodeoxyglucose (FDG) used in?
1 - PET-CT
2 - MRI
3 - CT fluroscopy
4 - radiotherapy
1 - PET-CT
- tumours use a lot of glucose so tumours show up well on imaging
Which radioactive marker can be injected into patients to accurately identify neuroendocrine tumours?
1 - flourodeoxyglucose (F18-FDG)
2 - iodine-131
3 - gallium Ga-68
4 - scandium-46
3 - gallium Ga-68
- still used PET-CT
- can also use this approach with theranostics, which is where radioactive compound targets the tumour
What is a sentinel lymph node?
1 - furthest lymph node affected from primary site
2 - biopsy of lymph node draining tumour
3 - lymph nope biopsy of all lymph nodes in local area
4 - all of the above
2 - biopsy of lymph node draining tumour
- if the lymph node draining tumour is negative then the change the tumour has spread is unlikely
- common in breast cancer
Does cancer typically begin at the somatic or germline level?
- somatic level
Match the definition of adjuvant and neoadjuvant with each of the definitions below:
- therapy given prior to primary intervention to reduce the tumour size
- therapy given following primary intervention
- adjuvant = therapy given following primary intervention
- neoadjuvant = therapy given prior to primary intervention to reduce the tumour size
Oligometastatic and polymetastatic relate to how many metastatic sites there are from the primary tumour. Which relates to lots of metastatic sites?
- polymetastatic
- oligo relates to a few metastatic sites
Is Radiotherapy a?
1 - Loco-regional treatment
2 - Systemic treatment
3 - Palliative treatment
4 - Radical treatment
5 - All of the above
5 - All of the above
- can vary depending on the type of cancer
What type of cell does chemotherapy typically target?
1 - proliferative cells
2 - differentiating cells
3 - specialised cells
4 - all of the above
1 - proliferative cells
- this is when cells increase in number
- BUT chemotherapy does NOT just target cancer cells, hence the side effects
- can target any stage of the cell cycle
Which side effect of chemotherapy can be life-threatening?
1 - Infertility
2 - Maculo-popular skin rash
3 - Febrile neutropenia
4 - Mucositis
3 - Febrile neutropenia
- low number of WBC in the presence of a fever
What is primary drug resistance in cancer treatment?
1 - cancer develops resistance to drug following initial treatment
2 - drug increases growth of cancer
3 - cancer is resistant to drug prior to any treatment
4 - no drugs are effective on cancer
3 - cancer is resistant to drug prior to any treatment
What is secondary drug resistance in cancer treatment?
1 - cancer develops resistance to drug following initial treatment
2 - drug increases growth of cancer
3 - cancer is resistant to drug prior to any treatment
4 - no drugs are effective on cancer
1 - cancer develops resistance to drug following initial treatment
Small molecules are used to treat cancer. What do they typically target?
1 - antigens
2 - receptors
3 - enzymes
4 - phospholipid membranes
3 - enzymes
- tyrosine kinase is an example
What is Synthetic Lethality?
1 - mutation in one of 2 genes can cause cell death
2 - mutation in 2 genes can cause cell death
3 - cell death can occur with 2 normal genes
4 - all of the above
2 - mutation in 2 genes can cause cell death
- in cancer a mutation of one gene can cause cell to grow and development as it has a 2nd gene to help
- however, if there are 2 mutated genes then the cancer cell has no back up gene to help it grow and develop
- in cancer treatment if a cancer cell has the mutated gene we can target the healthy gene, causing the cell to die
Synthetic Lethality is when there is a relationship between 2 genes that are important for cell survival. For example, BRCA2 and PAPR are both involved in DNA repair. Breast cancer causes a mutation in BRCA2, but PAPR can continue to function.
BUT if you target PAPR with cancer treatment the cell can no longer repair and the cancer cell will die
What is Immunotoxin in relation to cancer therapy?
1 - when immunoglobulins are able to detect the cancer and initiate apoptosis
2 - when cancer cells have antigens that immunoglobulins bind with and become toxic
3 - toxic substance is added to immunoglobulins or monoclonal antibody
4 - all of the above
3 - toxic substance is added to immunoglobulins or monoclonal antibody
- once immunoglobulin or monoclonal antibody binds with the cancer cell the toxic substance can then enter the cancer cell and induce apoptosis
