Intro to Oncology Flashcards
Cancer affects _____ of dogs and _____ of cats
1/3 of dogs and 1/4 of cats
Carcinomas generally spread via _______
lymphatics
Sarcomas generally spread via_____
hematogenous routes
6 Hallmarks of cancer
- resisting cell death
- sustaining proliferative signaling
- evading growth suppressors
- activating invasion and metastasis
- enabling replicative immortality
- inducing angiogenesis
What are the “emerging hallmarks” of cancer?
- deregulating cellular energetics
2. avoiding immune destruction
What are the “enabling characteristics” of cancer?
- genome instability and mutation
2. tumor-promoting inflammation
Drugs that interfere with sustaining proliferative signaling
Palladia, Masitinib
Therapies/drugs that interfere with tumors ability to avoid immune destruction
Metronomic Chemotherapy, Palladia, Masitinib
Therapies/drugs that interfere with induction of angiogenesis by tumors
Metronomic Chemotherapy, Palladia, Masitinib
Therapies/drugs that interfere with a tumors ability for replicative immortality
telomerase inhibitors
PAPR inhibitors interfere with what characteristic of cancer?
genome instability & mutation
Therapies/drugs that inhibit a tumors ability to deregulate cellular energetics
aerobic glycolysis inhibitors
Tumor cells often have mechanisms to resist cell death, but this class of drugs acts to interfere with this property.
BH3 mimetics
Carcinomas originate from __________
epithelial or glandular tissue
Sarcomas originate from ________
mesenchymal cells
Types of round cell tumors to be familiar with
- lymphoma
- MCT
- plasma cell tumor
- histiocytoma
- TVT
Name a breed predisposed to MCTs
Boxers
Name a breed predisposed to TCC
Scottish Terriers
Name a breed that often gets histiocytomas
Bernese Mtn Dogs
Name a tumor type that has a bimodal age distribution in animals
osteosarcoma
Why should you stain (diff-quik) one slide in-house?
to ensure you have a diagnostic sample to send off
What should you not package cytology samples with or get them near?
formalin! even the vapors can make them nondiagnostic
What is one tumor type that seeding IS a high risk if FNA is done?
TCC of lower UT
Histopathology characteristics
- more invasive than cytology
- larger sample size
- tissue architecture maintained
- can evaluate surrounding tissue reaction and invasion by the tumor
______ is thought of as an indicator of how quickly the tumor is likely to grow and spread
grade
Are all tumors graded the same?
no, and not all tumor types have a validated grading scheme
Why should resected tissue be submitted even when you had a pre-op diagnosis?
the grade could increase when more tissue is evaluated, possibly changing course of treatment and/or prognosis
“TNM” staging stands for _____?
Tumor, Node, Metastasis
____% of dogs that have oral melanoma and normal sized lymph nodes have microscopic evidence of metastasis
40%
When staging, what else besides palpate regional lymph nodes should you do?
FNA or biopsy
What modalities are used for evaluating distant metastasis?
Rads, US, CT or MRI, nuclear scintigraphy, PET/CT
You have a bladder tumor in a Scottish Terrier-what next tests do you suggest?
Abd US & Chest x-rays
You have a MCT on the left tarsus of a Golden Retriever-what next tests do you suggest?
Abd US
You have a soft tissue sarcoma on the maxilla of a Lab-what next tests do you suggest?
Chest x-rays
What is a paraneoplastic syndrome?
a disease or symptom that is a consequence of cancer being in the body, but NOT due to local presence of cancer cells
What are four reasons paraneoplastic syndromes are important
- diagnostic aid
- contributors to morbidity/mortality
- indicators of tumor biology
- marker for treatment response/recurrence
A cat with alopecia and shiny skin is a classic presentation for ____________
pancreatic adenocarcinoma
Two GI paraneoplastic syndromes
- cancer cachexia
2. GI ulceration
GI ulceration is a paraneoplastic syndrome that is most common with what type of tumors?
MCT
How do MCTs lead to GI ulceration?
degranulation of many mast cells at once->increased serum histamine->stimulation of gastric H2 receptors->increased gastric acid secretion->ulceration
Three endocrine paraneoplastic syndromes
- hypercalcemia
- hypoglycemia
- ectopic ACTH
Hypercalcemia DDX
D-vitamin D, dehydration R-renal, raisins A-Addison's, aluminum or vitamin A toxicity G-granulomatous disease, grapes O-osteolytic N-neoplasia S-spurious H-hyperparathyroidism, house plants, humoral hypercalcemia of malignancy I-idiopathic T-temperature (hypothermia)
Five hematologic paraneoplastic syndromes
- hypergammaglobulinemia
- anemia
- erythrocytosis
- neutrophilic leukocytosis
- thrombocytopenia/coagulopathy/DIC
Hypergammablobulinemia is associated with ________
multiple myeloma
What are some possible causes of anemia?
- anemia of chronic dz
- IMHA
- blood loss
- microangiopathic hemolysis
- bone marrow hypoplasia-secondary to hyperestrogenemia
What are six cutaneous paraneoplastic syndromes?
- alopecia
- flushing
- nodular dermatofibrosis
- necrolytic migratory erythema
- cutaneous necrosis of hind feet
- pemphigus vulgaris
Renal paraneoplastic syndromes
glomerulonephritis/nephrotic syndrome
Neurologic paraneoplastic syndromes
- myasthenia gravis
2. peripheral neuropathy
Misc. paraneoplastic syndromes
- hypertrophic osteopathy
2. fever
What is the main tumor type that myasthenia gravis is associated with?
thymoma
Clinical signs of myasthenia gravis
- exercise intolerance
- dysphagia
- megaesophagus
Myasthenia gravis often responds well to what treatment?
treatment of primary tumor (e.g. often thymoma)
Hypertrophic osteopathy is usually secondary to a tumor located where?
lungs
Treatments for hypertrophic osteopathy
- remove primary tumor
- supportive care
