Intro to oncology lecture

Question 1

What are some intrinsic aetiologies of cancer?

Answer 1

• Genetics
  Eg. BRCA, familial polyposis coli, genetic syndromes
• Increased age
• Immune system
  Eg. increased risk of squamous cell carcinoma in organ transplant recipients
• Chronic irritation
  Eg. Increased risk of squamous cell cancer in chronic ulcers and osteomyelitis
• Endogenous exposure to hormones
  Eg. Increased risk of breast cancer if early menarche, late menopause, delayed childbirth, post-menopausal obesity

Question 2

What are some extrinsic aetiologies of cancer?

Answer 2

• Environment
  Eg. Asbestos, tobacco, chemicals, air pollution, radiation, UV radiation, hormones
• Infectious agents
  *HIV – lymphoma, cervical cancer
  *EBV –lymphoma
  *HPV – cervical cancer
  *Hep B – hepatocellular cancer
  *KSHV – Kaposi’s sarcoma
  *H.Pylori – gastric cancer
  *Schistosomiasis – bladder cancer
• Diet
  Eg. alcohol, fat increases risk of breast and colon cancer, animal proteins like red meat increase breast and colon, salt-cured meats: gastric cancer
  fruit+veg is protective

Question 3

What are the symptoms of bone metastesis?

Answer 3

pain, pathological fractures, spinal cord compression, hypercalcaemia

Question 4

What are the symptoms of liver metastasis?

Answer 4

Pain, early satiety, easy bruising, jaundice

Question 5

What are the symptoms of lung metastasis?

Answer 5

SOB, cough, haemoptysis

Question 6

What are the symptoms of brain metastasis?

Answer 6

Confusion, nausea, headaches, motor/sensory symptoms, fits

Question 7

What are Paraneoplastic syndromes?

Answer 7

A group of rare disorders that occur when the immune system has a reaction to a cancerous tumour

Due to hormones or cytokines released by the tumour, or the immune response

Most are rare
Eg. neurological syndromes like cerebellar ataxia or skin rashes like dermatomyositis

Question 8

What are some examples of Paraneoplastic syndromes?

Answer 8

• Cerebellar degeneration: loss of nerves that control muscle functions and balance
• Limbic encephalitis: inflammation of the limbic system, which controls emotions, behaviours and certain memory functions
• Encephalomyelitis: inflammation of the brain and spinal cord
• Opsoclonus-myoclonus: dysfunction of the cerebellum or its connections
• Stiff person syndrome: Progressive, severe muscle stiffness or rigidity, mainly affecting your spine and legs
• Myelopathy: injury limited to the spinal cord, symptoms dependent on the level affected
• Lambert-Eaton myasthenic syndrome: disrupted communication between nerves and muscles
• Myasthenia gravis: rapid fatigue of muscles
• Neuromyotonia: abnormal impulses in nerve cells causing progressive stiffness, muscle cramps, slowed movement and other muscle impairments.
• Peripheral neuropathy
• Dysautonomia injury to the autonomic nervous system causing low bp, irregular heartbeats and trouble breathing

Question 9

What is FIGO staging?

Answer 9

International Federation of Gynaecology and Obstetrics

Used for gynae tumour staging

Question 10

What is Duke staging used for?

Answer 10

Colorectal cancers