Introduction to cancer Flashcards by Emily Moore

What is the six hallmarks of cancer?

Six biological capabilities acquired during the multi-step development of tumours, and is the underlying principles that healthy cells acquire in neoplastic development into tumorigenic cells.

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List the six hallmarks of cancer.

Sustaining proliferative signalling
Evading growth suppressors
Enabling replicative immortality
Activating invasion and metastasis
Inducing angiogenesis
Resisting cell death

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What are the two emerging hallmarks of cancer?

Deregulating cellular energetics
Avoiding immune destruction

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What are the two enabling characteristics of cancer?

Genome instability and mutation
Tumour promoting inflammation

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Where do nearly 50% of all cancer cases occur?

Asia

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Which continent contributes to 22.8% of worldwide cancer cases?

Europe

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What percentage of cancer cases does North America contribute to worldwide?

13.3%

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What percentage of cancer cases does Latin America and the Caribbean contribute to worldwide?

7.6%

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What percentage of cancer cases does Africa contribute to worldwide?

5.7%

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Which are the three types of cancer that have the highest incidence rate among males, worldwide?

Lung
Prostate
Colorectum

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Which are the three types of cancer that have the highest mortality rate among males, worldwide?

Lung
Liver
Colorectum and stomach (very similar mortality rate)

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Which are the three types of cancer that have the highest incidence rate among females, worldwide?

Breast
Colorectum
Lung

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Which are the three types of cancer that have the highest mortality rate among females, worldwide?

Breast
Lung
Colorectum and cervix uteri (very similar mortality rate)

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How cases of cancer are predicted to be preventable in the UK?

38%

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How many new cases of cancers and deaths from cancer each day?

1000 new cases and 450 deaths each day

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What are some of the risk factors of lung cancer?

Smoking
Chemical and workplace risk
Air pollution
Previous lung disease such as COPD or pneumonia
Exposure to radon gas
Family history of lung cancer (in a first degree relative)

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What are some of the risk factors of breast cancer?

Age (>50 years)
Obesity (especially post-menopausal)
Family history and genetics (BCRA1/A2)
Contraceptive pill
HRT
Alcohol
Previous diagnosis of cancer
Physically inactive
Dense breast tissue
Benign breast disease
X-rays and radiotherapy
Diabetes

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What are some of the risk factors of prostate cancer?

Age (most common between 75-79 years)
Ethnicity (more common in Black men)
Family history
Inherited faulty genes
Obesity
Height
Hormone level
Pesticides

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What are some of the risk factors of bowel cancer?

Diet- eating too much red and processed meat, 13% of bowel cancers are linked to poor diet. It is recommended to eat a maximum of 70grams (2 sausages of red meat a day). Eating too little fibre.
Obesity
Exercise
Smoking
Alcohol
Age (40% of all cases are diagnosed in the over 75s)
Family history and genetic conditions
Ulcerative colitis and Chron’s disease
Radiation
Infections
Diabetes
Previous diagnosis of cancer

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What are some of the risk factors of stomach cancer?

Age (half of cases >75 years)
Men more likely than women
Smoking tobacco (associated with 15% of cases)
Obesity
Alcohol (drinking 3 or more units of alcohol daily)
Work chemicals

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What infection is closely associated with stomach cancer?

Helicobacter pylori (H. pylori) responsible for about 40% of cases. The bacteria lives in the mucous in the stomach lining.

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Does H. pylori always cause stomach cancer?

No, normally it does not cause any problems but sometimes it can lead to inflammation and stomach ulcers which can then develop into cancer.

How is H. pylori spread?

Contaminated water and food

How is H. pylori detected?

Blood, stool and breath tests

How is H. pylori treated?

Antibiotics and a medicine to reduce the amount of acid in the stomach

What are some of the risk factors of liver cancer?

Age (>65 years) Men more likely than women Smoking Long-term Hep B or Hep C infection Cirrhosis (scarring of the liver) Type 2 diabetes Metabolic syndrome First degree relative

What are some of the risk factors of cervical cancer?

HPV infection Age (<45 years) Other STIs (chlamydia increases the risk) Smoking tobacco Contraceptive pill Having children (especially those who gave birth under the age of 17) Family history of cervical cancer in a first degree relative Previous cancer (vagina, vulva, urinary tract, kidney)

How many types of HPV are believed to cause cancer?

12 different types

Which types of HPV cause the highest incidence of cervical cancer?

HPV 16 and HPV 18 cause 70% of cervical cancer cases.

How long does it normally take for the body to get ready of a HPV infection?

2 years

How can you reduce the risk of contracting HPV?

As HPV is sexually acquired, it is recommended to wear condoms in order to prevent contracting it. Get vaccinated: HPV vaccine is offered at ages 12 or 13.

What are some of the risk factors of contracting melanoma?

Age (25% of cases occur in the over 75s) Having fair skin or freckles Ultraviolet light Moles Birthmarks Family history (if relative was under 30 or more than one first degree relative) Inherited condition known as familial atypical multiple mole melanoma syndrome Inflammatory bowel disease or a weakened immune system Body weight (overweight men)

What are the risk factors of acute myeloid leukemia?

Age Smoking Obesity Ionising radiation Exposure to benzene at work Inherited conditions Past chemotherapy Blood disorders Autoimmune conditions

What are some of the risk factors of acute lymphoblastic leukemia?

Genetic conditions (Down’s syndrome, Fanconi anaemia, ataxia telangiectasia) Previous treatment with chemotherapy (some chemotherapeutic drugs can increase the risk of ALL) Ionising radiation exposure Exposure to benzene Weakened immunity

What are some of the risk factors of chronic lymphocytic leukemia?

Age Sex Family history (first degree relative) Exposure to chemicals (may increase the risk such as pesticides, some hair dyes but this is uncertain)

What are some of the risk factors of chronic myeloid leukemia?

The only apparent risk factor for CML appears to be radiation even at a low dose of radiation.

Within the same tumour can there be different genetic mutations?

Yes, often there are multiple genetic changes within the same tumour. Changes in genes can be a result of: Inherited mutation Acquired mutations over lifetime

How many types of cancer are heredity cancers?

5-10%

What are some common inherited gene mutations causing cancer?

TP53, BRCA1/2, PTEN

List some of the cancer causing chemical substances?

Aflatoxins * Arsenic * Asbestos * Benzene * Cadmium, Nickel * Coal Tar, Coal emissions, Soot * Radon * Secondhand tobacco smoke * Vinyl chloride * Wood dust

What are some of the types of cancer linked to smoking?

Lung Larynx/Throat/Mouth Oesophagus Kidney Liver Pancreas Colorectal Cervix Acute myeloid leukemia

How does the tumour environment become suppressed?

M2 macrophage activation

What are some of the lifestyle interventions a patient could implement to prevent cancer?

Don't smoke or vape Balanced diet Moderate exercise Alcohol intake under 14 units Reduce exposure to toxins Health and safety in working environment Reduce exposure in water and monitor waste Reduce air pollution Care with exposure to sunlight

What are the most common sites of cancer metastasis?

Brain Respiratory Lymph nodes Liver Skeletal

What are some of the symptoms of cancer in the brain?

Vertigo Seizures Headaches

What are some of the symptoms of cancer in the respiratory system?

Cough Dyspnea Hemoptysis

What are some of the symptoms of cancer in the lymph nodes?

Lymphadenopathy

What are some of the symptoms of cancer in the liver?

Jaundice Hepatomegaly

What are some of the symptoms of cancer in the skeletal system?

Pain Fractures Spinal cord compression

What are some of the examples of imaging used in the diagnosis of cancer?

CT scan, nuclear scan, ultrasound, MRI, PET Scan, Xrays

What are the different types of biopsy?

Needle Endoscopy Surgical excision Incision Or sentinel lymph node biopsy

How is cancer usually diagnosed?

National screening programmes Genetic testing Family history Routine blood tests

What are some of the burdens of cancer?

Physical morbidity * Emotional distress and mental health * Financial distress and loss of job or caring responsibilities * Financial burden to NHS * Postcode lottery for new treatments

What are some of the cancer treatments available?

Surgery Chemotherapy Radiotherapy Laser therapy Immunotherapy Photodynamic therapy Thermal ablation (Heat)