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MD2 Foundation > Introduction to Cancer Medicine > Flashcards

Introduction to Cancer Medicine Flashcards

1
Q

What have the improvements in cancer medicine?

A 
Prevention
- Smoking cessation
- Sun smart
Screening
Diagnosis
Treatment
Holistic approach
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2
Q

What is the uptake of mammography screening?

A

40-50%

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3
Q

What is the uptake of faecal occult blood screening?

A

1 in 3

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4
Q

What are the hallmarks of cancer?

A 
Evading apoptosis
Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Tissue invasion and metastasis
Limitless replicative potential
Sustained angiogenesis
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5
Q

What does the doctor need to do when a woman presents with a breast lump?

A 
Take full history
- Family history of cancer
- History of lump
Perform full examination
Assess breast mass itself
Imaging
- Ultrasound
- Mammography
Referral to breast surgeon
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6
Q

How can a breast lump be orientated?

A

Like clock face

Distance from nipple

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7
Q

How do you describe a breast lump?

A 
Orientation
Fixed/mobile
Texture
Skin changes
Pain
Nipple retraction
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8
Q

What does nipple retraction suggest?

A

Advanced mass

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9
Q

What are the available local therapies?

A

Surgery

Radiotherapy

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10
Q

What are the available systemic therapies?

A

Chemotherapy
Hormone therapy
Immunotherapy
Molecular therapy

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11
Q

How does molecular therapy work?

A

Only acts if there’s a target

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12
Q

What is the role of clinical trials in cancer care?

A

Important aspect

Only 5-10% of patients get onto clinical trials

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13
Q

What sort of therapy does a local problem require?

A

Local

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14
Q

What sort of therapy does a systemic problem require?

A

Systemic

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15
Q

What is sentinel node biopsy?

A

Inject blue dye/radioactive material into tumour bed
Visualise movement of injected fluid
First lymph node to pick up fluid = sentinel node

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16
Q

What is Her-2?

A

Growth factor receptor

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17
Q

Why is a breast tumour assessed for the presence of Her-2?

A

In 20-25% of patients, Her-2 amplified > more aggressive cancer
Target therapy available: herceptin binds to EC domain of Her-2

18
Q

In which stages of the tumour is it not necessary to do a full body CT scan?

A

Stage 1-2

19
Q

What does it mean if a cancer is locally advanced?

A

Big in terms of tumour size, or involvement of regional lymph nodes

20
Q

What is adjuvant therapy?

A

Therapy that aims to improve chance of cure to prevent chance of relapse

21
Q

What is neo-adjuvant therapy?

A

Given before surgery to decrease size of tumour

22
Q

In which cancers is adjuvant treatment common?

A

Breast
Colon
Lung
Sarcoma

23
Q

What sorts of risks does adjuvant therapy decrease?

A

Risk of local recurrence
Risk of systemic recurrence
Improves overall survival

24
Q

Is adjuvant therapy finite or ongoing?

A

Finite - 3-6 months

25
Q

Why is some toxicity tolerated in adjuvant therapy?

A

Because looking at long-term cure

Level of toxicity tolerated higher than that for palliative therapy

26
Q

Where does breast cancer commonly metastasise to?

A

Bone
Liver
Brain

27
Q

How does treatment intent change when a cancer goes from being curable to incurable?

A

Treatment now palliative

Emphasis on quality of life

28
Q

Why is breast cancer relapse often treated, provided the patient is well?

A

Because quite chemosensitive

29
Q

What is the ECOG scale of performance status?

A

Describes patient’s level of functioning in terms of their ability to

  • Care for themselves
  • Daily activity
  • Physical ability
30
Q

What are some examples of metastatic cancers that can be cured?

A

Stage 4 lymphoma
Metastatic bowel cancer - to liver only
Germ cell cancer with lung metastasis
Sarcoma with lung metastasis

31
Q

What are some examples of local cancers that can’t be cured?

A

Glioblastoma
Stage 3 primary lung cancer
Stage 3c cervical cancer
Peritoneal cancer

32
Q

Why is it important to discuss treatment goals with patients?

A

So they have realistic expectations

33
Q

What are some guiding principles in cancer medicine?

A 
Biopsy critical
Refer to appropriate clinicians
Define disease extent
What is intention of treatment?
Performance status more important than age
Multi-disciplinary care
34
Q

Is palliative care synonymous with terminal care?

A

No

35
Q

Name the molecular target and the cancer in which it used for the following drug: glivec/imatinib?

A

Bcr-Abl in chronic myeloid leukaemia

C-kit in gastrointestinal stromal tumours

36
Q

Name the molecular target and the cancer in which it used for the following drug: iressa/gefitinib?

A

Anti-EGFR in lung cancer

37
Q

Name the molecular target and the cancer in which it used for the following drug: bevacizumab?

A

VEGFR in colon cancer

38
Q

Name the molecular target and the cancer in which it used for the following drug: sunitinib?

A

VEGFR in renal cancer

39
Q

Name the molecular target and the cancer in which it used for the following drug: herceptin/trastuzumab?

A

Her-2 in breast cancer

40
Q

Name the molecular target and the cancer in which it used for the following drug: mabthera/rituximab?

A

Anti-CD20 in lymphoma

41
Q

Name the molecular target and the cancer in which it used for the following drug: vemurafenib?

A

B-Raf in melanoma

42
Q

Name the molecular target and the cancer in which it used for the following drug: crizotinib?

A

ALK in lung cancer

MD2 Foundation (42 decks)

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