Introduction to Oncology Flashcards
What is cancer?
Diseases in which abnormal cells divide without control and are able to invade other tissues
What are the cardinal features of a cancer?
Loss of regulation of cell division and cell death
Ability to invade surrounding structures/metastasize to other parts of the body
What is a carcinoma?
Cancer that begins in epithelial tissues
Give examples of carcinomas
Adenocarcinoma
Squamous cell carcinoma
Transitional cell carcinoma
Small cell carcinomas
What is an adenocarcinoma?
Cancer from glandular epithelium, e.g. stomach, intestine, some lung cancers
What is squamous cell carcinoma?
From squamous epithelium, e.g. cervix, anus etc.
What is a transitional cell carcinoma?
Cancer from urethelium, e.g. renal pelvis, bladder etc.
What are sarcomas?
Cancer that begins in mesenchyme (e.g. bone, cartilage, fat, muscle, BVs or other connective tissue)
What are leukaemias?
Cancers that start in the blood forming tissue, e.g. bone marrow
What are lymphomas/myelomas?
Cancers beginning in cells of the immune system
What are germ cell tumours?
Cancers originating from germ cells in the testes/ovaries
What are the ways cancer can spread to other tissues?
Direct invasion
Lymphatic spread
Haematogenous spread
Trans-colaemic spread
What is direct invasion?
Directly spreading to adjacent tissues
What is lymphatic spread?
Spread of cancer to regional lymph nodes
What is haematogenic spread?
Spread via the bloodstream to distant organs
Where does prostate cancer tend to spread to?
Bone
Where does bowel cancer tend to spread to?
Liver
What is trans-coelomic spread?
Across one of the three body cavities (pleura, peritoneum or pericardium)
Give an example of a cancer that often spreads trans-coelomic
Ovarian cancer typically spreads across the peritoneal cavity producing multiple seedings in the peritoneum, often causing ascites
What is staging of cancer?
Defining the extent of the spread of cancer
What is the most commonly used staging system for cancer?
TNM staging
T - local tumour extent (1-4)
N - regional nodal involvement (0/1)
M - metastases (0/)1
What imaging is best for prostate cancer?
MRI of pelvis and bone scan to check for mets
What are the three ways in which you can give treatment for a cancer?
Local - aimed at anatomical target
Regional - aimed at treating draining nodal region
Systemic
What are the 4 ‘intents’ of cancer treatment?
Curative/radical - aimed at curing
Palliative - improving QoL/prolonging life if cure not possible
Adjuvant - given after definitive treatment to eradicate micrometastatic disease
Neo-adjuvant - adjuvant treatment given before definitive treatment
What are the main types of local treatment in cancer medicine?
Surgical resection
Radiotherapy
Others: cryotherapy, radiofrequency ablation, photodynamic therapy, high intensity focussed US
What are the two main regional treatments in cancer medicine?
Surgery/radiotherapy to draining lymph nodes
What are the systemic therapies used in cancer medicine?
Chemotherapy
Biologics
Hormonal therapy
Immunotherapy
