Introduction (Week 1 Lecture 1)

Question 1

Cancer incidence

Answer 1

new cancer cases observed over a period of time

Question 2

Cancer prevalence

Answer 2

numbers of people alive at a specific point in time with cancer

Question 3

cancer mortality

Answer 3

death due to cancer

Question 4

Why might cancer be the leading cause of death?

Answer 4

Obesity is the leading cause of cancers
* weight gain cancers are most effected by obesity

Question 5

Prevalence of cancer in Canada

Answer 5

• 2 in 5 Canadians (44% of men and 43% of women) are expected to develop cancer during their lifetime.
• About 1 out of 4 Canadians (26% of men and 22% of women) is expected to die from cancer.

Question 6

Average age for cancer

Answer 6

65 years

Question 7

What are the leading types of cancers in adults?

Answer 7

1. prostate for M and breast cancer for F
2. Colorectal for both

Question 8

What are the leading cancers in children?

Answer 8

1. Leukemia
2. CNS
3. lymphoma

Question 9

Economic burden of cancer

Answer 9

billions of dollars

Question 10

What are the hallmarks of cancer?

Answer 10

• evading growth suppressors
• nonmutational epigenetic reprogramming
• avoiding immune destruction → tumour cells can cloak and lymphocytes cannot detect
• enabling replicative immortality → infinite cell division
• tumor-promoting imflammation → inflammation response increases blood flow to the tumour
• polymorphic microbiomes → bacteria, fungi, viruses)
• activating invasion & metastasis
• inducing or accessing vasculature
• senescent cells
• genome instability & mutation
• resisting cell death
• deregulating cellular metabolism
• unlocking phenotypic plasticity
• sustaining proliferic signalling

Question 11

What does staging cancer tell us

Answer 11

Describes the severity of cancer
* Extent of original tumour
* Spread of the tumour

Question 12

Importance of staging cancer

Answer 12

• Planning appropriate treatment
• Estimating prognosis
• Clinical trial entry
• Provides a common terminology for patient care

Question 13

Difference between benign and malignant

Answer 13

Primary tumour (benign) growing in place it began but then it can migrate to local tissue and then get into circulation (blood and lymph) and start to reside in other tissue
* benign —> resides in 1 place
* malignant—> wont stop dividing and doesn’t know where it should be so wanders all over the place

Question 14

How is staging of cancer determined?

Answer 14

• physical exams
• imaging studies
• laboratory tests
• pathology reports
• surgical reports

Question 15

physical exams to determine cancer stage

Answer 15

physician examines the patients and looks, feels and listens for anything unusual. The physical exam may show the location and size of the tumor(s) and the spread of the cancer to the lymph nodes and/or to other organs.
* i.e. swollen lymph nodes

Question 16

Imaging studies to determine cancer

Answer 16

capture images inside the body. Imaging techniques include x-rays, computed tomography scans (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. These show the location of the cancer, the size of the tumor, and whether the cancer has spread.
* risk/benefit with radiation causing cancer but benefits outway this
* main way to diagnose tumours to find particular masses with radioactive dye and detecting glucose uptake of tissue to get biological activity

Question 17

Laboratory tests for determining cancer

Answer 17

include studies of blood, urine, other fluids, and tissues taken from the body. For example, tests for liver function and tumor markers can provide information about the cancer.
* provincial law to biopsy for potential positive identification

Question 18

pathology reports for determining cancer

Answer 18

may include information about the size of the tumor, the growth of the tumor into other tissues and organs, the type of cancer cells, and the grade of the tumor. Pathology report is typically provided on a biopsy sample, whereas cytology describes findings from an examination of cells in the body.

Question 19

Surgical reports

Answer 19

tell what is found during surgery. These reports describe the size and appearance of the tumor and often include observations about lymph nodes and nearby organs.

Question 20

Elements of staging system

Answer 20

• Site of the tumour (Primary)
• Tumor size and number
• Lymph node involvement
• Cell type (morphology of cancer)
• Tumour grade (how closely do they resemble “healthy” cells?)
• Presence or absence of metastasis

Question 21

Location stages

Answer 21

• In situ
• localized
• regional
• distant
• unknown

Question 22

In situ

Answer 22

Abnormal cells are present only in the layer of cells in which they developed.

Question 23

localized

Answer 23

Cancer is limited to the organ in which it began, without evidence of spread.

Question 24

regional

Answer 24

Cancer has spread beyond the primary site to nearby lymph nodes or organs and tissues.

Question 25

Distant

Answer 25

Cancer has spread from the primary site to distant organs or distant lymph nodes.

Question 26

Unknown

Answer 26

There is not enough information to determine the stage.

Question 27

TMN staging

Answer 27

• T umor, extent of tumor → Tx, T0, Tis, T1, T2, T3, T4 (range of size)
• N odes, extent of spread to lymph nodes → NX, N0, N1, N2, N3 (number od nodes)
• M etastasis, extent of distal metastasis → MX, M0, M1

x = unknown; 0 = not; is = in situ

Question 28

treatments for cancer

Answer 28

• surgery
• chemotherapy
• radiotherapy
• immunotherapy

Question 29

surgery treatment

Answer 29

Involves removal of the primary tumor
* May also occur with other treatment modalities
* Usually localized

Question 30

chemotherapy treatment

Answer 30

Drugs, or a combination of
cytotoxic drugs are used (many classes)
* oral

Question 31

radiotherapy treatment

Answer 31

Radiation beams directed at tumor
* localized

Question 32

immunotherapy

Answer 32

targeted therapies
* usually oral