L07: Diagnosis And Treatment Of Cancer Flashcards
What are the 3 diagnostic pathway for diagnosing cancer
Symptomatic e.g weight
Screening test
Incidental of a different symptom
What are the 4 methods to diagnose cancer
History taking
Imaging
Blood test
Tissue biopsy
List the common symptoms that might suggest the types of cancer
- Change in bowel or bladder habits (for stomach, colon, pancreatic cancer)
- a sore that does not heal with unusual shape and fail smelling discharge (skin cancer)
- unusual bleeding when passing urine (bladder, kidney cancer)
- breast lump or thickening (breast cancer)
- indigestion or difficulty in swallowing (throat or oesophageal cancer)
- extreme fever with night sweat (lymphoma)
- persistent cough or hoarseness (lung cancer)
What are the common symptoms of lung cancer
Cough Breathlessness Pain Loss of appetite Coughing up blood
If someone has these symptoms what also should be explored
Smoking status
Occupational exposure to chromium, arsenic and asbestos
Characteristic of symptom i.e has anything changed
What are the signs of local spread in lung cancer
Obstruction to superior vena cava
Horners syndrome: pupil is small, droopy eyelid
Pancoast syndrome
If there is ectopic hormone production what can it present as
Cushing’s syndrome
What are the major symptoms of colon cancer
Change in bowel habits Red blood dark, red or black Discomfort in abdomen Weight loss Anaemia
After an clincal examination what sort of imaging can be done
Ultrasound
Ct scan
MRI scan
Radio isotope scans
Which imaging is 3D
Ct scan
MRI scan
Name some example of radio isotope scans
Bone scans
Pet scan
MIBG scan
What is radio-isotope scans for
Metastatic cancer
If there is a mass upon imaging what is done next
Tissue biopsy
When we do blood tests for patients with cancer what do we look for
Tumour markers
Give an example of tumour marker for prostate cancer
Prostate specific antigen (PSA) cancer
What is the NICE guideline for rapid referral
If you have symptoms of cancer you should be seen in 2 week wait referral for further investigation
Before giving treatment to a patient with cancer what do we have to do
Stage
What is staging based on
Size and location and spread of the cancer
What system do we use to stage cancer
TNM
What does TNM stand for
T= tumour Size n= lymph nodes M= metastases
How many T stages are there
4
What does t1 mean
Invades the mucosa
What does t2 mean
Invades the muscularis propria
What does t3 mean
Invades to subserosa
What does t4 mean
Invades other organs
How many stages of N are there
3
What is N0
No node metastasis
What is n1
1 or 3 pericolic nodes
What is N2
More than pericolic nodes
What is N3
Vascular trunk nodes
What are the stages of m
M0- no metastasis
M1= distant metastasis
What are the treatment modalities of cancer
Surgery
Radiotherapy
Chemotherapy
What is neo adjuvant chemotherapy
Chemotherapy that your start prior to surgery so you shrink the tumour
Why is adjuvant chemotherapy
Chemotherapy that is deliver after the primary treatment to destroy the remaining cancer cells
What does chemotherapy involve
Cytotoxic drugs
Small molecule targeted drugs
Immunotherapeutics
How do cytotoxic drugs work
Toxic drugs that are for rapidly diving cells they also target normal cells
What are small molecule targeted drugs
Specific agents that target small molecules such as receptors e.g receptor tyrosine kinase inhibitors
What does immunotherapy involve
Monoclonal antibodies
Checkpoint inhibitors
Oncolytic vaccines
Car-t-cell therapy
What is the 2nd most commonest bone tumour in childhood
Ewing sarcoma
What is the treatment for Ewing sarcoma
Surgery
Chemotherapy
Radiotherapy
What are the chemotherapy drugs given for Ewing sarcoma
Vincristine Actinmycin D Andriamycin Alkalayting agents Etoposide
What other treatments are available to treat cancer
Personalised medicine
What is palliative care about
Adding days to life and improve quality
