L22- Behaviour of Tumours

Question 1

Malignant Tumours : What is invasion of a tumour?

Answer 1

Invades adjacent normal tissue

Destroys normal tissue

Question 2

Malignant Tumours: What is Metastasis of a tumour?

Answer 2

Spreads from site of origin to distant sites and forms new tumours in these new areas

Question 3

What occurs as a result of invasion?

Answer 3

Increased motility

Decreased adhesion

Production of proteolytic enzymes

Question 4

Epithelial cells vs Mesenchymal cells in tumours

Answer 4

There is a Epithelial – Mesenchymal Transition when it becomes malignant

Epithelial cells are tightly connected, polarised and tethered

Mesenchymal cells loosely connected, able to migrate

In cancer epithelial cells gain mesenchymal properties and can invade and migrate

Question 5

Metastasis - Routes : Lymphatic

Answer 5

Distant or local lymph nodes

Question 6

Metastasis - Routes: Blood

Answer 6

Liver, lungs, bone, brain etc

Question 7

Metastasis - Routes: Transcoelomic

Answer 7

Across peritoneal, pleural, pericardial cavities or in CSF

Question 8

Metastasis - Routes: Implantation

Answer 8

Spillage of tumour during biopsy/surgery

Question 9

What are the stages of Metastasis?

Answer 9

1) Detachment invasion
2) Intravasation
3) Survival Against Host defences
4) Adherence Extravasation
5) Growth

Question 10

Stages of Metastasis: What is Intravasation

Answer 10

the invasion of cancer cells through the basal membrane into a blood or lymphatic vessel

Question 11

What is the pattern of Metastasis spread between Carcinomas and Sarcomas?

Answer 11

Carcinomas - Lymphatic spread first

Sarcomas - Blood spread first

Question 12

Where do Transcoelomic Tumours tend to metastasise to?

Answer 12

Ovaries

Question 13

Where do Brain and adrenal Tumours tend to metastasise to?

Answer 13

Lungs

Question 14

Bone metastasises can be….

Answer 14

Lytic

or

Sclerotic

Question 15

Why are cancers staged and graded?

Answer 15

Determine Prognosis – survival time, quality of life

Decide how to treat the tumour

Research – compare therapies or prognostic factors

Question 16

What are cancer stages?

Answer 16

How advanced is the tumour?

Has the cancer spread and if so what is the extent of spread

Has it metastasised?

Question 17

What are cancer Grades?

Answer 17

how aggressive is the tumour?

Differentiation – how much does the tumour resemble tissue it originates from

How fast is it growing?

Question 18

What are tumours graded by?

Answer 18

TMN system

T= Tumour - Size +/- extent of primary tumour

M= Metastases - Presence and extent of distant metastases

N= Nodes - = Presence and number of lymph node metastases

TMN can be combined to give an overall stage for the tumour —> 1 to 4

Question 19

In breast cancer staging, what does Tis (Tumour stage) mean?

Answer 19

In situ disease

Question 20

Name the stages of Dukes Staging for Colorectal Cancer ? (A—>D…gets worse as you go up the alphabet)

Answer 20

A = invades into, but not through bowel wall

B = invades through the bowel wall but with no lymph node metastases

C = Local lymph nodes involved

D = Distant metastases