Lect 22 - Behaviour of Tumours Flashcards
how many patients are killed by Metastatic Disease?
Half of all cancer patients
The majority of lung cancer patients
One third of breast cancer patients
( on the other hand Essentially no patients with basal cell carcinoma)
What molecules attach cells to the extracellular matrix?
Integrins
What molecules attach cells to eachother?
Cadherins
Mutation of E-cadherin leads to loss of cell-cell adhesion
what process gives cancer cells motility?
Epithelial – Mesenchymal Transition
what enzymes can cancers give out to Degrade the extracellular matrix
Proteolytic Enzymes (Matrix Metalloproteinases)
when a patient’s cancer presses against vessels, what are they at risk of?
Pressure atrophy
how are hypotheses of patterns of metastatis divided
Mechanical hypothesis - directed by anatomy ie lymp/blood. grow where they end up.
Seed and Soil hypothesis - they go everywhere but only grow in certain vulnerable tissues
define stage of a cancer
How advanced is the tumour? Has the cancer spread and if so what is the extent of spread.
define grade of a tumour
how aggressive is the tumour? How different does it look from tissue of origin.
how are tumours staged?
using TMN:
T = TUMOUR (Size) M = METASTASES (present?) N = NODES (lymph involved)
are the TMN catagories the same for every cancer?
Each organ has an individual TMN system
Stage can be clinical, pathological or radiological
what are the boundaries of breast cancer T stage
T1 5cm
T4 Involving skin or chest wall
what are the boundaries of Breast caner N stage?
No - no nodes
N1 Ipsilateral nodes
N2 lots of node involvement.
Colorectal Cancer uses a different staging system - what is it
Dukes Staging
what are the 4 parts of Dukes staging?
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
