Lecture 11.1: Effects of Neoplasms on the Host

Question 1

Red Flags for Lung Cancer (4)

Answer 1

• Age 40 years and over with
• Persistent cough for more than three weeks
• Recurrent chest infections
• Coughing up blood (haemoptisis)

Question 2

Red Flags Oral Cancer (3)

Answer 2

• Red and white patches
• Ulcers that do not heal within three weeks
• An unexplained lump in the neck, on the lips or in the mouth

Question 3

Red Flags Upper Gastrointestinal Cancer (9)

Answer 3

• Difficulty swallowing is a red flag in all cases, irrespective of age
• Age 55 years and over
• Unintentional weight loss
• Persistent indigestion/nausea/vomiting on most days for 3 weeks
• Food sticking on swallowing
• Tongue or mouth ulcer lasting longer than three weeks
• Upper abdominal pain
• Dyspepsia
• Reflux

Question 4

Red Flags for Lower Gastrointestinal Cancer (3)

Answer 4

• Age 40 years + with unexplained weight loss and abdominal pain
• Age 50 years + with unexplained rectal bleeding
• Age 60 years + with changes in their bowel habit

Question 5

Red Flags for Skin Cancer (3)

Answer 5

• Any age
• New mole persisting for more than four weeks
• Significant change in an existing mole

Question 6

Red Flags for Renal Tract Cancer (4)

Answer 6

• Age 45 years and over
• Visible blood in the urine
• Persistent change in the bladder habit for 4 weeks
• Problems with urination (ask during medicine use review)

Question 7

Red Flags for Head & Neck Cancer (3)

Answer 7

• Unexplained lump in neck
• Unexplained ulceration in mouth lasting more than three weeks
• Age 45 years and over + persistent hoarseness for four weeks

Question 8

Red Flags for Breast Cancer (7)

Answer 8

• Age 30 years and over + unexplained breast/axilla lump

Age 50 years and over with any of the following symptoms in one nipple only:
• Discharge
• Retraction
• Other changes of concern
• With an area of persistent skin changes on breast

Question 9

What can tumour biomarkers can be comprised of? (3)

Answer 9

• Hormones
• Enzymes
• Immunoglobulins

Question 10

Examples of Isoenzyme Biomarkers (4)

Answer 10

• Acid phosphatase – in prostate cancer
• Placental ALP - in sera with various malignant diseases
• Novel gamma-glutamyltranspeptidase (gamma-GTP) isoenzyme -
60% of sera from patients with HCC
• Variant ALP - specific tumour marker for hepatocellular carcinoma
(HCC)

Question 11

CA 125 Tumour Biomarker: What type? What cancers is it associated with?

Answer 11

• Antigen Biomarkers
• Ovarian Cancer
• Uterine Cancer
• Cervical Cancer
• Pancreatic Cancer
• Lung Cancer
• Colon Cancer
• Breast Cancer
• Other GI Cancers

Question 12

CEA (carcino-embryonic antigen) Tumour Biomarker: What type? What cancers is it associated with?

Answer 12

• Antigen Biomarkers
• Used to monitor Colorectal Cancer disease and treatment
• Lung
• Breast Cancer
• Pancreas Cancer
• Stomach Cancer
• Cervix Cancer

Question 13

What are Pleomorphic Cells?

Answer 13

Cells that have variation in the size and shape of cells or their nuclei

Question 14

What are the Hallmarks of Malignancy? (6)

Answer 14

• Growth signals: autonomous drive to proliferation
  (activation of oncogenes such as ras or myc)
• Inactivation of tumour suppressor genes, such as
  Rb (inhibits growth)
• Avoid programmed cell death (apoptosis)
• Limitless replication potential
• Sustained angiogenesis
• Tissue invasion and metastasis

Question 15

Local Effects of Neoplasms on the Host (5)

Answer 15

• Mechanical pressure or obstruction
• Tissue destruction
• Non-metastatic hypercalcaemia
• Haemorrhage
• Infection

Question 16

Systemic Effects of Neoplasms on the Host (8)

Answer 16

• Pyrexia
• Cachexia
• Immune system
• Haematological effects
• Endocrine effects
• Bone and soft tissue (non-metastatic)
• Nerve and muscle (non-metastatic)
• Skin