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Y1 - PP > Lecture 17 - Neoplasia 5 > Flashcards

Lecture 17 - Neoplasia 5 Flashcards

1
Q

What are the most common cancers world wide?

A

Female breast
Prostrate cancer
Lung
Bowel

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1
Q

What are the 4 most common cancers world wide?

A

Female breast
Prostrate cancer
Lung
Bowel

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2
Q

What are the most common causes of cancer in Males?

What are the most common causes of cancer in Females?

A

Males = Prostate
Females = Breast

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3
Q

Why are most cancers diagnosed at age over 65yrs?

A

There’s more time for initiation, promotion and progression to take place

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4
Q

What are some common cancers in children?

A

Leukaemia
CNS tumour
Lymphomas

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5
Q

What is a commonly used chemotherapeutic drug for prostate cancer?

A

Cisplatin

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6
Q

Why have the incidences of malignant melanoma decreased?

A

Inc public awareness
Better suncream usage

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7
Q

What can be biopsied to see if a malignant melanoma has spread?

A

Sentinel lymph nodes

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8
Q

Why are brain cancers difficult to treat?

A

Hard for chemotherapy agents to cross blood brain barrier

Radiotherapy damages surrounding healthy brain

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9
Q

What determines whether an individual will have a favourable outcome with cancer?

A

Co-morbidities
Age
Tumour site
Tumour type
Tumour stage
Well differentiated

Availability of treatment

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10
Q

What is the definition of cancer specific survival?

A

% of patients with a specific type and stage of cancer who have not died from their cancer during a certain period of time after diagnosis

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11
Q

What is the definition of relative survival?

A

% of cancer patients who have survived for a certain period of time after diagnosis compared to people who do not have cancer

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12
Q

What is the definition of disease free survival?

A

% of patients who have no signs of cancer during a certain period of time after treatment

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13
Q

What is the definition of Cure?

A

There are no traces of cancer after treatment and the cancer will NEVER come back

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14
Q

What is the definition of Resmission?

A

Signs and symptoms of your cancer have reduced

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15
Q

What are the 2 types of remission?

A

Partial remission
Complete remission

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16
Q

What is partial remission?

A

Signs + symptoms of the cancer have reduced

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17
Q

What is complete remission?

A

Signs + symptoms have disappeared

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18
Q

Why is it risky to say that a patient is cured from cancer?

A

May still be some cancer cells in the body and these can come back one day to causes cancer
(Melanoma does this a lot)

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19
Q

How are tumours/cancers classified?

A

TNM staging system (can only be used for solid tumours

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20
Q

What does the TNM staging system mean?

A

T = size of primary Tumour
N = extent of regional lymph Node involvement
M = Metastatic spread via the blood

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21
Q

What are the tumour sizes?

A

T1 (smallest)
T2
T3
T4 (largest)

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22
Q

What are the (N) regional lymph node involvement classifications?

A

N0
N1
N2
N3

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23
Q

What does N0 mean?

A

No evidence of lymph node metastasis

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24
Q

What does N1, N2 and N3 mean?

A

N1 = evidence of a single group of lymph nodes with metastasis
N2 = more lymph nodes affected
N3 = many lymph nodes affected

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25
Q

What does M0 mean in terms of metastatic spread?

A

Don’t have metastasis

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26
Q

What does M1 mean in terms of metastatic spread?

A

Do have Metastatic spread

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27
Q

What is meant by tumour stage?

A

A measure of the overall burden of the malignant neoplasm

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28
Q

What does a Stage 1 tumour/cancer mean?

A

Early local disease

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29
Q

What does a Stage 2 tumour/cancer mean?

A

Advanced LOCAL disease

So N0 and M0 (Large size like T3 or T4)

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30
Q

What does a Stage 3 tumour/cancer mean?

A

Regional metastasis
(Does not spread through blood so is M0)

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31
Q

What does a Stage 4 tumour/cancer mean?

A

Advanced disease with distant metastasis (M1)
METASTATIC

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32
Q

What is the Ann Arbor Staging system used to classify?

A

Lymphomas

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33
Q

What are the 4 stages of the Ann Arbor Staging system?

A

I - Lymphoma affects only 1 set of lymph nodes
II - more than 1 lymph nodes affected
III - lymph nodes that are affected are on different sides of the diaphragm
IV - non lymph nodes are also affected

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34
Q

What is the Dukes Staging System used to classify?

A

Bowel cancers

35
Q

What are the 4 classes of the Duke Staging System for bowel cancer?

A

A - Cancer only penetrated inner lining of bowel

B - Cancer penetrates through inner lining penetrating muscle wall

C - Cancer all way through muscle wall affect lymph nodes

D - Cancer metastasises

36
Q

What is tumour grading?

A

When the degree of differentiation of the neoplasm is described

37
Q

What does G1, G2, G3 and G4 mean?

A

G1 = well-differentiated
G2 = moderately differentiated
G3 = poorly differentiated
G4 = undifferentiated or anaplastic

38
Q

How does a Grade 1 breast tumour compare to a Grade 3 tumour in a microscopic view?

A

G1:
-low mitotic count
-low pleomorphism
-low nuclear to cytoplasm ratio

G3:
-high mitotic count
-high pleomorphism
-High nuclear to cytoplasm ratio

39
Q

When a patient has a prostate cancer to you treat them straight away?

A

Depends how serious it is
Normally you would monitor their PSA levels

40
Q

What are some examples of different types of treatments for cancer?

A

Surgery
Radiotherapy
Chemotherapy
Hormone therapy
Immunotherapy

41
Q

What are treatments that can be given before or after surgery?

A

Adjuvant
Neoadjuvant

42
Q

What is an adjuvant (surgery)?

A

Treatment is given AFTER a surgical removal of a primary tumour to eliminate sub clinical disease (any excess cancer cells floating at distant site)

43
Q

What is a Neoadjuvant?

A

Treatment that is given PRIOR/BEFORE surgical excision to reduce the size of the primary tumour (hopefully making surgery easier)

44
Q

What is radiation therapy?

A

Where high dosage ionising radiation (like x-rays, gamma rays, alpha particles) are used to kill proliferating cells

45
Q

How does Radiation therapy kill proliferating cells?

A

Triggering apoptosis or interfering with mitosis

DIrect DNA or free radicals induced damage which is detected by cell cycle triggering apoptosis

Double stranded DNA breaks

46
Q

What sort of doses are given for Radiation therapy?

Why is this done?

A

Fractioned doses
Minimise damage to normal cells

47
Q

What are the 2 types of radiation therapy?

A

External beam radiotherapy
Internal radiation therapy

48
Q

What is external beam radiotherapy?

A

External machine aims radiation at the cancer

49
Q

What are the 2 types of internal radiation therapy?

A

Brachytherapy - seeds of radiation particles, ribbons or capsules are place in or near the tumour

Systemic - radioactive iodine (I-131

50
Q

What must people undergoing systemic internal radiation therapy no do?

A

Go near children or pregnant women

51
Q

What is therapy induced cancer?

What helps reduce this when radiation therapy is being given to treat cancer?

A

When cancer s acquired as a result of exposure to radiation from treatment

Fractioned doses (multiple smaller doses of radiation)

52
Q

What is Chemotherapy?

A

Systemic treatment kills cancer cells that have spread to other parts of the body

53
Q

How do alkylating and Platinum based drugs work?

A

Cross link the 2 strands of the DNA helix

54
Q

What are some examples of Alkylating and Platinum based chemothrapeutic drugs?

A

Cisplatin
Cyclophosphamide

55
Q

How do Antimetabolite chemotherapeutic drugs work?

A

Mimics normal substrates involved in DNA replication

56
Q

How does Vincristine act as a chemotherapeutic drug?

A

Blocks microtubules assemble and interferes with mitotic spindle formation

57
Q

Why does chemotherapy have a negative side effects on the body?

A

Targets rapidly proliferating cells

58
Q

What are some negative side effects of chemotherapy on the body?

A

Hair loss
Mouth sores
Weakened immune system
Bruising
Bleeding
Nausea, vomiting
Constipation, diarrhoea
Ulcers of GI tract

59
Q

Why is the bodies immune system weakend as a result of chemotherapy?

A

Stops blood cells proliferating

Low WBC = Low immunity
Low RBC = Anaemia
Low Platelets = Bruising + bleeding

60
Q

What is bio marker testing?

A

Precision medicine where specific genes, proteins and other bio makers are looked for

61
Q

What type of breast cancers can be treated with Selective Oestrogen Receptor Modulators? (Hormone Therapy)

A

ER +ve (Oestrogen Receptor positive)

62
Q

What is an example of a Hormone (Selective Oestrogen Receptor modulator)?

A

Tamoxifen

63
Q

How does Tamoxifen act as a Hormone Therapy to ER +ve Breast cancer?

A

It is a Selective Oestrogen Receptor Modulator

Binds to oestrogen receptors preventing oestrogen binding to oestrogen receptors

64
Q

What 2 drugs can be used to target oncogenes so will target cancer cells?

A

Trastuzumab(Herceptin)
Imatinib(Gleevec)

65
Q

What is Herceptin/Trastuzumab used to treat?

A

HER2 +ve breast cancers

66
Q

What is imatinib used to treat?

A

Lymphoma (Targets their oncogenes)

67
Q

What does HER2 stand for?

A

Human epidermal growth factor receptor 2

68
Q

How can HER2 +ve breast cancers be identified?

A

Monoclonal antibodies

69
Q

What is used to treat HER2 +ve breast cancer?

A

Trastuzumab/Herceptin

70
Q

What is immunotherapy?

A

When the immune system is targeted to help it by recognising and attacking

71
Q

Are tumour infiltrating lymphocytes a good sign?

What do they indicate?

A

Good sign

TILs indicate that the immune system is responding to the tumour

72
Q

What are some examples of immuotherapeutic drugs that can attack and shrink tumours?

A

Ipilimumab
Nivolumab

73
Q

How do immune checkpoint inhibitors work in immunotherapy?

A

Block immune checkpoints allowing immune cells to respond more strongly

74
Q

How do monoclonal antibodies be used in immunotherapy?

A

Proteins bind to specific targets making cancer cells stand out

75
Q

What is an example of a vaccine used to help treat a cancer?

A

Oncolytic virus therapy

76
Q

How does oncolytic virus therapy work?

A

Herpes simplex virus type 1 given
Virus infects cancer cells and healthy cells
Healthy cells can destroy virus
Cancer cant
Cancer cells destroyed by virus

77
Q

What are tumour markers?

A

Substances released by cancer cells into circulation

Can be measured assessing response to therapy, recurrence, diagnosis

78
Q

What is a tumour marker used to detect a Testicular Tumour and Choriocarinoma?

A

HCG (human Chorionic Gonadotrophin)

79
Q

What is a tumour marker used to detect a hepatocellular carcinoma and germ cell tumours?

A

Alpha fetoprotein

80
Q

What is a tumour marker used to detect a prostate carcinoma?

A

Prostate specific antigen (PSA)

81
Q

What is a tumour marker used to detect Ovarian cancer?

A

CA125

82
Q

What is a tumour marker used to detect pancreatic, gallbladder, bile duct and gastric cancers?

A

CA19.9

83
Q

What is a tumour marker used to detect colorectal cancer?

A

CEA

84
Q

What is a tumour marker used to detect neuroendocrine tumours?

A

Chromgranin A

Y1 - PP (20 decks)

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