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Patho > Lesson 13 Cancer > Flashcards

Lesson 13 Cancer Flashcards

1
Q

Progression to neoplasm

A

Normal
Dusplasia
In-situ neoplasm
Invasive neoplasm

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2
Q

Characteristics of tumors

A

Benign tumor
1. Well differenciated
2. Do not spread

Malignant tumors
1. More rapid growth rate
2.specific microscopic alternation( loss of differentiation)
3. Absence of normal tissue organisation, no capsule
4. Invade into blood vessel and lymphatics and have distant spread

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3
Q

Pathophysiology of cancer tumor

A

1.Altered cell membrane including surface antigen
2. Expanding mass compressing vessel and strucutr around -> necrosis
3. Normal organisation, growth control, cell cell communication absent

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4
Q

Angiogenesis is what?

A

Development of new capillaries in the tumor-) promote tumor development

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5
Q

Carcinogenesis and tumorigenesis definition

A

Carcinogenesis
The transformation of normal cell into cancer cell

Tumorigenesis
The process of cancer cells transforming into production of tumor

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6
Q

Gene-environment interaction
Gene related problem

A

Lack of tumor suppressant hence promotes neoplasia

Leukemia
Breast cancer

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7
Q

Risk factors of cancer

A

Diet, nutrition, smoking, tobacco use, sexual behaviour, uv radiation, oral contraceptives

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8
Q

Diet risk factors

A

Increase when women gain weight
(Endometrical cancer, breast cancer
Prostatic and renal cancer)

Use of preservation(nitrite)
Fish and meat preservation
-) gastric cancer

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9
Q

Nutrition and disease risk factors

A

To avoid cancer:
Low fat, high in fiber
More fruit and vitamine A, C, E
Soy provduct
Avoid food with high amount of preservation
Less alcohol intake

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10
Q

Smoking risk factor:

A

Smoking is carcinogenesis
Passive smoker have greatest chance of lung cancer

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11
Q

Alcohol risk factors

A

Alcohol interact with smokes, increase risk of malignant tumor formation.
Alcohol act as solvent of carcinogenic chemicals
Links to breast cancer

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12
Q

Sexual risk factors

A

Sex-)HPV-) cervix cancer

early age of first sex
Multiple partners

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13
Q

Occupational risk factors to cancer?

A

Miners and shipyard workers
Asbestos inhalation—>lung cancer

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14
Q

Ultraviolet radiation risk factors to cancer

A

Risk of forming malignant melanoma

Affect tissue antioxidants—> tissue and DNA damage
Outdoor worker, fisherman, living in high sunlight exposure area

On area of head, neck, upper extremities

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15
Q

Oral contraceptives

A

Endometrium, ovary, breast cancer risk reduced

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16
Q

Cancer in Hong Kong

A

Is 2nd cause of death
1961 72 in 100k
1990 150 in 100k
(Lifestyle changed)

17
Q

Ranking of cancer

A

1st lung cancer
2nd colorectal cancer
3rd breast cancer

18
Q

Benign tumor

A

Tumor which closely resemble to tissue of origin

Grow locally

Grow slowly

Not fetal

19
Q

Malignant tumor

A

Able to spread invasion
Can move to different part of body
Grow separately

20
Q

How malignant neoplasm spread

A

Local invasion
Direct growth to adjacent tissue

Lymphatic spread
Through lymphatic node

Vascular spread
Spread via veins

Transfer by implantation
Graft donation, surgery

21
Q

Degree of differentiation and grading (1-4)

A

Grade 1
Well differenciated
Tumor closely resemble to tissue

Grade 2
Moderately differentiated
Tumor is slightly less resemblance to tissue of origin
More various in size

Grade 3
Poorly differentiated
Not closely resembled tissue to origin

Grade 4
Very poorly differenciated
No resemblance to tissue of origin
Grreat variation in size and shape

22
Q

Site of tumor

A

Carcinomas -）epithelial tissue
Liposarcoma-) adipose
Sarcomas-) connective tissue
Lymphomas-) lymphatic tissue
Leukemias-) blood forming organs, mainly bone marrow
Osteosarcoma-) bone

癌症——上皮組織
• 脂肪肉瘤－脂肪
• 肉瘤－結締組織
• 淋巴瘤－淋巴組織
• 白血病－造血器官，主要是骨髓
• 骨肉瘤－骨

23
Q

Tumor staging-system
Tumor 0-3
Node (involvement) 0-2
Metastasis (轉移）0-2

A

T0= no tumor
T1= lesion <2cm
T2= lesion 2-5cm
T3= skin/ chest wall involved by invasion

N0=no nodes involved
N1= mobile nodes involved
N2= fixed node involved

M0= no metastasis
M1= demonstrable metastasis 可證明的
M2= suspected metastasis

24
Q

Staging
1-4

A

Stage 1: T1 N0 M0
Stage 2: T0-2 N0 M0
Stage 3: T3 N1 M0
Stage 4: T4 N3 M3

25
Q

Both benign/ malignant neoplasm causing death

Loss of appetite , progressive weakness
-) pneumonia
Obstruction to vital organ is fatal
E.g. benign tumor in brain is fatal.

A
26
Q

Clinical manifestations-pain

A

No pain in early stage
But occurs in 60-80% in late stage

Mechanism- pressure, obstruction, invasion, sensitive structure, stretching of visceral surface, tissue destruction

27
Q

Cancer-type of pain

A

Bone metastasis- fucking pain

Referred pain- back pain

Hepatic malignancies-) stretch liver-) dull pain, feeling full

Tumor compression of nerve ending
Little space to grow, compressing blood vessels

28
Q

Fatigue

Decreased muscle contractility/ lose of muscle function to perform activities
Patient is: exhausted, depression, sleepiness
Not able to concentrate

A
29
Q

Anorexia, 0 hungry , weight loss, anemia
Cachexia- fucking malnutrition

A
30
Q

Anemia 貧血

A

Hemoglobin<9g/dl

Related to chemotherapy

Reason: malignance in blood forming organ
E.g. chronic lymphocytic leukemia
E.g. GI chronic bleeding

31
Q

Leukopenia, thrombocytopenia (少）
why？

A

When tumor invasion to bone marrow
Chemotherapeutic drugs are toxic to bone marrow
Causing: leukopenia- decreasing number of platelet.

32
Q

Infection

A

Prone to infection& death
Decrease in lumpocyte count
Reduce immunologic function
Because: surgery, Hospital related infection, bad wound care

33
Q

Diagnosis of neoplasia

A
  1. Imaging test
    MRI, CT scan can see staging
  2. Laboratory testing
    Alpha fetoprotein (AFP)= liver cancer
34
Q

5 year surviving rate

Pancreas cancer, liver cancer, oesophagus <10%
Lung cancer, stomach 10-20%
Colon, rectum cancer 50%
Cervix cancer 65%

A
35
Q

Cancer treatment

A
  1. Surgery
    Tumor removal-) colon, breast, ovary, lung

2.chemotherapy-eradicate tumor cell
Treatment to help stop or slow down cancer growth

Side effects: bone marrow depression, hair loss

  1. Radiotherapy
    Damage to target cell without causing toxicity to normal cell
  2. Immunotherapy
    Encourage killer T cell to attack cancer cells
    For cancer not effective with chemotherapy( bone marrow)

Palliative
When the cancer is advanced, tend to reloef the manifestation

36
Q

Primary/ secondary prevention

A

Primary prevention： avoid known carcinogens
Lifestyle, diary change, reduce cancer risk

Secondary prevention: screening to achieve early diagnosis:
Self breast exam
Self testicular exam
Screening colonscopy

37
Q

Nasalpharynegeal carcinoma

A

All carcinomas arising in nasalpharynx
Clustering diseases reported in families
Chromosomes 6

Consumption in salted fish in infancy

38
Q

Prevention of nasalpharynegeal carcinoma

A

EBV screening test
Serological test
Biopsy(鼻咽黏膜切片) of nasalpharynegeal mucosa

Patho (12 decks)

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