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oncology > Malignant Diseases > Flashcards

Malignant Diseases Flashcards

1
Q

Social importance of malignant diseases

A 
Wide currency 
Increasing frequency of cases 
Social consequences e.g. 
1. Can’t work 
2. Early disability 
3. Early death
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2
Q

What are the requirements(demands) of rx in oncology

A

1)Programs for early detection and prophylaxis

2) Availability of resources e.g.
- high tech equip
- modern surgical and radio surgical procedures
- expensive drugs
- ability to provide complex health care

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3
Q

Types of malignancy

A

Neoplasms(solid tumors)

  • carcinoma’s (200+)
  • sarcoma

Haematological

  • leukaemia
  • lymphoma
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4
Q

What is the incidence

A

Total number of NEW in w given diseases in a population during a DEFINED TIME INTERVAL

( /year /month etc)

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5
Q

What is the incidence rate

A

Incidence within a given number of the population

Incidence per 100 ppl

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6
Q

What is the mortality

A

Total number of disease related deaths in a set time interval
(Deaths caused by cancer every year)

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7
Q

Mortality rate ?

A

Mortality in a specific number of the population

Cancer related deaths per year

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8
Q

What is RISK

A

Likelihood of an event occurring in a set time

Incidence risk= risk of getting a certain tumor

Mortality risk= risk of dying of a disease

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9
Q

Which statistic parameters should you know

A

Incidence

Incidence rate

Mortality

Mortality rate

Risk

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10
Q

what cancer has he highest mortality rate

A

1) Lung cancer
2) bowel cancer
3) breast/ prostate cancer

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11
Q

4 basic Cancer control steps (can be applied by every country)

A

Prevention

Early detection and screening

Early diagnosis

Access to rx and palliative care

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12
Q

Define oncogenesis

A

formation of a cancer, where normal cells are transformed into cancer cells.

The process is characterized by changes at the cellular, genetic, and epigenetic levels and abnormal cell division.

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13
Q

What is a carcinogen

A

Any substance that promotes the formation of cancer

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14
Q

Types of mutations in oncogenesis

A

Point mutations/ cytogenetic aberration

  • translocation/ inversion/ deletion
  • changes the activity of regulatory genes e.g. p53/ pRB!!

Hereditary/ germline mutations

  • found in every cell in the body including reproductive cells
  • passes onto subsequent generations
  • BRACA1 BRACA2= breast & ovarian cancer
  • 5-20%

Spontaneous/ somatic mutations
-most common type

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15
Q

5 Key biological characteristics of malignant cells

A

1) Unlimited proliferation (IMMORTAL)
2) AUTONOMOUS GROUTH as they lack anti proliferation feedback mechanisms
3) NO APOPTOSIS
4) NEOVASCULARISATION
5) INVASIVE/METASTATIC

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16
Q

Explain unlimited proliferation in cancer cells

A

Normal cells: require extra cellular growth signals that enter via TRANSMEMBRANE receptors

Tumor cells:
Generate their own growth signals
Altered structure Of transmembrane(TYPICAL IN ONCOGENESIS) receptors preventing their regulation
- e.g
Epidermal GF receptor w/ tyrosine kinase is over expressed in stomach, brain, breast cancer

17
Q

Explain autonomous growth and loss of anti proliferative fb

A

Cell cycle is dysreg! D/2 immunity from inhibitory substances in the storma or inhibitory signals

Immune to controls that prevent proliferation of cells w/ damaged dna

18
Q

What is the cyclin dependant kinase family

A

A kinase family that promotes the transit through phases of the cell cycle

Requires cycling protein for activity

19
Q

Explain the loss of apoptosis induction in cancer cells

A

The apoptosis programme is in all cells

Tumor cells develop resistance to apoptosis by either

  1. Loss of p53 tumor suppressor gene
    - loss of apoptosis
    - loss of cell cycle arrest
  2. Mutation of an oncogene
    - accelerated tumor growth
    - active inhibition of apoptosis by inhib p53
    - enhanced resistance to chemo
20
Q

Explain replicative immortality in tumor cells

A

Telomeres are protective structures at the end of eukaryotic chromosomes

Telomeres are lost/ shortened during cell division

Telomerase maintains the structural integrity of telomeres but is suppressed in humans leading to replocarive senescence( growth of old cells)

Tumors have increased telomerase expression which maintains length of telomeres in cancer cells and ensure repeated division of tumor cells

21
Q

Explain neovascularization in cancer cells

A

Tumor releases vascular endothelial growth factor (VEGF)

VEGF stimulates endothelial cells to produce matrix metalloproteinases (MMP)

MMP break down the ecm allowing endothelial cells to migrate into that space

22
Q

Rx of malignancies

A

Interdisciplinary approach if

Surgery

Drug therapy( immunno, target, chemo)

Radiotherapy

Experimental methods w/ gene therapy

Integrative medicine w/ close or-doc relationship

23
Q

Surgical rx of MG

A

Surgical biopsies for dg & staging

Surgical tumor removal

Surgical removal of non essential organs for prevention

24
Q

What is HIFU

A

High Intensity Focused Ultrasound surgery

Focus of US waves to ablate target Rosie and protect surrounding tissues

25
Q

Chemotherapy rx in mg cancers

A

Drug requirements

  • different mech of activity
  • different tissue toxicity causing therapeutic effectiveness and reduced resistance
26
Q

Target molecule groupsnin target therapy if mg cancer

A

1) monoclonal antibodies
2) tyrosine kinase inhibitors
3) m-TOR inhibitors
4) proteasome cyxlin d inhibitors
5) immunooncology
6) gene therapy

27
Q

Principles of oncological therapy

A

Adjuvant rx:

Neoadjuvant rx:

Curative rx:

Palliative rx:

Supportive rx:

28
Q

What is personalised medicine / precision medicine

A

Procedure in medicine separating pts into diff groups w/ actions tailored to the individual pt based on their PREDICTED RESPONSE / risk of diseases

Genomics is used to group patients together

29
Q

What is the transition into personalised care for oncology pts

A

Personalised therapy

Psychooncology

Rehabilitation

Palliative care

30
Q

Predictive bio markers in oncology

A

They evaluate how likely a patient will benefit from a particular clinical intervention and the toxicity

Examples

Breast cancer: HER2,

Colorectal RAS( KRAS & NRAS)

Lung adenocarcinoma EGFR, ALK

Melanoma BRAF, NRAS

Gastrointestinal stromal tumour. cKIT

31
Q

What is psychooncology

A

Interdisciplinary practice that Studies of the psychological aspects of cancer

32
Q

Rehabilitation in cancer

A

Helps pts improve cancer related sx & side effects of rx

Promotes optimal function of pts everyday life

Rxment of musculoskeletal and neurological problems

33
Q

Palliative care

A

Improves QOL by preventing pain and distressing sx and providing adequate nutrition

34
Q

Prevention & screening

A

Secondary: screening

Tertiary: post rx follow up and early detection of relapse

35
Q

Primary screening

A

Defines, recognised and avoided risk factors

  • excercise
  • healthy nutrition
  • risk factors

Genetic RF
-FAP, HNPCC, BRACA1&2

Acquired

  • smoking: lung/breast
  • alcohol: head of pancreas, hepatocellular, GI
  • asbestos: lung
  • infection: hepatitis, HPV, H.pylori,
  • sunlight : melanoma, nasal cell carcinoma
36
Q

Secondary prevention

A

Screening programs

Cervical&endometrial Cancer: 20yo women and above

Breast: 30yo+ W

Colorectal: 45yo+ M&W

Prostate: 45yo+ men

oncology (10 decks)

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