MoD 11 (Neoplasia 4) Flashcards
Name the most common 4 cancers in the UK, from most common to least:
1) Breast cancer
2) Lung
3) Prostate
4) Bowel
What are the most common cancers affecting children < 14 yrs?
- Leukaemia’s
- Lymphoma’s
- CNS tumours
Which cancers have the highest 5 year survival rates?
- Testicular cancer
- Malignant melanoma
- Breast cancer
- Hodgekin lymphoma
- Prostate cancer
When predicting the outcome of a malignant neoplasm, what factors must be taken into account?
- Age
- General health
- Tumour site
- Availability of effective treatment
- Tumour type
- Tumour grade
- Tumour stage
Define tumour stage:
Measure of the malignant neoplasm’s overall burden
What is the most commonly used tumour staging system?
TNM staging system
Explain the TNM staging system:
T = size of primary tumour (T1-T4) N = extent of regional node metastasis (N0-N3) M = extent of distant metastatic spread (M1-M2)
T only = Stage I or II
T + N = Stage III
T + N + M = Stage IV
Name the system used to stage colorectal carcinoma:
Dukes’ staging system
Explain Dukes’ staging system:
A = Invasion into but not through bowel wall B = Invasion through bowel wall, not through basement membrane C = Regional node metastasis D = Distant metastasis
What damage may be caused in Axillary Node Clearance?
- Thorocodorsal nerve damage
- Long thoracic nerve
Define tumour grade:
The degree of differentiation of a neoplasm (G1 - G4)
What are the microscopic changes seen in a poorly-/undifferentiated neoplasm?
- Increased nuclear:cytoplasmic ratio
- Increased number of mitotic figures
- Hyperchromasia
- Pleomorphism
What type of cancer is the Nottingham modification of the Bloom-Richardson Grading Scale used for?
What 3 factors does it base the grade on?
Invasve breast cancer
1) Tubule formation (less tubules = higher grade)
2) Nuclear pleomorphism (if large and vary in shape = higher grade)
3) Mitotic count (higher = higher grade)
If an invasive breast cancer is made up of < 10% tubules, is it likely to be low grade or high grade?
High grade
What is the main treatment of cancer?
Surgery
Define neoadjuvant treatment:
Given prior to surgical excision, to reduce size of tumour
Define adjuvant treatment:
Given after surgical removal of tumour, to eliminate subclinical disease
How does radiotherapy kill cancer cells?
- Ionising radiation triggers direct or free-radical induced DNA damage = triggers apoptosis
Why is radiotherapy given in fractionated doses?
To minimise damage to surrounding healthy tissue
Name the 4 classes of chemotherapy:
1) Antimetabollites
2) Alkylating and Platinum-based
3) Antibiotics
4) Plant-derived
In what class of chemotherapy is Fluorouracil?
Antimetabollites - it mimics normal substrates (Uracil) in DNA replication
In which class of chemotherapy is Cisplatin?
Alkylating and Platinum-based = crosslinks strands of double helix
In which type of breast cancers is Tamoxifen used? Which type of cancer does it increase the risk of, and why?
Breast cancers containing Oestrogen receptors (ER)
Increases risk of endometrial cancer, as Tamoxifen is an agonist at the ER’s in the uterus
25% of breast cancers are HER2+. Which drug is used to treat these cancers?
Herceptin
Which tumour marker does ovarian cancer often release?
CA-125
What are the cancer screening programs in the UK?
1) Cervical cancer between ages of 25-64
2) Breast cancer between ages of 50-70
3) Colorectal cancer between ages of 60-74
What are the 3 main problems associated with screening programs?
1) Overdiagnosis
2) Length bias
3) Lead-time bias
List some risk factors associated with cervical cancer:
- HPV
- Herpes
- Smoking
- Immunocompromised
- the pill
What is the most common type of cervical cancer?
Squamous cell carcinoma
What is the main symptom of cervical cancer?
Bleeding from the vagina
Where does Ovarian cancer usually metastasise to?
- Liver
- Lung
- Peritoneum
What is the most common type of Thyroid cancer?
Papillary thyroid cancer (80%)
Where does thyroid cancer commonly metastasise to?
- Bone
- Liver
- Lung
What is felt when manually palpating a breast cancer lump?
Immobile, hard, painless lump with irregular margin
What are the signs/symptoms of breast cancer?
- Immobile, hard, painless lump with irregular margin
- ‘peau d’orange’ = pititng/dimpling of skin
- Change in shape/size of breast/nipple
- Rash on nipple
- Bloody discharge
Why are urinary symptoms rarely seen in prostate cancer?
Cancer grows on the outside margin of the prostate, so doesn’t affect the urethra
