MoD Session 11- Neoplasia 4 Flashcards
What are the three most common cancers in children under 14?
Lymphoma, leukaemia and CNS tumours
What are the three best survival rates?
- testicular - 98%
- melanoma - 90%
- Breast - 87%
What are the three worst survival rates?
- oesophageal - 15%
- lung - 10%
- pancreatic - 3%
What is an individual’s prognosis based upon? (6)
- tumour size and type
- tumour site
- age
- general health status
- grading and staging
- availability of effective treatments
What is tumour staging?
A measure of the malignant neoplasms overall burden
What is the common method of staging and describe it.
TMN staging.
T is a measure of the primary tumour size. T1-4
M is a measure of metastasis. M0 or M1
N is a measure of regional node metastasis. N0-N3
What are the four stages determined by TMN staging?
Stage 1- early local disease
Stage 2- advanced local disease
Stage 3- regional metastasis
Stage 4- advanced disease with distant metastasis.
What is Ann Arbor staging used for?
Staging lymphoma
What are the four stages of Ann Arbor staging?
Stage 1- lymphoma in a single nodal region
Stage 2- lymphoma in 2 nodal regions on one side of the diaphragm
Stage 3- lymphoma on both sides of the diaphragm
Stage 4- disseminated involvement of 1 or more extra lymphatic organs.
What is dukes staging used for?
Staging colorectal carcinoma.
What are the four stages of dukes staging?
A. Invasion into but not through the bowel
B. Invasion through the bowel wall
C. Involvement of the lymph nodes
D. Distant metastasis
What is tumour grading?
The degree of differentiation of a neoplasm.
What is the difference between tumour staging and tumour grading?
Staging- how much of the tumour there is.
Grading- how differentiated the tumour is.
What are the four grades?
G1. Well differentiated
G2. Moderately differentiated
G3. Poorly differentiated
G4. Undifferentiated/ anaplastic.
What is the bloom Richardson grading system used for?
Grading Breast carcinoma.
What does the bloom Richardson grading system assess? (3)
Tubule formation
Nuclear variation
Number of mitoses
What is tumour grading important for? (2)
Planning treatment and estimating prognosis
What is tumour staging important for?
Predicting survival
What are the five broad treatments of cancer?
Chemotherapy Radiotherapy Surgery Hormonal treatment Tumour specific therapy
What is the intent of surgery in:
Early stage cancer
Advanced cancer?
Early stage- cure
Advanced- palliative intent
What is adjuvant treatment?
Treatment given following surgical removal of a primary tumour to eliminate subclinical disease and prevent relapse.
What is neojuvant treatment?
Treatment given before surgical intervention in order to reduce the soze of the primary tumour.
What effect does radiotherapy have on cells?
Kills proliferating cells
How is radiotherapy given and why?
In fractionated doses.
To minimise damage to normal tissues.
Which cells does chemotherapy effect?
Proliferating cells.
Why does chemotherapy have side effects?
Because it is non specific to cancerous cells
Give an example of a hormone therapy and what it does.
Tamoxifen acts on oestrogen receptors and competitively binds to them. Because oestrogen is a proliferator, by binding to their receptors, this prevents further tumour growth.
Give an example of a specific tumour therapy and what it does.
Herceptin acts on HER-2 signalling which is over-expressed in 1/4 Breast carcinomas.
What are tumour markers used for?
Small role in diagnosis. Mainly used for monitoring cancer burden.
What are the four types of tumour marker? Give an example of each and what carcinoma releases them.
Hormone marker - HCG. Testicular tumours
Oncofetal antigen- AFP. Heptatocellular carcinoma
Specific proteins- PSA. Prostate carcinoma
Mucins and glycoproteins. CA-125. Ovarian cancer
What are the three UK screening programmes?
Breast
Colorectal
Cervical
Who is eligible for cervical screening and when does it occur?
25-49 yrs old is every 3 years.
50-64 yrs old is every 5 years.
Who is eligible for colorectal screening and when does it happen?
Men and women aged 60-69 every 2 years.
Who is eligible for breast screening and when does it occur?
50-70 yrs old every 3 years.
What are the 4 most common cancers in adults?
Breast, prostate, lung and bower carcinomas
