Neoplasia 4

Question 1

What is tumour stage?

Answer 1

Measure of a malignat neoplasms overall burden

Question 2

What is the TNM grading system?

Answer 2

T-size primary tumour (1-4)
N-extent of regional node metastasis (0-3)
M-extent of distant metastatic spread (0 or 1)

Converted into stages

Question 3

What are the stages of TNM?

Answer 3

1- early localised
2-advanced localised
3-regional metastasis
4-advanced disease with metastasis

Question 4

What does the Ann Arbor grading system measure?

Answer 4

The grading of lymphoma

Question 5

What are the stages of lymphoma grading?

Answer 5

1-in single node regiom
2- two separate regions on one side diaphragm
3-spread on both sides of diaphragm
4-diffuse/disseminated involvement of extra-lymphatic organs

Question 6

What does tumour grade show?

Answer 6

The degree of differentiation of a neoplasm

Question 7

What is the typical grading system?

Answer 7

G1- well differntiated
G2-moderately differntiated
G3-poorly differntiated
G4-undifferantiated/ aplastic

Question 8

What is Bloom-Richardson grading used for?

Answer 8

Breast carcinomas

Question 9

Why is tumour grade important?

Answer 9

For planning treatment and estimating prognosis

Question 10

How do you predict outcome of a tumor?

Answer 10

Age/gener/ general wellbeing 
Tumour site/type
Grade 
Stage 
Available effective treatments

Question 11

What are tumour markers?

Answer 11

Substances realeased by cancer cells into the circulation

Question 12

Name some tumour markers

Answer 12

Hormones (gonadotropin realesed by testicular cancer)
Oncofetal antigens (from hepatic cancenomas)
Specific proteins (prostate specific antigen)
Mucins/glycoproteins (CA-125 by ovarian cancer)

Question 13

Why are tumour makers useful in treatment?

Answer 13

Monitor the tumour burden of a patient

See how effetive a treatment is being

Question 14

How are tumor markers used in diagnosis?

Answer 14

Specific tumours relases specific tumour markers so can tell if present or not

Question 15

What is adjuvent treatment?

Answer 15

After surgical removal of a primary tumour to eliminate subclinical disease

Question 16

What is neoadjuvent treatment?

Answer 16

Given to reduce the size of a primary tumour prior to surgical excision

Question 17

How does radiotherapy work?

Answer 17

Kills proliferatinf cells by triggering apoptosis/ altering mitosis

Causes direct or free-radical induced DNA damage

Targeted at tumour area- reduces damage to surrounding tissues

Question 18

How does chemotherapy work?

Answer 18

Affecting prolifering cells in various ways

Question 19

How do antimetabolites work?

Answer 19

Mimic normal substrates in DNA replication

Prevent normal replication

Question 20

How fo Alkyating and platinum based drugs work?

Answer 20

Cross linking od DNA double helix

Question 21

How do antibiotics work?

Answer 21

Inhibit DNA tropoisomerases
Cause double stranded breaks
Block microtubule assembly

Question 22

How do hormone therapies work?

Answer 22

SERMS bind to oestrogen receptors preventing oestrogen binding
Treats hormone receptor positive breast cancers

Relativly non toxic

Question 23

What is an example of a molecular targeted therapy?

Answer 23

Herceptin
Blocks HER-2 gene signalling in breast cancers

Imatinib
Inhibits fusion protein in Chronic myeloid leukemia

Question 24

How can we use molecular targeted treatments?

Answer 24

By identifying cancer soecific alterations such as oncogene mutations

Question 25

What are the most common cancers in women?

Answer 25

Breast Lung Bowel

Question 26

What are the most common cancers in males?

Answer 26

Prostate Lung Bowel

Question 27

What are the most common cancers in children?

Answer 27

Leukaemias CNS tumours Lymphomas

Question 28

What cancers have the highest survival rates? | Highest to lowest

Answer 28

``` Testicular Maligant melanoma Breast Prostate Hodgkin lymphoma ```

Question 29

What cancers have the lowest survival rates? | Most to least deaths

Answer 29

``` Pancreas Lung Brain Stomache Oesophagus Leukaemia ```

Question 30

What are the most common causes of cancer deaths in women in the UK?

Answer 30

Lung Breast Bowel (Higher prevelance of these types over those with lowest survival rates)

Question 31

What are the most common causes of cancer deaths in males?

Answer 31

Lung Prostate Bowel (Not just types with lowest survival due to prevalance of these types as well)

Question 32

What are the 3 cancer screening programms in the UK?

Answer 32

- Breast - Cervical - Bowel

Question 33

What are the key points about breast screening?

Answer 33

Women 47-73 Every 3 years Mammogram (low energy x-rays)

Question 34

What are the key points about cervical screening?

Answer 34

Women 25-49 (3 yrs) 50-64 (5 yrs) Smear test (looks for HPV virus)

Question 35

What are the key points about Bowel screening?

Answer 35

Men and women (60-74) Home testing faecal Men and women (55) Bowel scope screening

Question 36

How can tumour markers be used in prostate cancer?

Answer 36

After removal of prostate if prostate specific antigen levels rise high suggests that they has been metastaic spread of cancer Not as accurate in diagnosis as elevated levels could be due to imflammation

Question 37

What cancer is human choronic gonadatrophin used in and how is it used?

Answer 37

Testicular tumours Diagnosis-Beta HCG never normally found in men (so if present= malignancy) Monitoring- measure residual tumour and treatment effectivity

Question 38

What cancer is Alpha Fetoprotein used in?

Answer 38

Hepatocellular carcinomas

Question 39

How is Alpha fetoprotein used?

Answer 39

Diagnosis- elevated serum levels indicate hepatocellular carcinoma

Question 40

What are oncofetal antigens?

Answer 40

Antigens expressed in high levels in cancer and fetal tissues but not adult tissue

Question 41

What cancer is Carcioembryonic antigen (CEA) used in relation too?

Answer 41

Bowel

Question 42

What is carcioembryonic antigen used for?

Answer 42

Measing how well treatment is working agaist the tumour

Question 43

What caner is CA 125 (cancer antigen 125) used in relation too?

Answer 43

Ovarian cancer

Question 44

What is CA 125 used for?

Answer 44

Look for early signs of ovarian cancer in people at high risk Monitor cancers (multilpe varieties during and after treatment)