Neoplasia 4 Flashcards
What factors help to predict the prognosis for cancer?
Age Site of tumour General health status Tumour type Grade Stage Availability of effective treatments
What are the four most common cancers in people?
Breast, lung, prostrate and bowel
What does the T mean in TNM staging? Scale?
The size of the tumour
T1-T4
What does N mean in TNM staging? Scale?
The extent of regional node metastasis
N0 - N3
What does M mean in TNM staging?
The extent of distant metastatic spread
What do each of the stages mean in TNM staging?
Stage I: early local disease
Stage II: advanced local disease
Stage III: regional metastasis
Stage IV: advanced disease with distant metastasis
What type of cancer is Ann Arbour staging used for?
Lymphoma
What do each of the stages of Ann Arbour mean?
Stage I: Lymphoma in a single node region
Stage II: Two separate regions on the same side of the diaphragm
Stage III: Spread to both sides of the diaphragm
Stage IV: Diffuse or disseminated involvement of one or more extra-lymphatic organs such as lungs or bone marrow
Stages of Duke’s?
A: invasion into but not through the bowel
B: invasion through the bowel wall
C: involvement of lymph nodes
D: distant metastasis
Give the stages of grading of a malignant neoplasm
G1: well differentiated
G2: moderately differentiated
G3: poorly differentiated
G4: undifferentiated/anaplastic
What does the Bloom-Richardson staging asses?
Breast cancer
- tubule formation
- nuclear variation
- number of mitoses
Treatments for cancer?
Surgery Chemotherapy Radiation Hormone therapy Treatment targeted for specific molecular alterations
What is adjuvant therapy?
Treatment given after surgery when there is a high chance of tumour recurrence. Destroys microscopic tumour cells.
What is neoadjuvant therapy?
Treatment given to reduce the size of a tumour prior to surgical excision
How does radiation therapy kill cancer cells?
Targets rapidly dividing cells by
- triggering apoptosis by causing direct or free radical DNA damage that is detected by cell cycle checkpoints
- disrupting mitosis by causing double stranded DNA breakages, causing damage to chromosomes
What are antimetabolites?
Molecules which mimic normal substrates needed for DNA replication eg folic acid
What are alkylating and platinum-based drugs?
Drugs which cross-link the two strands of DNA helix
How do antibiotics act in the treatment of cancer?
Inhibit DNA topoisomerase which is needed for DNA synthesis
Cause double stranded DNA breaks
How do plant-derived drugs work in treating cancer?
Block microtubule assembly and interfere with spindle fibre formation.
Give examples of how hormone therapy works in treating malignant cancers
Selective oestrogen receptor modulators (SERMs) bind to oestrogen receptors and prevent oestrogen from binding
Treat hormone receptor-positive breast cancer
Androgen blockade used to treat prostate cancer
What are tumour markers used for?
Monitoring tumour burden during treatment and follow up
What hormone is released by testicular cancer tumours?
Chorionic gonadotropin
Name some tumour markers and what they are released by
Oncofetal antigens (eg alpha fetoprotein released by hepatocellular carcinoma) Specific proteins eg prostate-specific antigen released by prostate carcinoma Mucins/glycoproteins (eg CA-125 released by ovarian cancer)
How can drugs be targeted specifically at cancer cells?
Identifying cancer-specific alterations such as oncogene mutations
Give an example of a drug targeted specifically at cancer cells and how it works
Herceptin
Breast cancer has over expression of the HER-2 gene
Herceptin can block HER-2 signalling
Problems of cancer screening?
Lead time bias
Length bias (screening over-represents less aggressive disease)
Overdiagnosis
What is Duke’s staging used for?
Colorectal cancer
