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Mechanisms Of Disease > Neoplasia 4 > Flashcards

Neoplasia 4 Flashcards

0
Q

What factors help to predict the prognosis for cancer?

A 
Age
Site of tumour
General health status
Tumour type
Grade
Stage
Availability of effective treatments
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1
Q

What are the four most common cancers in people?

A

Breast, lung, prostrate and bowel

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2
Q

What does the T mean in TNM staging? Scale?

A

The size of the tumour

T1-T4

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3
Q

What does N mean in TNM staging? Scale?

A

The extent of regional node metastasis

N0 - N3

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4
Q

What does M mean in TNM staging?

A

The extent of distant metastatic spread

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5
Q

What do each of the stages mean in TNM staging?

A

Stage I: early local disease
Stage II: advanced local disease
Stage III: regional metastasis
Stage IV: advanced disease with distant metastasis

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6
Q

What type of cancer is Ann Arbour staging used for?

A

Lymphoma

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7
Q

What do each of the stages of Ann Arbour mean?

A

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

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8
Q

Stages of Duke’s?

A

A: invasion into but not through the bowel
B: invasion through the bowel wall
C: involvement of lymph nodes
D: distant metastasis

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9
Q

Give the stages of grading of a malignant neoplasm

A

G1: well differentiated
G2: moderately differentiated
G3: poorly differentiated
G4: undifferentiated/anaplastic

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10
Q

What does the Bloom-Richardson staging asses?

A

Breast cancer

  • tubule formation
  • nuclear variation
  • number of mitoses
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11
Q

Treatments for cancer?

A 
Surgery
Chemotherapy
Radiation
Hormone therapy
Treatment targeted for specific molecular alterations
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12
Q

What is adjuvant therapy?

A

Treatment given after surgery when there is a high chance of tumour recurrence. Destroys microscopic tumour cells.

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13
Q

What is neoadjuvant therapy?

A

Treatment given to reduce the size of a tumour prior to surgical excision

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14
Q

How does radiation therapy kill cancer cells?

A

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
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15
Q

What are antimetabolites?

A

Molecules which mimic normal substrates needed for DNA replication eg folic acid

16
Q

What are alkylating and platinum-based drugs?

A

Drugs which cross-link the two strands of DNA helix

17
Q

How do antibiotics act in the treatment of cancer?

A

Inhibit DNA topoisomerase which is needed for DNA synthesis

Cause double stranded DNA breaks

18
Q

How do plant-derived drugs work in treating cancer?

A

Block microtubule assembly and interfere with spindle fibre formation.

19
Q

Give examples of how hormone therapy works in treating malignant cancers

A

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

20
Q

What are tumour markers used for?

A

Monitoring tumour burden during treatment and follow up

21
Q

What hormone is released by testicular cancer tumours?

A

Chorionic gonadotropin

22
Q

Name some tumour markers and what they are released by

A 
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)
23
Q

How can drugs be targeted specifically at cancer cells?

A

Identifying cancer-specific alterations such as oncogene mutations

24
Q

Give an example of a drug targeted specifically at cancer cells and how it works

A

Herceptin
Breast cancer has over expression of the HER-2 gene
Herceptin can block HER-2 signalling

25
Q

Problems of cancer screening?

A

Lead time bias
Length bias (screening over-represents less aggressive disease)
Overdiagnosis

26
Q

What is Duke’s staging used for?

A

Colorectal cancer

Mechanisms Of Disease (11 decks)

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