Neoplasia 4

Question 0

What are the common types of cancer in children?

Answer 0

• Leukaemia
• CNS tumours
• Lymphomas

Question 1

What types of cancer make up 50% of all incidences?

Answer 1

• Breast
• Lung
• Bowel
• Prostate

Question 2

Which types of cancers have the highest survival rates?

Answer 2

• Testis
• Prostate
• Breast
• Malignant melanoma

Question 3

What types of cancer have the lowest survival rates?

Answer 3

• Stomach
• Brain
• Oesophagus
• Lung
• Pancreas

Question 4

What factors dictate prognosis?

Answer 4

• Age
• General health state
• Grade
• Tumour stage
• Tumour type
• Effectiveness of treatments
• Tumour site

Question 5

What is the TNM system?

Answer 5

• T: size of primary tumour T1-T4
• N: extent if regional node metastasis N0-N3
• M: extent of distant metastatic spread M0-M1

Question 6

TNM is converted into a staging system what is this?

Answer 6

• 1: early localised disease
• 2: advanced localised disease (NO/M0)
• 3: regional metastasis (N1 or greater/M0)
• 4: advanced with distant metastasise (M1)

Question 7

What is the Ann Arbor system used for and outline the system.

Answer 7

• Lymphomas
• 1: single node region
• 2: separate regions same side of diaphragm
• 3: separate regions either side of diaphragm
• 4: lymphatic organ(s) involved e.g. Lung/bone

Question 8

What is the tumour grading system and why is it used?

Answer 8

• Prognosis and planning of treatment
• G1: well differentiated
• G2: moderately differentiated
• G3: poorly differentiated
• G4: undifferentiated or anaplastic
• Used for colorectal and squamous cell carcinomas

Question 9

What is the grading system for breast cancer?

Answer 9

• Bloom-Richardson

Question 10

What the treatments given relating to surgery and why is surgery used?

Answer 10

• Mainstay, most effective treatment
• Adjuvent: after surgical removal to eliminate sub clinical diseases
• Neoadjuvent: to decrease the size of tumour prior to surgery

Question 11

What are the different types of chemotherapy and what does it affect?

Answer 11

• Affects proliferating cells, non specific
• Antibiotics
• Antimetabolics mimic normal substrates involved in DNA replication
• Alkylating and platinum based drugs cross link 2 DNA helix strands

Question 12

What is radiation therapy, what does it affect?

Answer 12

• Kills proliferating cells via apoptosis and interfering with mitosis
• Free radicals
• Kills G2 especially as these are rapidly dividing
• Double stranded DNA breaks causing damaged chromosomes preventing M phase from completing

Question 13

How is radiation therapy optimised?

Answer 13

• Radiation is pointed at tumour, surrounding tissue is shielded
• Fractionated doses to minimise normal cell damage

Question 14

What is hormone therapy and what role do SERMs have in breast cancer?

Answer 14

• SERMs: selective oestrogen receptor modulators
• e.g. Tamoxifen
• Prevents oestrogen from binding by blocking receptors
• Used to treat hormone receptor-positive breast cancer
• Androgens blockades used for prostate cancer

Question 15

How can oncogenes be targeted and what does this allow, give an example?

Answer 15

• Due to their mutations
• Can target drugs specifically at cancer cells
• HER 2 gene and herceptin used in breast cancer

Question 16

What are the possible problems with cancer screening?

Answer 16

• Lead time bias: time between screening detecting the cancer and clinical presentation
• Length bias (detecting early may seem to show a correlation between screening and higher survival rates)
• Overdiagnosis

Question 17

How are tumour markers useful and give some examples.

Answer 17

• Monitoring cancer burden
• Various substances released by cancer cells into the circulation
• Hormones/oncofetal agents/specific proteins