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Mechanisms Of Disease > Neoplasia 4 > Flashcards

Neoplasia 4 Flashcards

1
Q

What are the 4 most common cancers in the UK?

A

Breast
Lung
Prostate
Bowel

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2
Q

What are the 3 most common cancers in children under 14?

A

Leukaemias
CNS tumours
Lymphomas

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3
Q

Which type of cancer causes the most UK deaths?

A

Lung

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4
Q

Name 5 types of cancer with high 5 year survival rates

A 
Testes
Malignant melanoma
Breast 
Hodgkin lymphoma 
Prostate
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5
Q

Name 5 cancers with very low 5 year survival rates

A 
Pancreas
Lung
Oesophagus 
Brain 
Stomach
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6
Q

What factors do we need to consider in predicting outcome of cancer?

A 
Age 
General health status 
Tumour site
Tumour type
Grade (differentiation) 
Stage 
Availability of effective treatment
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7
Q

Tumour stage is a measure of …

A

Neoplasm burden

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8
Q

Describe the TNM staging system

A

Most widely recognised system worldwide
T = size of primary tumour (T1-T4)
N = extent of regional node metastasis (N0-N3)
M = distant metastatic spread (M0-M1)
Each cancer has its own specific TNM criteria

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9
Q

Describe (generally) stage I to IV of cancer

A 
I = early local disease
II = advanced local disease
III = regional metastasis 
IV = advanced disease with distant metastasis
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10
Q

Which type of cancer do we use the Ann Arbor staging for?

A

Lymphoma

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11
Q

Describe the Ann Arbor staging?

A

Used to stage lymphoma
I = lymphoma in single node region
II = 2 separate regions on same side of diaphragm
III = spread to both sides of diaphragm
IV = metastasis to one or more extra-lymphatic organ

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12
Q

Which cancer do we use Dukes’ staging for?

A

Colorectal carcinoma

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13
Q

Describe Dukes’ staging

A 
For colorectal carcinoma
A = invasion into but not through bowel wall 
B = invasion through bowel wall
C = involvement of lymph nodes
D = distant metastases
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14
Q

Briefly describe the tumour grading system

A 
Describes the degree of differentiation 
G1 = well differentiated 
G2 = moderately differentiated 
G3 = poorly differentiated 
G4 = undifferentiated/anaplastic
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15
Q

Which grading system is used for breast carcinoma and what do we have to assess to grade?

A

Bloom-Richardson System

Assess: tubule formation, nuclear variation and number of mitoses

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16
Q

What is the main treatment for most cancers?

A

Surgery

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17
Q

What is adjuvant treatment?

A

Given after surgery

Eliminate any sub-clinical disease remaining (micromets)

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18
Q

What is neoadjuvant treatment?

A

Given prior to surgery

Reduce the tumour size to make it more operable

19
Q

How does radiation therapy work?

A

Kills proliferating cells by triggering apoptosis or interfering with mitosis

20
Q

Describe the process of radiotherapy

A

Focused on tumour with shielding of the surrounding tissues
Given in fractionated doses to minimise normal tissue damage
Use ionising radiation (eg. Xray)
Causes direct or free radical induced DNA damage - triggers apoptosis
Or causes double stranded DNA breaks which prevent mitosis

21
Q

How do anti metabolites work?

A

Mimic normal substrates involved in DNA replication

Eg. Fluorouracil

22
Q

How do alkylating and platinum based drugs work?

A

Cross-link the 2 strands of the DNA helix

Eg. Cisplatin

23
Q

How do antibiotics work as chemotherapy?

A

May inhibit DNA topoisomerase needed for DNA synthesis

May causes double stranded DNA breaks (no mitosis)

24
Q

How do plant-derived drugs work in chemotherapy?

A

Blocks microtubule formation

Cannot undergo mitosis

25
Q

What are SERMs?

A

Selective oestrogen receptor modulators
Eg. Tamoxifen
Binds to oestrogen receptors to prevent oestrogen binding
Limit tumour growth
Treatment for hormone receptor positive breast cancer

26
Q

What do we call the hormone therapy used to treat prostate cancer?

A

Androgen blockade

27
Q

How can we target oncogenes in breast cancer?

A

25% of breast cancers have over expression of HER-2

Use Herceptin which blocks HER-2 signalling

28
Q

How can we target oncogenes in chronic myeloid leukaemia?

A

Shows a chromosomal rearrangement known as Philadelphia chromosome which encodes a oncogenic fusion protein BCR-ABL
Imatinib inhibits this protein

29
Q

What hormone may be released from testicular tumours?

A

hCG

30
Q

Which antigen may be released from hepatocellular carcinoma?

A

Alpha fetoprotein

31
Q

What protein may be released from prostate carcinoma?

A

PSA - prostate specific antigen

32
Q

What can be used as a marker for ovarian cancer?

A

CA-125

33
Q

Name the problems with cancer screening

A

Lead time bias
Length bias
Over diagnosis

34
Q

Describe lead time bias

A

People appear to be living longer with the particular cancer but actually we are just finding it earlier

35
Q

Describe length bias

A

Screening preferentially identifies slower growing tumours

36
Q

Describe over diagnosis

A

Diagnosing cancers that may never progress or cause a problem to that person during their lifetime
May be giving unnecessary treatment

37
Q

Which cancers currently have screening programmes for them in the UK?

A

Breast
Cervical
Bowel

38
Q

What is cervical cancer strongly associated with?

A

HPV

Over 90% of cases

39
Q

What types of cancers occur in the cervix?

A 
90% = squamous cell carcinoma
10% = adenocarcinomas
40
Q

What is the likelihood for any woman of developing breast cancer?

A

1 in 8

41
Q

What is the commonest cancer in men?

A

Prostate carcinoma

42
Q

Where does prostate carcinoma metastasise to?

A

Lymph nodes and bone

43
Q

Germ cell testicular tumours often release which markers?

A

AFP

hCG

44
Q

Which cells are indicative of Hodgkin’s lymphoma?

A

Reed-Sternberg cells

Multinucleated

Mechanisms Of Disease (11 decks)

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