Neoplasia 4 Flashcards

1
Q

What are the 4 main types of cancers in the UK?

A

1) breast
2) lung
3) prostate
4) bowel

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2
Q

Which cancer is the biggest cause of cancer related death in the UK?

A

Lung cancer

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3
Q

What factors should be considered when predicting outcome for malignant neoplasms?

A

1) age
2) general health
3) tumour site
4) tumour type
5) grading
6) staging
7) availability of effective treatment

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4
Q

Explain the commonest method of cancer staging

A

The TNM staging system

T= size of tumour (T1-T4)

N= extent of metastasis to nodes (N0 = no nodes - N3)

M= extent of distant metastatic spread via blood (M0-M1)

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5
Q

Describe cancer staging from 1-4

A

Stage 1=T1 or T2

Stage 2= T3 or T4

Stage 3= any T, >1 node

Stage 4= any T, any N and M1

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6
Q

Name and describe the cancer staging for Lymphoma

A

Ann Arbor cancer staging

1= lymphoma in a single node region

2= two separate nodes on one side of the diaphragm

3= spread to nodes both sides of the diaphragm

4= spread to extra- lymphatic organs e,g bone marrow or lung

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7
Q

Name and describe the staging used for colorectal cancer

A

Dukes staging

Dukes A= invasion but not through the bowel wall

DukesB= invasion through the bowel wall

Dukes C= involvement in lymph nodes

Dukes D= distant metastasis

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8
Q

Describe the principles of tumour grading

A

Rumours are graded from G1 to G4

G1= well differentiated - G3= poorly differentiated

G4= undifferentiated/ anaplastic

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9
Q

Name and describe the grading system of breast cancer

A

Modified Bloom-Richardson system

  1. Tubules
  2. Mitoses
  3. Nuclear pleomorphisms
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10
Q

What is the difference between adjuvant and neo adjuvant cancer treatment?

A

Neo-adjuvant = treatment given before surgery to reduce the size of the primary tumour

Adjuvant = treatment given after surgical removal of a tumour to try and eliminat micrometastasis

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11
Q

How does radiotherapy kill cancer cells?

A

Radiotherapy targets proliferating cells by triggering apoptosis by interfering with mitosis at G2 stage of the cell cycle

Radiation directly or indirectly (by free radical production) damages the DNA, triggering cell cycle check points

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12
Q

What is the best way to give radiotherapy?

A

In multiple smaller doses to allow healthy cells more time to recover

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13
Q

How do antimetabolites target proliferating cells?

A

They mimic the normal substances involved in DNA replication e.g fluorouracil

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14
Q

How do alyklating and platinum based drugs target proliferating cells?

A

Cause cross linking of the 2 strands of the DNA helix e.g. cyclophosphamide and cisplatin

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15
Q

How do antibiotics affect proliferating cells?

A

Doxorubicin inhibits DNA topoisomerase

Bleomycin causes DS DNA breaks

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16
Q

How do plant derived drugs target proliferating cells?

A

Vincristine blocks microtubule assembly which interferes with mitosis spindle formation

17
Q

How does tamoxifen work?

A

Tamoxifen is a selective oestrogen modulator that binds to the oestrogen receptor to prevent oestrogen binding and driving cell proliferation

Only works in hormone receptor positive breast cancers

18
Q

How does Herceptin work?

A

Binds to cells that over express the HER 2 gene to stop HER 2 signalling

19
Q

What proportion of breast cancers have over expression of HER 2?

A

1/4

20
Q

How does imatinib work?

A

Imatinib inhibits the fusion of BCR and ABL proteins (Philadelphia chromosome) in chronic myeloid leukaemia

21
Q

What tumour markers are released by testicular tumours?

A

Human chorionic gonadotropin

22
Q

What tumour markers are released by hepatocellar carcinoma?

A

Oncofetal antigens

23
Q

In what cancer would AFP (alpha fetoportin) be raised?

A

Male with testicular teratoma

24
Q

What is most important for determining cancer prognosis?

A

Presence of metastasis in lymph nodes

25
Q

What blood marker is raised in ovarian carcinoma?

A

Cancer antigen 125

26
Q

What kind of cancer is least likely to develop in those <16 years old?

A

Carcinoma