Neoplasia 4 Flashcards
What are the 4 main types of cancers in the UK?
1) breast
2) lung
3) prostate
4) bowel
Which cancer is the biggest cause of cancer related death in the UK?
Lung cancer
What factors should be considered when predicting outcome for malignant neoplasms?
1) age
2) general health
3) tumour site
4) tumour type
5) grading
6) staging
7) availability of effective treatment
Explain the commonest method of cancer staging
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)
Describe cancer staging from 1-4
Stage 1=T1 or T2
Stage 2= T3 or T4
Stage 3= any T, >1 node
Stage 4= any T, any N and M1
Name and describe the cancer staging for Lymphoma
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
Name and describe the staging used for colorectal cancer
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
Describe the principles of tumour grading
Rumours are graded from G1 to G4
G1= well differentiated - G3= poorly differentiated
G4= undifferentiated/ anaplastic
Name and describe the grading system of breast cancer
Modified Bloom-Richardson system
- Tubules
- Mitoses
- Nuclear pleomorphisms
What is the difference between adjuvant and neo adjuvant cancer treatment?
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
How does radiotherapy kill cancer cells?
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
What is the best way to give radiotherapy?
In multiple smaller doses to allow healthy cells more time to recover
How do antimetabolites target proliferating cells?
They mimic the normal substances involved in DNA replication e.g fluorouracil
How do alyklating and platinum based drugs target proliferating cells?
Cause cross linking of the 2 strands of the DNA helix e.g. cyclophosphamide and cisplatin
How do antibiotics affect proliferating cells?
Doxorubicin inhibits DNA topoisomerase
Bleomycin causes DS DNA breaks
How do plant derived drugs target proliferating cells?
Vincristine blocks microtubule assembly which interferes with mitosis spindle formation
How does tamoxifen work?
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
How does Herceptin work?
Binds to cells that over express the HER 2 gene to stop HER 2 signalling
What proportion of breast cancers have over expression of HER 2?
1/4
How does imatinib work?
Imatinib inhibits the fusion of BCR and ABL proteins (Philadelphia chromosome) in chronic myeloid leukaemia
What tumour markers are released by testicular tumours?
Human chorionic gonadotropin
What tumour markers are released by hepatocellar carcinoma?
Oncofetal antigens
In what cancer would AFP (alpha fetoportin) be raised?
Male with testicular teratoma
What is most important for determining cancer prognosis?
Presence of metastasis in lymph nodes
