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Path Pro > Neoplasia 4 > Flashcards

Neoplasia 4 Flashcards

1
Q

What are the commonest cancers in Men and Women

A

Men: Lung, Bowel, Prostate

Women: Lung, Bowel, Breast

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2
Q

What are the commonest cancers in Children (below 14)

A

Leukaemias
CNS tumours
Lymphomas

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3
Q

State the survival rates for;

  • Testicular cancer
  • Melanoma
  • Breast cancer
  • Pancreatic cancer
  • Lung cancer
  • Oesophageal cancer
A
  • Testicular: 98%
  • Melanoma: 90%
  • Breast: 87%
  • Pancreatic: 3%
  • Lung: 10%
  • Oesophageal: 15%
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4
Q

Which cancer is the biggest cause of deaths in the UK?

A

Lung cancer

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5
Q

What are 7 factors that influence the outcome of a malignant neoplasm?

A
  • Age
  • General health status
  • Tumour site
  • Tumour type
  • Grade (differentiation)
  • Tumour stage
  • Availability of effective treatments
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6
Q

Tumour stage is a measure of the malignant neoplasm’s overall burden.

The most common system used to measure this is the TNM system. Explain this system

A

T: Refers to size of primary tumour (T1-T4)

N: Describes the extent of regional lymph node involvement (N0-N3)

M: Denotes the extent of metastatic spread via blood (M0 or M1)

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7
Q

For a given cancer the T,N and M status are usually converted to stages 1-4. The staging varies for each cancer.

Give broad descriptions of each stage

A

Stage I: Early local disease

Stage II: Advanced local disease (N0, M0)

Stage III: Regional metastasis (M0 with N1 or more)

Stage IV: Advanced disease with distant metastasis (M1)

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8
Q

Name and describe the staging system used for Lymphoma (Has its own staging system)

A

Ann Arbor Staging System

Stage I: Lymphoma in a single node region

Stage II: Lymphoma in 2 separate regions on same side of diaphragm

Stage III: Spread of lymphoma to both sides of diaphragm

Stage IV: Indicates diffuse/ disseminated involvement of 1/ more extra-lymphatic organs (Such as lungs, bone marrow)

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9
Q

Dukes’ Staging System used to be used specifically for one kind of cancer.

It is now incorporated into the TNM system.

Which cancer was it, and is still used for?

A

Colorectal carcinoma (bowel cancer)

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10
Q

Describe the Stages in Dukes’ Staging System (Colorectal carcinoma)

A

Dukes’ A: Invasion into, but not through bowel

Dukes’ B: Invasion through bowel wall

Dukes’ C: Involvement of lymph nodes (outside bowel wall)

Dukes’ D: Distant metastases (such as in liver)

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11
Q

Tumour grade describes the degree of differentiation of a neoplasm

What do the 4 grades mean?

A

G1: Well-differentiated

G2: Moderately differentiated

G3: Poorly differentiated

G4: Undifferentiated or Anaplastic

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12
Q

For what 2 cancers, is the Tumour Grading system used?

A

Squamous cell carcinoma

Colorectal carcinoma

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13
Q

Name the grading system used for Breast Carcinoma

What 3 things does it asses?

A

Bloom-Richardson System

Assesses;

  • Tubule formation
  • Nuclear variation
  • Number of mitoses/ mitotic figures
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14
Q

Tumour grade is more important than tumour stage, for planning treatment and estimating prognosis in certain types of malignancy.

Name 4 of these malignancies

A
  • Soft tissue sarcoma
  • Primary brain tumours
  • Lymphomas
  • Breast and prostate cancer
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15
Q

List 6 types of Cancer Treatment

A
  • Surgey
  • Radiotherapy
  • Chemotherapy
  • Hormone therapy
  • Targeted molecular therapies
  • Immunotherapy
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16
Q

In reference to cancer, when is Adjuvant Treatment given? What is its purpose?

A
  • Given after surgical removal of a primary tumour

- To eliminate subclinical disease (micrometastases)

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17
Q

In reference to cancer, when is Neoadjuvant Treatment given? What is its purpose?

A
  • Given before surgical removal of a primary tumour

- To reduce size of the primary tumour

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18
Q

Radiotherapy kills proliferating cells by triggering apoptosis or interfering with mitosis.

What are 2 ways it minimises damage to normal tissues

A
  • Focused on tumour (with shielding of surrounding healthy tissue)
  • Given in fractionated doses
19
Q

How does Radiotherapy kill rapidly dividing cancer cells (especially in G2 of cell cycle)?

A

High dosage causes either Direct or Free-radical Induced DNA damage.

This is detected by cell cycle check points triggering apoptosis

20
Q

How does Radiotherapy interfere with mitosis in cancer cells?

A

Causes double strand DNA breaks, leading to damaged chromosomes

Thus, M phase is prevented from completing correctly

21
Q

List 4 classes of Chemotherapy agents

A
  • Antimetabolites
  • Antibiotics
  • Plant derived drugs
  • Alkylating and Platinum based drugs
22
Q

Antimetabolites are a class of chemotherapy agents.

How do they work?
Give 1 example

A
  • Mimic normal substrates involved in DNA replication

- Fluorouracil

23
Q

Antibiotics are a class of chemotherapy agents.

Give 2 examples
How does each one work?

A

Doxorubicin;
- Inhibits DNA topoisomerase (needed to make DNA)

Bleomycin;
- Causes double strand DNA breaks

24
Q

Plant derived drugs are a class of chemotherapy agents.

Give 1 example
How does it work?

A

Vincristine (from Periwinkles);

- Blocks microtubule assembly and interferes with mitotic spindle formation

25
Q

Alkylating and Platinum based drugs are a class of chemotherapy agents.

How do they work?
Give 2 examples

A

Cross link the 2 strands of the DNA helix

  • Cyclophosphamide
  • Cisplatin
26
Q

List 4 side effects of Chemotherapy, other than Pain, Vomiting and Hair loss

A
  • Mouth sores
  • Weakened immune system
  • Rashes
  • Nausea/ vomiting
  • Constipation/ diarrhoea
  • Bruising/ bleeding
27
Q

Hormone therapy is a relatively non-toxic treatment for certain malignant tumours

What kind of drugs do use to treat hormone receptor positive breast cancer?
Give an example?

A

Selective Oestrogen Receptor Modulators (SERMs)

Tamoxifen

28
Q

How do Selective Oestrogen Receptor Modulators (SERMs) work?

One example is Tamoxifen

A

Bind to oestrogen receptors, preventing oestrogen from binding

29
Q

Give an example of using Selective Oestrogen Receptor Modulators (SERMs) to treat prostate cancer

A

Androgen blockade

30
Q

Identifying cancer specific alterations (such as oncogene mutations) allows us to create drugs targeted specifically at cancers cells

Give 2 examples of such drugs

A

Herceptin (trastuzumab)
Gleevec (imatinib)

(These are oncogene targeting drugs)

31
Q

A quarter of breast cancers have over-expression of the HER2 gene (Encodes a GF receptor).

Suggest 1 oncogene targeting drug that can be used, and how it works

A

Herceptin, blocks HER2 signalling

32
Q

Chronic Myeloid Leukaemia (CML) creates an abnormal Philadelphia chromosome in which an oncogene could fusion protein (BCR-ABL) is encoded.

Suggest an oncogene targeting drug that can be used
How does it work?

A

Gleevec (imatinib), inhibits the fusion protein

33
Q

Cancer cells release various substances into circulation. These are called Tumour Markers.

What are they used for?

A
  • Mainly, to monitor tumour burden during treatment and follow up
  • Some have a role in diagnosis
34
Q

List 4 types of Tumour Markers

A
  • Hormones
  • Oncofetal antigens
  • Specific proteins
  • Mucins/ glycoproteins
35
Q

Given an example of a Hormone Tumour Marker

What kind of cancer releases it?

A
  • Human Chorionic Gonadotropin (HCG)

- Testicular tumours

36
Q

Given an example of an Oncofetal antigen Tumour Marker

What kind of cancer releases it?

A
  • Alpha fetoprotein (AFP)
  • Hepatocellular carcinoma

(Another example is CEA- Carcinoembryonic Antigen)

37
Q

Given an example of a Specific Protein Tumour Marker

What kind of cancer releases it?

A
  • Prostate specific antigen (PSA)

- Prostate carcinoma

38
Q

Given an example of a Mucin/ Glycoprotein Tumour Marker

What kind of cancer releases it?

A
  • CA125 (cancer antigen 125)

- Ovarian cancer

39
Q

Cancer screening is meant for healthy people with no symptoms.

What are 3 possible problems with screening?

A
  • Over diagnosis
  • Lead time bias
  • Length bias
40
Q

In the UK, name 3 cancers that have established national screening programmes

A
  • Cervical cancer
  • Breast cancer
  • Bowel cancer
41
Q

Who is offered Breast cancer screening?

A

Women, aged 50-71

2 tests every 3 years, looks for tumours that can be surgically removed

42
Q

Who is offered Cervical Cancer Screening in the UK?
How often?

(Tests for HPV)

A

Women aged 25-64

Every 3 years for women aged 25-49
Every 5 years for women aged 50-64

43
Q

Describe Bowel Cancer Screening in the UK

A

2 methods

  • Home testing kit: For men and women aged 60-74 (Every 2 years)
  • Bowel scope screening: For men and women 56 or above (Only in some parts of England)

Path Pro (14 decks)

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