neoplasia 5 Flashcards
what are the most common types of cancer in women?
- breast
- lung
- bowel
what are the most common types of cancer in men?
- prostate
- lung
- bowel
what are the 4 most common cancers worldwide?
- lung
- femal breast
- bowel
- prostate
what are the most common cancers in children?
- leukaemia
- CNS tumour
- lymphomas
what are the different outcomes for cancer patients?
- cure
- remission
- death
what is meant by the term cure in regards to cancer outcomes?
no traces of cancer after treatment and cancer will never come back (most cancers return within 5 years of treatment)
what is meant by the term remission in regards to cancer outcomes?
signs and symptoms of cancer are reduced (partially or completely)
what is cancer specific survival?
% of patients with a specific type and stage of cancer who have not died from their cancer during a certain period of time
what is relative survival?
% of cancer patients who have survived for a certain period of time after diagnosis compared to people who dont have cancer
what is disease free survival?
% of patients who have no signs of cancer during a certain period of time after treatment
what is the tumour stage?
standardised staging system across the world to describe solid tumours (not leukaemias):
TNM staging system
T = size of PRIMARY tumour (T1 = small, T2 = larger etc.)
N = extent of regional lymph node involvement (N0 = no lymph nodes, N1 = 1 lymph node etc.)
M = metastatic spread via blood (M0 = no metastasis, M1 = metastatic)
what are the 4 different tumour stages?
- stage 1 = early local disease
- stage 2 = advanced local disease
- stage 3 = regional metastasis
- stage 4 = advanced disease with distant metastasis
what is the ann arbor staging system?
determines the severity of a lymphoma:
Stage 1 = lymph nodes effected are on same side of diaphragm
Stage 3 = lymph nodes effected on different sides of diaphragm
Stage = spreads to other organs
what is the Duke staging system?
staging system specific to bowel cancer
Duke A = cancer is only just invading the bowel
Duke B = cancer has infiltrated muscle wall
Duke C = cancer has fully infiltrated and lymph node involvement
Duke D = metastises
what are the different grading stages?
G1 = well differentiated
G2 = moderately differentiated
G3 = poorly differentiated
G4 = undiferentiated or anaplastic
what are the different treatments for cancer?
- surgery
- radiotherapy
- chemotherapy
- hormone therapy
- treatments targeted to specific molecular alterations
- immunotherapy
what are adjuvant treatments?
treatment given after surgical removal of primary tumour to eliminate subclinical disease
(trying to mop up and rogue cells)
what are neoadjuvant treatments?
treatment is given prior to surgical excision to reduce size of primary tumour
what are the basic principles of radiation therapy?
- kills proliferating cells by triggering apoptosis and interfering with mitosis
- doesnt kill cancer cells immediately but has longer lasting affects
- given in fractionated doses to minimise normal tissue damage
- causes either direct damage or free radical damage which is detected by cell cycle checkpoints
what are the types of radiation therapy?
- external beam radiotherapy - external machine aims radiation at cancer
- internal radiation therapy - source of radiation put in body:
* local = radiation put inside tumour
* systemic = radioactive iodine
what are the basic principles of chemotherapy?
- systemic treatment
- kills cancer cells that have spread to other parts of body
- used in isolation or with other chemotherapeutic agents
- usually used with other cancer treatments
what are differnet types of chemotherapy?
- antimetabolites = mimic normal substrates involved in DNA replication
- alkylating + platinum based drugs = cross link 2 strands of DNA helix causing damage
- antibiotics = damage DNA
- plant derived drugs = prevents spindle formation which stops DNA replication
what are some consequences of chemotherapy?
- hair loss
- pain
- mouth sores
- weaken immune system
- anaemia
- stops platelet production - results in bleeding
what is biomarker testing?
- precision medicine
- process to look for genes, proteins and biomarkers
- therapies are then selected based on gene profiling
what are hormone therapies and how do they work?
selective oesterogen receptor modulators (SERMs): Tamoxifen
* bind to oestrogen receptors thus prevent oestrogen receptors to prevent oestrogen from binding
* used to treat hormone receptor positive breast cancer
what are targeting oncogene drugs?
identifying cancers which have caused mutations in oncogenes allows us to use drugs which can target the specific cancer cells
what are the basic principles of immunotherapy?
- targets immune system to help it fight cancer
- detects and destroys abnormal cells + prevents growth of cancers
- tumours infiltrating the lymphocytes are a sign that the immune system is responding to the tumour
what are the different types of immunotherapy?
- Immune checkpoint inhibitors = block immune checkpoints which allows immune cells to respond more strongly
- T cell transfer therapy = boosts natural ability of T cells to fight cancer
- Monoclonal antibodies = help immune system proteins to bind to specific targets on cancer cells - names usally end in -mab
- Treatment vaccines = boost immune response against cancer cells (e.g. oncolytic virus therapy)
what are tumour markers?
substances that are released by cancer cells into blood
these can be measured:
* to help diagnose
* measure tumour burden
* assess response to therapy
* assess recurrence
What are the the side effects of tamoxifen?
Increased risk of endometrial cancer
Induces menopause
What are some drugs which target oncogenes and what cancer are they used for?
Trastuzumab - for HER2 positive breast cancers
Imatinib - for leukaemias
