Neoplasm IV Flashcards
What is staging?
The extent of spread of tumour
What is TNM staging?
T = Primary Tumour
N = Regional Lymph Node involvement
M = Metastasis
Differences between different cancers
What is Duke’s staging for colorectal carcinomas?
A - Confined to bowel wall. Not extending through muscularis propria
B - Through bowel wall (Muscularis propria)
C - Regional Lymph nodes involved
D - Apical node (furthest away node) involved
What is the Ann Arbor classification?
Used to classify Hodkin’s lymphoma
I – One lymph node involved
II – Two lymph nodes on one side of the diaphragm
III - > Two lymph nodes on both sides of the diaphragm
IV – Multiple foci (Bloody everywhere)
What is Grading?
Based on the degree of differentiation of tumour cells. Attempts to judge the extent to which tumour cells resemble or fail to resemble their normal counterparts.
What is the Scarff-Bloom-Richardson Grading system?
Used to grade breast carcinomas (Grade 1 –> 3)
Degree of tubule formation
Extent of nuclear variation
Number of mitoses
What is the Gleason Grading System?
Used to grade Prostate carcinomas
Have 2 scores - 1 is grade of most common tumour pattern (2–>10) + 1 is highest grade present (1–>5)
How does Radiotherapy treat cancer?
External radiation to rumour at fractionated doses with shielding of adjacent normal tissues
Causes damage to DNA of rapidly dividing cells
If DNA damage is extensive –> Apoptosis
How does Chemotherapy treat cancer?
Drugs used have effects at particular stages of the cell cycle. Also have effects on rapidly dividing cells
How does Cyclophosphamide treat cancer?
Type of Chemotherapy - Act on cells in G1/S and mitosis
How does Vincristine treat cancer?
Type of Chemotherapy - Block cells entering cell cycle/act on mitosis
How does Methotrexate treat cancer?
Type of Chemotherapy - Acts on cells in S phase
How does Tamoxifan treat cancer?
Type of Hormone therapy - Competes for binding to Oestrogen Receptor - Shrinks primary tumour
50-80% of Breast Cancers express oestrogen receptors
How does Herceptin treat cancer?
Type of Hormone therapy - HER-2 Growth factor receptor
Overexpressed in 20-30% of breast carcinomas
Herceptin = Humanised monoclonal antibody
Side effects – Cardiac/pulmonary toxicity, can be fatal
Shrinks size of primary tumour
How do hormones treat prostate cancer?
Depends on androgens
To treat, deprive tumour of testosterone
Shrinks the size of the tumour
How is carcinoembryonic antigen useful in cancer treatment?
Normally only in embryonic tissue, but cells become so undifferentiated express it
Can see if there is any residual disease left after the removal of tumours.
How is Alpha-Fetoprotein useful in cancer treatment?
Normally synthesised early in foetal life by yolk sac, foetal liver and foetal GIT.
Raised plasma levels associated with cancer of liver and yolk sac tumour of testis (nonseminomatous testicular tumours)
How is Prostate Specific Antigen useful in cancer monitoring?
Shows enlargement of the prostate (could be due to prostate carcinoma)
How is Prostate Specific Antigen useful in cancer monitoring?
Shows enlargement of the prostate (could be due to prostate carcinoma)
Why was screening brought into the UK?
Screening aims to detect pre-malignant, non invasive and early invasive cancers to improve prognosis
Why was screening brought into the UK?
Screening aims to detect pre-malignant, non invasive and early invasive cancers to improve prognosis
What are the 3 main screening programmes in the UK?
Breast - Mammograms to look for densities/calcifications
Cervix - Take some of endometrium lining
Bowel
What are the 3 main screening programmes in the UK?
Breast - Mammograms to look for densities/calcifications
Cervix - Take some of endometrium lining
Bowel
