ONCO Flashcards
name the 5 most common site for head and neck cancers
nasophrynx
oral cavithy
oropharynx
hypopharynx
larynx
what is the most commonhistological type of head & neck cancer
squamous ce3ll carcinoma
what is the main risk factor for Head and neck cancers
give 2 others
HPV (16)
2 others: alcohol, smoking, EBV
give 5 Sx suggesting head & neck cancer
- Dysphagia
- odynophagia
- dysphonia ,
- ALARM symptoms ( tiredness, unexplained weight loss, loss of appetite)
- Lymphadenopathy
o Many cancers may just present as a neck lump due to metastasis to lymph node - airway compromise (stridor)
- halitosis
- focal neurology (VII cranial nerve palsy)
what is the genetic inheritance of Li-Fraumeni syndrome
Autosomal dominant
an inherited condition that is characterized by an increased risk for certain types of cancer (sarcomas/ leukaemiaS)
mutations to what gene causes Li-Fraumeni syndrome
p53 tumour suppressor gene
what cancers are associated with Li Fraumnei syndrome
an inherited condition that is characterized by an increased risk for certain types of cancer.
when are Ix for Li-Fraumeni syndrom conducted
Hx sarcoma in <45 yo
1st degree relative with cancer <45 + other family member with malignancy (<45yo) or sarcoma ( any age)
on what chromosome is BRCA 1 carried
17
what chromosome is the BRCA 2 gene found
13
the BRCA genes are associated with a 60% risk of developing breast cancer. what other cancer are females with these genes at risk of devloping
ovarian
( 55% risk with BRCA 1 , 25% risk with BRCA 2)
the BRCA genes are associated with a 60% risk of developing breast cancer. Which of these genes increases the risk of what other cancer in males ?
prostate
BRCA 2
what is hereditary non-polyposis colorectal cancer (HNPCC) also known as
lynch syndrome
what is the hereditary pattern of lynch syndrom
AD
( as with Li-Fraumeni)
what cancers are people with Lynch syndrome at risk of devloping at a young age?
colonic
endometrial
what criteria is used to determine the risk of having lynch syndrome
amsterdam criteria
what are the features of amsterdam criteria
> /=3 family members with confirmed colorectal cancer ( 1 is 1st degree relative of the other 2)
2 successive affected generations
/= 1 colon cancer in diagnosed <50yrs
Familial adenomatous polyposis has been excluded
what gene is mutated in Gardners syndrome
APC gene (chromosome 5)
what is the genetic inheritance of gardners syndrome
AD
( like Li-Fraumeni (breast cancer) and Lynch (colon cancer) )
what are the non-GI signs of gardners syndrome
skull osteoma, thyroid cancer and epidermoid cysts, dental issues (e.g caries/ supernumary teeth)
what Mx is often used in pts with Gardners syndrome
colectomy to reduce colorectal cancer risk
what anti-emetic is used in nausea and vomiting caused by intracranial tumours
dexamethasone
(reduces ICP)
Sx of metastasis to bones (x2)
pain
pathological fractures
hypercalcaemia
raised ALP ( raised ALP on its own is bone)
sx metastasis to brain (x3)
headaches
seizures
neuro deficits
Sx metastasis of lung cancer
cough
SOB
chest pain
what are the most common causes of bone mets (x3)
descrending order
prostate
breast
lung
Po – Prostate
R – Renal
Ta – Thyroid
B – Breast
Le – Lung
what cancers typically metastesis to the lung
breast (also common in bone)
colorectal
renal (also common in bone)
bladder
prostate (also common in bone)
how do lung mets appear on X-ray
cannonball metastases
multiple, round, well-defined lung cancers
most common with renal cell cancer but also choriocarcinoma/prostate
what is the monoclonal antibody tumour marker for breast cancer?
CA 15-3
what is the monoclonal antibody tumour marker for pancreatic cancer?
CA 19-9
what is the monoclonal antibody tumour marker for ovarian cancer?
CA 125
( think of them in order form top to bottom - breast (15-3), pancreas (19-9), ovarian (125))
what is the tumour antigen tumour marker for prostatic carcinoma?
Prostate specific antigen (PSA)
what is the tumour antigen tumour marker for hepatocellular carinomas & teratomas ?
alpha-feto protein (AFP)
what is the tumour antigen tumour marker for colorectal cancer?
carcinoembryonic agent (CEA)
what is the tumour antigen tumour marker for melanoma & schwannomas ?
S-100
what cancer(s) does the tumour antigen bombesin indicate?
small cell lung carcinoma
gastic cancer
neuroblastoma
how do pathological fractures appear
compression fractures and focal sclerotic bony lesions.
how do the fractures in bone mets differ to those in Pagets disease of the bone/multiple myeloma on X-ray
multiple myeloma/ pagest disease
osteolytic lesions ( loss of bones)
bone mets - sclerotic regions - thick areas of bones
apart from metastatic cancer and multiple myeloma, give 2 causes of pathological fractures
cancerous: sarcoma
non-cancerous: metabolic:
- osteoporosis,
- hyperparathyroidism
Bone disease
pagets disease
what is the most common cause of pathological fractures
tumours
features suggesting a pathological fracture
Pain: localised, severely disproportionate to injury
fracture followign minor trauma
deformity at fracture site
impaired function of affected limb
what genetic condition are desmoid tumours associated with
Gardners syndrome, mutation of PAPC gene on chromosome 5
desmoid tumours (fibrous growths which occur anywhere in the body) are found in 15% of cases
what is the difference in location between squamous cell lung canrcinomas and lung adenocarcinomas
squamous cell - close to large airways “lung nodule in close proximity to his left main bronchus.”
adenocarcinomas: peripheral lung
