Oncology Flashcards
what is tumour grading?
histological features of a tumour
what is tumour staging?
tumour burden and sites involved
what does TNM stand for in tumour grading?
T= which primary Tissue is affected N= metastatic spread to lymph Nodes M= distant Metastasis sites
which lymph nodes do most tumours spread?
go to nearest node towards centre of body
where do cranial abdominal tumours spread (LN)
sternal lymph nodes
thyroid carcinoma LN spread?
retropharyngeal LN
distal forelimb LN spread?
prescapular LN
proximal forearm LN spread
axillary node
if on cytology a tumour sample has 3 or more of these, what does this indicate?
nuclear: multinucleation karygomegaly mitoses nuclear moulding- rapid cell growth large angular or variably sized nuclioli
hypercellarity
pleomorphism
high and variable N:C ratio
criteria of malignancy
histiocytoma, lymphoma, mast cell tumours and plasmacytomas are which kind of tumours?
round cell tumours (lymphocyte origin)
trichoblastomas, sebaceous adenomas, hepatoid gland tumour, squamous cell carcinoma and anal sac adenocarinomas are which types of tumour cells?
epithelial tumours
malignant forms end in -carcinoma
perivascular, nerve sheath tumours. fibrosarcomas and injection site sarcomas are which type of tumour cells?
mesenchymal/ spindle cell tumours
malignant end in -sarcoma
what does
- excisional biopsy
- insicional biopsy
mean
excisional= whole mass is removed + histopathology
benign masses, small masses
incisional= part of mass removed + histopathology
what surgical margin should a benign mass have
1cm surrounding margin
what surgical margin should most carcinomas have
1cm surrounding margina dn one fascial plane deep
what surgical margin should soft tissue sarcomas and mast cell tumours have
2-3cm margins and one deep fascial plane
this is ‘wide’
what is a ‘radical’ surgical margin
removal of whole tissue compartment
Define: primary chemotherapy
sole anti cancer treatment in highly sensitive tumour types
define adjuvant chemotherapy
treatment given after surgery to mop up microscopic residual disease
define: neoadjuvant chemotherapy
before surgery to shrink tumour size and increase chance of successful resection
concurrent chemotherapy
simulatatious chemo and radiation therapy
- increases tumour sensitivity to radiation
what is the growth fraction of a tumour
fraction of cells dividing at any one time
what is the mitotic index of a tumour
% or number od mitoses per high field power on light microscopy (cells in M phase)
what is the mass doubling time of a tumour
time it takes for a tumour to double in size
what does the gompertzian growth model show?
increasing number of cells in tumour decreases the growth rate
the following drugs are which kind of chemotherapy agents? cyclophosphamide melphalan chlorambucil lomustine
alkylating agents
affects DNA replication
the following drugs are which kind of chemotherapy agents?
doxorubicin, epirubicin
mitoxantrone
actinomycin D
antitumour antibiotics
affects DNA replication
the following drugs are which kind of chemotherapy agents? cytosine arabinoside methotrexare 5- fluorouracil
antimetabolites
affects purine and pyrimidine synthesis
the following drugs are which kind of chemotherapy agents?
vincristine
vinblastine
vinca alkaloids (interfere with mitosis)
useful for mast cell tumours: vincristine + prednisolone
how can L-asparaginase and corticosteroids be used in cancer tx?
both are chemotherapy like drugs
note: do not use steroids if going to start chemo later on as makes resistance higher later on
define metronomic chemotherapy
continous low dose chemotherapy, more drug dense
drugs: cyclophosphamide
CHOP, CEOP protocols in dog
COP protocol in cat.
are used to tx which tumour type?
lymphoma
tumour cell death in radiotherapy occurs due to what?
proton beam inducting apoptosis, permanent cell cycle arrest or mitotic catastrophe
what are the 4 Responses to radiotherapy
Repair
Repopulation- cells recruited from G0
Redistribution
Reoxygenation
what is fractionation radiation therapy?
2 doses of radiation therapy given at different times
gives time for healthy tissue to repair, but also time for tumour cells to repair :(
which tumour characteristics are more sensitive to radiation therapy?
smaller more rapidly dividing
carcinomas> sarcomas
list 3 highly radiosensitive tumours
lymphoma
transmissible venereal tumour
gingival basal cell carcinoma
are these tumours moderately or poorly radiosensitive?
- Oral SCC (dogs)
- Oral malignant melanoma (dogs)
- Nasal tumours
- Perianal adenocarcinoma
- MCTs
- Rhinarial SCC (cats)
- Thyroid carcinomas
- Brain tumour
moderate
are these tumours moderately or poorly radiosensitive?
- Fibrosarcoma
- Haemangiopericytomas
- Oral SCC in cats
- Osteosarcomas
- Rhinarial SCC in dogs
poor
most common oral tumours in dog
malignant melanoma> squamous cell carcinoma> fibrosarcoma
m>s>f
most common oral tumours of cat
SCC> fibrosarcoma
S>F
which dog oral tumour is this
Sp/br: smaller older dogs, golden retriever, cocker spaniel, miniature poodle, chow chow
Px: very locally invasive, high metastatic rate
Dx: melanin containing mesenchymal cells, elevated mitotic index
Tx:
- Surgery: Mandibulectomy preferred
- Radiation therapy
- Anti-metastatic treatment- chemo does not extend survival, plasmid vaccine immunotherapy (stimulates response to melanocytes)
malignant melanoma
which dog oral tumour is this
low metastatic rate, varies with grade.
Tx:
mandibulectomy preferred, RT a lot better survival than melanoma
Medical: piroxicam, piroxicam +carboplatin
tonsil from is highly metastatic
SCC
which dog oral tumour is this
Sp/br: golden retriever and lab, middle aged
Px: often caudal maxilla in younger large breed dogs
B: locally invasive, low/ moderate metastatic risk
Tx: local control mainly- surgery>multimodal >RT alone, smaller tumour better outcome
fibrosarcoma
what are epiludes?
non metastatic lesions arising from gingiva