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402 Oncology & Haematology > Oncology > Flashcards

Oncology Flashcards

1
Q

What 4 infections contribute towards the development of cancer?

A

HPV
Helicobacter pylori
HBV
HCV

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2
Q

Define adjuvant therapy?

A

Chemotherapy given after a debulking procedure to remove micro-metastases

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3
Q

Define neoadjuvant therapy

A

Chemotherapy given before a debulking procedure to reduce the size of mass

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4
Q

What is the term used to describe tumours that have not yet invaded the basement membrane ?

A

In situ tumours

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5
Q

What does the greek suffix “-oma” mean and what is it used to denote?

A

Swelling - a benign tumour

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6
Q

What is the suffix for malignant epithelial tumours?

A

-carcinoma (greek for crab)

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7
Q

What is the suffix for tumours derived from connective tumours?

A

-sarcoma (greek for flesh)

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8
Q

What are the 4 main originating tissues for cancer?

A

Epithelial
Connective
Lymphoid & Haemopoetic
Germ

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9
Q

What is the suffix used for tumours derived from germ cells?

A

-terato (Greek for monster)

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10
Q

How are tumours graded?

A

By degree of differentiation

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11
Q

What is the tumour grading scale?

A

1 - Well differentiated
2 - in the middle
3 - Poorly differentiated

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12
Q

How do the grades of differentiation relate to how closely cancer cells resemble origin tissue?

A

Well differentiated = more closely resemble

Poorly differentiated = do not resemble origin tissue

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13
Q

How does differentiation relate to mitotic and therefore growth rate of cancer cells?

A

Well differentiated - slower

Poorly differentiated - faster, more aggressive

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14
Q

What term is used to describe cancer cells which are so poorly differentiated that they have very few features of their origin tissue?

A

Anaplastic

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15
Q

How does tumour grading relate to prognosis?

A

1 - (well differentiated) favourable prognosis

3 - (poorly differentiated) worse prognosis

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16
Q

With regard to tumour grading, why is it important to sample a sufficient amount of tissue and microscopic sections?

A

They can be heterogenous such that different areas of it will have different amount of differentiation and mitotic activity within the tumour.

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17
Q

Prolonged exposure to what hormone is thought to play a role in breast cancer and how does this relate to menarche and menopause as a risk factor?

A

Oestrogen
Early menarche
Late menopause

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18
Q

How does parity relate to risk of breast cancer?

A 
Null parity 
Late parity (35+) increase of breast cancer
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19
Q

Does the combined oral contraceptive pill significantly increase the risk of breast cancer?

A

Not significantly no

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20
Q

How does HRT relate to the risk of breast cancer?

A

Increases it (1.66)

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21
Q

What is the commonist breast cancer in terms of histology?

A

invasive ductal carcinoma (DCIS)

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22
Q

What is there a high risk of with DCIS?

A

it becoming invasive

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23
Q

In terms of masses, how does breast cancer usually present?

A

a mass that persists throughout the menstrual cycle

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24
Q

In breast cancer how often does nipple discharge and pain occur?

A

discharge - 10%

pain 7%

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25
Q

What are the 4 communist sites of breast cancer metastasis?

A

Bone
Lung
Liver
Pleura

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26
Q

What are triple negative breast cancers?

A

Triple-negative breast cancer is cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein.

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27
Q

What are the implications of a breast cancer being triple negative in terms of treatment?

A

Triple negative cancers are not fuelled by hormones (progesterone/oestrogen) ot HER2 protein and so wil not respond to hormone treatment or medicines that target HER2 receptors

28
Q

In what age group do the majority of colorectal cancer deaths occur?

A

Over 60s (85%)

29
Q

Is their a gender bias in colorectal cancer?

A

No

30
Q

How do colorectal cancer rates differ between developing and developed world?

A

More common in developed world

31
Q

What aetiological factors are colorectal cancer most commonly related to?

A

Lifestyle

Advancing age

32
Q

What dietary factors are thought to increase the risk of colorectal cancer?

A

red meat
calorie
alcohol

33
Q

How does IBD relate to risk of colorectal cancer and what are the caveats applied to this?

A

Increases risk

But risk is also related to duration and severity of inflammation

34
Q

Around 5% of colorectal cancers occur as a consequence of genetic syndromes, which of these is the most common?

A

hereditary non-polyposis colorectal cancer

35
Q

What is the inheritance pattern of HNPCC?

A

Autosomal dominant

36
Q

How does the gene mutation for HNPCC relate to rissk of developing colorectal caner?

A

40% lifetime risk

37
Q

In which decade to pts with genetic predisposition most commonly develop HNPCC?

A

4th

38
Q

What is a rare but important genetic condition that significantly increases chances of developing bowel cancer?

A

familial adenomatous polyposis

39
Q

What is the inheritance pattern of FAP?

A

Autosomal dominant

40
Q

How does FAP usually develop over lifetime?

A

Numerous benign colonic polyps from young age.

Cancerous lesions in 3rd and 4th decade

41
Q

What prophylactic procedure would be strongly advised in pts with FAP?

A

colectomy

42
Q

What drug is used for oestrogen positive (ER+) breast cancer?

A

Tamoxifen (oestrogen antagonist)

43
Q

Can tamoxifen be used in post or pre menopausal women?

A

Both

44
Q

What drug only works if women have HER2 receptor?

A

Herceptin

45
Q

What type of drugs are used in post menopausal women and 3 examples?

A

Aromatase inhibitors

46
Q

10 hallmarks of cancer

A 
Genome instability
Resisting cell death
Evading growth suppressors
Evading replicative mortality 
Angiogenesis
Invasion and metastasis
Tumour inflammation 
Evading immune destruction 
Reprogramming energy metabolism   
Sustaining proliferative signalling
47
Q

What is the most important genetic regulator of tumour suppression via apoptosis?

A

TP53

48
Q

What tumour suppressor is most commonly lost in cancer cells?

A

TP53

49
Q

Angiogenesis is dependent upon which growth factors?

A

Vascular and platelet derived endothelial growth factors:
VEGF
PDGF

50
Q

What is the most common metabolic emergency in malignancy?

A

Hypercalcaemia

51
Q

What does hypercalcaemia in malignancy indicate about prognosis?

A

That it’s shit

52
Q

In what type of cancers in hypercalcaemia particularly common?

A 
Multiple myeloma
Breast
Lung
Head & neck
Lymphoma
53
Q

What are the vast majority (80%) of malignancy related hypercalcaemia caused by?

A

Parathyroid hormone related peptide (PTHrH) release by the tumour

54
Q

What are the minority (20%) of malignancy related hypercalcaemia caused by?

A

Release of calcium by osteoclasts in malignant cells

55
Q

10 signs and symptoms of hypercalcaemia

A 
Weight loss
Anorexia
Polydipsia
Polyurea 
Constipation
Abdominal pain
Dehydration 
Weakness 
Confusion 
Seizure 
Coma
56
Q

What is the management of hypercalcaemia and how long does it usually take to normalise?

A

Aggressive Rehydration
Bisphosphonates IV
3 days

57
Q

Is there a genetic mutation to routinely screen for in lung cancer?

A

No

58
Q

5 Local problems to suspect lung cancer?

A 
Cough
Haemoptosis 
Pain
Recurrent pneumonia
SoB
59
Q

Systemic problems associated with lung cancer

A 
Weight loss/anorexia  - shite prognosis
Voice change 
Dysphagia
paraneoplastic syndromes 
Clubbing
60
Q

What is an EBUS?

A

Endobroncial utrasound scan

61
Q

Investigaions for suspected lung cancer

A 
CXR
Bloods Sa02
CT 
EBUS
PET CT
62
Q

What does radical treatment mean?

A

Curative

63
Q

When would you not order a PET CT?

A

If someone has known metastatic disease.

64
Q

2 broad categories of lung cancer?

A

Small cell

Non small cell

65
Q

What type of lung cancer accounts for about 20% of cancers and usually affects the larger airways?

A

Small cell

66
Q

With which type of lung cancer usually presents with systemic disease and metastasis?

A

Small cell

67
Q

What syndromes might be associated with small cell lung cancer and why?

A

Cushings (ACTH)
SIADH
The small cells contain neurosecretory granules.

402 Oncology & Haematology (2 decks)

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