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BioMed S2 > Oncology altered > Flashcards

Oncology altered Flashcards

1
Q

What is a neoplasm?

A

A mass of tissue that grows faster than normal in an uncoordinated manner

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2
Q

What is a tumour?

A

Mass / growth of tissue.
benign or malignant

Tumour means ‘swelling’

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3
Q

‘RED’ how does a tumour no longer respond?

A

Tumour no longer responds to normal growth factors, GROWING FASTER THAN NORMAL - UNCO-ORDINATED MANNER

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4
Q

What are the most common causes of cancer death in the world?

A 
LungLiverColorectalStomachBreast
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5
Q

Which types of countries have higher cancer rates?

A

Developed countries

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6
Q

Globally no. of people with cancer is projected to…?

A

double by 2030

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7
Q

WHO links what in developed countries to cancer

A

environment
lifestyle
diet
drugs
meds

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8
Q

What type of cell division do cancer cells undergo?

A

Mitosis

Mitosis is growth and repair of somatic cells

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9
Q

What architecture do normal cells have?

A

Differentiated and specialised
Organised in the tissue and fulfil a particular function

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10
Q

What architecture do cancer cells have?

A

Not differentiated
Grow in an uncontrolled manner
function is lost Becoming irregular and disorganised Specialised

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11
Q

How does cancer come about?

A

Through genetic mutations

Result of an underlying cause
environmental interaction Promoting mutations of multiple genes

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12
Q

What are tumour suppression genes (TSG)?

A

They tell a cell when to stop dividing

Like an off switch

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13
Q

What happens to tumour suppression genes (TSG) during cancer cell growth?

A

TSG becomes deactivated oncogenes are formed

(genetic mutations)

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14
Q

We have these genes called ONGOGENES

A

When we have these genetic mutations, these ONCOGENES are formed - they promote growth Factors which INCREASES the rate of cell division so these cells need a blood supply so they undergo ANGIOGENISIS

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15
Q

What is angiogenesis?

A

Growth of new blood vessels

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16
Q

What is contact inhibition

A

Proteins produced by cells preventing cells dividing beyond the space available

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17
Q

Why do malignant cells undergo angiogenesis?

A

As they can only grow to 12 mm³ without a blood supply

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18
Q

What is the prime environment for cancer cells to thrive in?

A

Acidic
Anaerobic
Glucose rich

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19
Q

What is contact inhibition?

A

We have this spread and growth - Proteins produced by cells preventing cells dividing beyond the space available

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20
Q

Do cancer cells have contact inhibition?

A

No

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21
Q

What is mutation?

A

Change in genetic sequence

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22
Q

What is a mutagen?

A

An agent that changes the genetic sequence

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23
Q

Examples of mutagens

A

Chemicals
Radiation
Viruses
Inflammation (chronic)Stress emotional trauma
Defective immunity
Environmental hazards

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24
Q

What is a carcinogen?

A

A cancer-causing agent

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25
Q

What is carcinogenesis?

A

process of normal, healthy cells becoming cancer cells

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26
Q

Examples of carcinogens

A

Heavy metals
Asbestos
X-ray
UV rays
Parabens
Formaldehyde

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27
Q

What percentages of cancers are attributed to genetics vs environmental factors?

A

5-10% genetics
90-95% environment lifestyle

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28
Q

How long can tumours take to develop?

A

20-40 years

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29
Q

What are risk factors for cancer?

A

Genetics
Chronic inflammation
Chronic stress
Smoking
Radiation excess alcohol
alcoholObesityExcessive exposure to sunlight Compromised immunity
Metal toxins
Medications
Vaccine ingredients
Drugs cosmetics
GIT dysfunction
(poor liver function)
Sexual behaviour
Vit D deficiency
thyroid disease

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30
Q

What are dietary risk factors for cancer?

A

Red meats
Burnt food
Low fibre
Refined sugars
Dairy
Table salt
Pesticides
Aspartame
N-nitroso compounds
(cured meats)

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31
Q

How can chronic immunodeficiency increase the risk of cancer?

A

Cytotoxic T-cells, NK cells, macrophages are needed to destroy abnormal cells. However..HIV targets CD4 cells, compromising the immune system

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32
Q

How can chronic stress suppress the immune system?

A

By elevating cortisol levels

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33
Q

What is the architecture for benign tumours?

A

Differentiated cells Appear similar to normal cells
May be functional

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34
Q

How do benign tumour cells reproduce?

A

At a higher rate than normal

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35
Q

How do benign tumour cells grow?

A

Very slowlyDoesn’t spread (encapsulated - no metastasis)

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36
Q

Are benign tumours life-threatening?

A

No but damage can result from compression of tissues*| eg brain tumour increasing intra-cranial pressure

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37
Q

What is the architecture for malignant tumours?

A

Undifferentiated cells
Non functional
Varied shapesand sizes

Large nuclei

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38
Q

How do malignant tumour cells reproduce?

A

Much faster than normal

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39
Q

How do malignant tumour cells grow?

A

RapidlyNot encapsulated so they metastasiseCan spread quickly to other organs

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40
Q

Are malignant tumours life-threatening?

A

Yes due to tissue destruction and spread

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41
Q

What is grading?

A

measure of degree of cell differentiation abnormality

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42
Q

What are grade 1 tumours?

A

BenignSimilar to original cellsDifferentiated and specialised

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43
Q

What are grade 4 tumours?

A

UndifferentiatedAbnormal cells varying in size and shape

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44
Q

What is staging?

A

Classification of malignant tumours according to size and spread of the tumour

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45
Q

What are the benefits of staging?

A

Helps to identify treatment approaches, disease progression and prognosis

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46
Q

What is stage 0 cancer?

A

Pre-cancerous cells

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47
Q

What is stage 1 cancer?

A

Cancer limited to tissue of origin

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48
Q

What is stage 2 cancer?

A

Limited local spread of cancerous cells

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49
Q

What is stage 3 cancer?

A

Extensive local and regional spread

50
Q

What is stage 4 cancer?

A

Distant metastasis

51
Q

What is the TNM staging system?

A

TumourNodeMetastasis

52
Q

What does T (1-4) staging stand for?

A

Size of primary tumour

53
Q

What does N (0-3) staging stand for?

A

Degree of lymph node involvement

54
Q

What does M (0-1) staging stand for?

A

Metastasis - 1 indicates metastasis

55
Q

What are the local effects of a tumour?

A

Compresses blood vessels - leads to necrosis of surrounding tissue or tumour itself
Obstruction of tubes or ducts Tissue ulceration necrosis may produce infection (increased risk with chemo)|

calcification can be seen on x-ray

56
Q

What are the systemic effects of a tumour?

A

Weight loss & Cachexia - strong appetite
Anaemia
Infection
Para-neoplastic syndromes

57
Q

What are para-neoplastic syndromes?

A

Set of signs and symptoms as a result of a cancerous tumoureg lung cancers may produce ACTH leading to Cushing’s syndrome (excess corticosteroids produced by lung tumour cells)

58
Q

What is metastasis?

A

Describes spread of a malignant tumour

Cells break off (non-encapsulated tumour) spread via blood or lymphatic system

produce secondary tumours

59
Q

How do malignant tumours spread?

A

Via blood or lymph
Produce secondary tumours

60
Q

Are secondary tumour cells similar to parent tumour?

A

Yes

61
Q

What are the common sites for metastasis?

A

BoneLiverLungsBrain

62
Q

How can cancer present in signs and symptoms?

A 
Solid lumpSwollen lymph nodesDifficulty swallowingPersistent coughChange in bowel/bladder habitsAppearance of wart/moleUnexplained weight loss (red flag)Anaemia/fatigueDrenching night sweats
| Initially few vague symptoms
63
Q

What are the typical diagnostic tests for cancer?

A

Blood testsTumour markersImagingBiospies| None 100% reliable, also more effective in later stages

64
Q

What do blood tests look for?

A

HaemoglobinErythrocytesLeukocytesPlatelets

65
Q

What are tumour markers?

A

Substances (usually proteins) produced by tumours

66
Q

Where can tumour markers be found?

A

BloodUrineStoolsTissues| Depends on the specific marker

67
Q

Can tumour markers be used on their own to diagnose cancer?

A

No, must be used in context of patient presentation and other clinical findingsTumour markers can be present in non-cancerous conditions

68
Q

Examples of tumour markers

A 
CA-125 (ovarian cancer)CA 15-3 (breast cancer)CEA (colorectal cancer)PSA (prostate cancer)hCG (testicular cancer)Tumour M2-PK (colorectal cancer)
69
Q

What is CEA?

A

Carcinoembryonic antigenGlycoprotein present in normal mucosal cells Normally undetectable after birthBlood-borne marker

70
Q

How is CEA tested?

A

Blood test

71
Q

What is CEA testing used for?

A

MonitoringDue to low sensitivity and specificity| Small raises could be due to smoking

72
Q

In which conditions may CEA be elevated?

A

Colorectal cancerUlcerative colitisPancreatitisLiver cirrhosis

73
Q

What is PSA?

A

Prostate specific antigenProtein produced by prostate glands

74
Q

In which conditions may PSA be elevated?

A

Prostate cancerBenign Prostatic hyperplasia

75
Q

What is PSA testing used for?

A

Diagnosis of prostate cancer
Monitor tumour progression
Monitor metastasis

76
Q

What is hCG?

A

Human chorionic gonadotrophin

77
Q

What is hCG testing used for?

A

Testicular cancer
Pancreatic cancer
Pituitary gland cancer
Pregnancy

Should only be present in pregnant women

78
Q

What is tumour M2-PK?

A

Not organ specific so may be elevated in many tumour types

79
Q

How is tumour M2-PK tested?

A

Stool test

80
Q

In which conditions may tumour M2-PK be elevated?

A

Colorectal cancer
Gastric cancer

81
Q

What is CA-125 used to test for?

A

Ovarian cancer

82
Q

How is CA-125 tested?

A

Blood test
Normal range <35 U/ml

83
Q

What is CA-15-3 used to test for?

A

Breast cancer

84
Q

How is CA-15-3 tested?

A

Blood test
Normal range <30 U/ml

85
Q

Examples of imaging

A

X-rays
MRI
CT scan
Radioisotopes

86
Q

Examples of biopsies

A

Fine needle
Core needle
Surgical biopsy

87
Q

What happens during a biospy?

A

Small tissue sample is removed and examined

88
Q

What are the risks of a biopsy?

A

Procedure may cause cancer cells to break off and spread

89
Q

What are the basic allopathic treatments for cancer?

A

SurgeryChemoRadiation

90
Q

What are the conventional treatment approaches?

A

CurativePalliative

91
Q

What is curative care?

A

Treatment used to resolve the malignancy

92
Q

What is palliative care?

A

Focuses on reducing symptom severity rather than ‘curing’
Quality of life

93
Q

Examples of cancer surgery

A

Mastectomy
Prostatectomy
Orchiectomy

94
Q

What is a mastectomy?

A

Removal of breast

95
Q

What is a prostatectomy?

A

Removal of prostate gland

96
Q

What is a orchiectomy?

A

Removal of the testes

97
Q

What does radiotherapy do?

A

Affects cells which divide most rapidly - cancer and healthy cells
Causes loss of reproduction & Induces apoptosis

98
Q

Examples of radiotherapy

A

External beam
Internal beam
Systemic beam

99
Q

What is external beam radiotherapy?

A

Beams generated from outside the patient

100
Q

What is internal beam radiotherapy?

A

Higher dose of radiation released from within a body cavity Probe used (cervical, colorectal)| Also known as Brachytherapy

101
Q

What is systemic beam radiotherapy?

A

Radioactive material enters the blood to reach cells all over the body

102
Q

What are the adverse effects of radiotherapy?

A

Bone marrow depression* => immunocompromised Burns => inflammation ulceration of skin
Hair loss Gut ulceration (diarrhoea, bleeding)
Sterility
Fatigue Fibrosis| *leads to aplastic anaemia with pancytopenia

103
Q

What kind of natural support can be given during radiotherapy?

A

Exercise*Rest/relaxation (good sleep and stress management)Creams/gels for skin irritation| *reduces fatigue

104
Q

What is chemotherapy?

A

Chemical agents destructive to malignant cells

105
Q

What does chemotherapy do?

A

Targets rapidly dividing cells - cancerous and healthy

106
Q

What does chemotherapy interfere with?

A

Protein synthesis
DNA replication

107
Q

What are the adverse effects of chemotherapy?

A

Bone marrow depression Diarrhoea Vomiting Nausea
Hair loss
Organ damageCancer

108
Q

Examples of drug treatments in cancer

A

Hormones
Biologic response modifier Analgesics

109
Q

Example of hormone drug treatment in cancer

A

Tamoxifen

110
Q

What does tamoxifen do?

A

Blocks oestrogen receptors

111
Q

What is an adverse effect of tamoxifen?

A

Induces menopause

112
Q

Example of an analgesic

A

Opioid analgesic - morphine
(acts on CNS)

113
Q

What complementary therapies can be used to support cancer?

A 
Nutrition - high antioxidant, high anti-inflammatory, high fibre, whole plant foods, omega-3, 7-9 portions fruit/vegMedicinal mushrooms*Amygdalin (B17) => cyanide in cancer cellsHerbsAcupunctureHomeopathy
| *beta glucans immune modulating, anti-cancer properties
114
Q

What is ‘cured’ from cancer?

A

5 years without reoccurrence

115
Q

Why is cancer hard to diagnose?

A

Some cancers only present clinically once disease is very advanced

116
Q

What are the different categories of cancer?

A

Carcinomas
Sarcomas
Leukaemias

Over 200 types of cancer

117
Q

What are carcinomas?

A

Cancers forming in epithelial tissue

118
Q

Where can carcinomas be found?

A

Skin
Mouth
Nose
Throat
Respiratory tract
Lung
Breast
Prostate
Stomach

119
Q

What are sarcomas?

A

Cancers forming in connective tissue

120
Q

Where can sarcomas be found?

A

Bone
Cartilage
Muscle
Tendons

121
Q

What are leukaemias?

A

Cancers found in blood and bone marrow
Abnormal leukocytes travel through bloodstream NOT solid tumours

BioMed S2 (34 decks)

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