Oncology - Principles of cancer Flashcards
What does Adenocarinoma mean
Tumour from the glandular epithelial tissue
What does Sarcoma mean
Tumour of the connective tissue origin
What’s the features of a benign tumour
- Encapsulated edges
- No metastasis and invasion
- Low growth rate
- Normal nuclei
- Normally look like the cell it came from
What are the features of a malignant tumour
- Irregular edges
- Metastasis and Invasion
- Does not look like the cell it comes from
- High growth rate
- Irregular nuclei
What are the classification of tumours using the TNM class
T - tumour size, extent of invasion and penetration of tumour boundaries
T1 - tumour 3cm or less
T2 - tumour more than 3cm but less than 5cm
T3 - tumour more than 5cm but less than 7cm
T4 - tumour more than 7cm
N- number and presence of lymph nodes involved
N0 - no regional lymph nodes metastasis
N1 - single node <2cm
N2 - single node 2-5cm
N3 - multiple nodes >5cm; multiple node involvement across the body
M - Metastasis
M0- no distant metastasis
M1 - distant metastasis
What are the factors that influence cancer incidence
- Smoking
- Radiation
- Asbestos
- Hormone e.g oestrogen
What are proto-oncogenes and oncogenes
Porto-oncogenes - stimulate cell cycle progression in normal cells
Oncogenes - causes acceleration of cell growth in leading to cancer
What are tumour suppressor genes
They slow down cell division, repair DNA and cause apoptosis. The p53 gene does this and damage to it leads to uncontrolled cell growth hence cancer.
How does oncogene and tumour suppressor gene cause cancer
By over expression in oncogene and tumour suppressor gene turned off
What does tumour differentiation mean?
How well the tumour resembles the cell of origin.
High grade tumours are poorly differentiated and lack resemblance to normal cells whereas Low grade tumours are well differentiated and resemble normal cells
What are the different aims of chemotherapy?
Curative - intent to cure and get rid of the cancer
Adjuvant - given after definitive treatment such as surgery or radiotherapy
Neo-adjuvant - given before definitive treatment to decrease size of tumour
Palliative - controls symptoms and improves QoL, no intent to cure.
What are the advantages and disadvantages of oral chemotherapy
Advantages:
- convenient
- less expensive
- lower toxicity
- avoid complications associated with IV access
Disadvantages:
- Adherence
- Variable plasma pharmacokinetics
- Management of drug interactions
- Nausea and vomiting
- Toxicity profile of newer agents
What are the monitoring requirement for chemotherapy
Response to treatment:
- measured using tumour markers and imagery
- dependent on disease and treatment intention
Toxicity review:
- full blood count
- weight
- toxicity/symptom review
- U&ES
What are the different drug resistance of cancer
Intrinsic - growth characteristics of the tumour
Acquired - drug deactivated/ removed from the cancer cell - inherent DNA repair
Cross-resistance - increased with different treatment used.
