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Cancer Care > Other Cancers > Flashcards

Other Cancers Flashcards

1
Q

Risk factors for breast Ca

A
  • early menarche
  • late menopause
  • exogenous oestrogen: OCP, HRT
  • obesity
  • breast density
  • Hereditary: BRCA 1+2, p53
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2
Q

Presentation of breast Ca

A
  • Lump: hard, irregular, painless, fixed in place, may be tethered to skin or chest wall
  • skin dimpling
  • nipple retraction
  • lymphadenopathy, esp axillary
  • systemic Sx: weight loss, lethargy
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3
Q

Breast Ca screening

A

Ages 47-73, 2 view mammogram every 3yrs

High risk pts: annual mammogram from as early as 30

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4
Q

Referral criteria for breast Ca

A

2ww
>30 and unexplained breast lump
>30 and unexplained axillary lump
>50 and skin changes suggestive of breast Ca
>50 and unilateral nipple changes e.g., discharge or retraction

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5
Q

Prophylactic breast Ca Mx

A
  • chemoprevention: tamoxifen or anastrozole

- Risk reducing mastectomy or oophorectomy

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6
Q

Types of breast Ca

A 
DCIS - pre cancerous 
LCIS - pre cancerous 
IDC
ILS, NST
Inflammatory
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7
Q

Histology findings for breast Ca types

A

DCIS - central necrosis with calcifications
LCIS
ILC - discohesive tumour cells arranged in single file
IDC

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8
Q

Metastasis of breast Ca

A
  • lymph nodes via lymph panic system: usually ipsilateral LN
  • spread by blood: 2Ls and 2Bs
  • ILC: peritoneum, retroperitoneum, GI tract, ovaries and uterus
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9
Q

Diagnosis + further investigations of breast Ca

A

Triple approach

  • clinical exam
  • mammogram/USS
  • core biopsy/FNAC

DISCUSS WITH MDT

Further investigations for staging

  • lymph node assessment and biopsy
  • CT CAP
  • isotope bone scan
  • MRI for breast and axillary
  • liver USS
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10
Q

Paget’s disease of the nipple

A
  • involvement of nipple, may indicate DCIS or invasive Ca
  • eczematous: erythematous, scaly rash
  • needs to be biopsied, staged and treated like any other breast Ca
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11
Q

Management of breast cancer

A

Local and regional

  1. Breast surgery
    - breast conserving surgery or mastectomy
    - +/- reconstructive surgery
  2. Axillary surgery
    Based on sentinel lymph node biopsy result or lymph node dissection
  3. Post op RT

Systemic

  1. Hormonal for ER+
    Tamoxifen or Anastrozole
  2. Herceptin Tx
    - trastuzumab

Gene expression profiling - ER+ only

Follow up - surveillance mammograms every 5yrs

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12
Q

Reconstructive surgery for breast Ca

A

Immediate or delayed

  1. After BCS
    - partial reconstruction
    - reduction and reshaping
  2. After mastectomy
    - implant
    - flap reconstruction
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13
Q

Non surgical Tx for chronic lymphoedema

A
  • Manual lymphatic drainage
  • Compression bandages
  • Exercises to improve lymph drainage
  • Weight loss if overweight
  • Good skincare
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14
Q

Risk factors for lung Ca

A 
High smoking pack year
Increasing age 
Severe airflow obstruction 
FH
Exposure to other carcinogens eg Abestos
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15
Q

Types of lung cancer and features

A

Small cell: very aggressive, surgery not an option at time of pres, chemo is mainstay of Tx
Non small cell
- squamous: central, in smokers,
- adenocarcinoma : most common in non smokers

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16
Q

Presentation of Lung Ca

A

Asymptomatic
Cough, haemoptysis, SOB, chest pain, weak voice
Horners syndrome, SVCO
Paraneoplastic syndromes

17
Q

Paraneoplastic syndromes for lung Ca

A 
Clubbing -SCC
Hypercalcaemia -SCC
Anaemia 
SIADH - SCLC
Cushings -SCLC
Lambert Eaton myasthenia gravis - SCLC
VTE
Gynacomastia - adenocarcinoma
18
Q

How do you assess pt’s fitness status before treatment

A

WHO performance status scorev

19
Q

Investigations for lung Ca

A

Bloods
FBC : anaemia
Ca: hyperCa
Na

Imaging
CXR
CT CAP and PET scan for staging

Histology for biopsy

  • US FNA
  • Bronchoscopy or EBUS
  • CTGB
  • Thoracoscopy
20
Q

2WW Referral criteria for lung Ca

A

> 40 and

  • lymphadenopathy
  • finger clubbing
  • raised platelets
  • recurrent pneumonia
  • chest signs of lung cancer
21
Q

Management of lung Ca

A
22
Q

Types of testicular cancer

A

Most are germ cell tumours

  • NSGCT: yolk sac, choriocarcinoma, teratoma
  • seminoma

Non germ cells: sertoli, leydig, lymphoma

23
Q

Presentation for testicular Ca

A

Testicular lump - painless, hard, irregular

Constitutional Sx?
Met to lungs: cough, haemoptysis

24
Q

Diagnosis of testicular Ca

A

USS scrotum = diagnosis
CT CAP for staging

Can check tumour markers - AFP, bHCG, LDH

25
Q

Testicular tumour markers

A

AFP -specific to GCT
bHCG - seminima and NSGCT
LDH - non specific

26
Q

Treatment of testicular Ca

A 
MDT discussion 
Inguinal orchidectomy 
Sperm banking <55
Radiotherapy for seminoma 
Chemo for mets

Cancer Care (3 decks)

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