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Ellie's Path Processes > Sesh 10- Neoplasia 4 > Flashcards

Sesh 10- Neoplasia 4 Flashcards

1
Q

Which 4 cancers make up over 50% of all new cancers in the UK?

A
  • Breast
  • Prostate
  • Lung
  • Bowel carcinoma
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2
Q

What are the 3 most common cancers in children under 14?

A
  1. Leukaemias
  2. CNS tumours
  3. Lymphoma
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3
Q

Which 3 cancers have the highest 5 year survival rates?

A
  1. Testicular
  2. Melanoma
  3. Breast
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4
Q

Which 3 cancers have the lowest 5 year survival rates?

A
  1. Oesophageal
  2. Lung
  3. Pancreatic
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5
Q

Which cancer is the biggest cause of cancer-related deaths in the UK, and why?

A

Lung

-V aggressive and high incidence

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6
Q

What is tumour stage a measure of?

A

The tumour’s overall burden.

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7
Q

What is the most common system used to stage a tumour?

A

TNM system

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8
Q

What do the ‘T’ ‘N’ and ‘M’ refer to in TNM staging?

A
  • T= tumour size
  • N= regional node metastasis via lymphatics
  • M= extent of distant metastasis
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9
Q

Describe the criteria for the TNM stages I- IV.

A
  • Stage I= early local disease (T1/2)
  • Stage II= advanced local disease (T3/4, N0, M0)
  • Stage III= regional node metastasis (any T, N1/+, M0)
  • Stage IV= advanced disease with distant metastasis (any T, any N, M1)
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10
Q

What can tumour stages be used for?

A

As a strong predictor of survival….good prognostic indicator i.e. stage IV lowest 5 yr survival rates

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11
Q

What is the staging system for lymphomas?

A

Ann Arbor

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12
Q

Describe the criteria for stages I-IV of the Ann Arbor staging system.

A 
I= lymphoma in 1 node
II= lymphoma in 2 nodes on same side of diaphragm
III= spread to both sides of the diaphragm
IV= disseminated spread involving 1/+ extra-lymphatic organs
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13
Q

What are lymphoma ‘B symptoms’?

A
  • Systemic symptoms e.g. fever, weight loss

- Indicate more advanced disease, and worse prognosis

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14
Q

What staging system is used for colorectal carcinoma?

A

Dukes staging

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15
Q

What are the 4 Dukes stages?

A

A- invasion of, but not through bowel
B- invasion through bowel wall
C- involvement of lymph nodes
D- distant metastases

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16
Q

What is tumour grade?

A

The degree of tumour differentiation.

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17
Q

What is the grading system for breast carcinoma?

A

Bloom-Richardsom grading system

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18
Q

What cellular features is the Bloom-Richardson grading system based on?

A
  1. Nuclear pleomorphism
  2. Tubule formation
  3. Mitotic index
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19
Q

What is tumour grade important for?

A
  • Mainly for planning treatment

- Only good for estimating prognosis of certain tumours e.g. breast, prostate

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20
Q

What is adjuvant treatment and the principle behind it?

A

Treatment given after surgical tumour excision to eliminate sub-clinical disease i.e. micrometastases

21
Q

What is neoadjuvant treatment and the principle behind it?

A

Treatment given prior to surgical tumour excision to shrink the tumour.

22
Q

In what sort of doses is radiotherapy given and why?

A
  • Fractionated doses

- To reduce normal tissue damage

23
Q

Name 3 other tissue/ cell types apart from the cancer that chemotherapy can damage.

A

Any rapidly proliferating cell

  1. Bone marrow
  2. Hair follicles
  3. GIT epithelia
24
Q

How do anti-metabolite chemotherapy agents work? Give an example of one.

A
  • Act by mimicking and competing with substrates (e.g. folic acid) for DNA synthesis and replication
  • Methotrexate
25
Q

How do alkylating and platinum-based chemotherapy drugs work?
Give an example of a drug of this type.

A
  • Forming cross-links between 2 DNA strands, that cells cannot repair.
  • Cisplatin
26
Q

How do plant-derived chemotherapeutics work?

A

Interfere with mitotic spindle formation

27
Q

How does the hormone therapy tamoxifen work?

A
  • Binds oestrogen receptors to prevent oestrogen binding… is a SERM
  • For oestrogen R +ve breast cancers
28
Q

What is a potential risk with tamoxifen use?

A

Is pro-estrogenic in the endometrium, so can lead to endometrial cancer

29
Q

What specific type of cancer is Herceptin used against?

A

Breast carcinomas over-expressing HER-2 gene

30
Q

What is Imatinib (Gleevec) used to target, and in what type of cancer?

A

Inhibits BCR-ABL in chronic myeloid leukaemia (CML)

31
Q

What are tumour markers most useful for?

A

Monitoring tumour burden during treatment and follow up

32
Q

What cancer type produces human chorionic gonadotrophin (hCG)?

A

Testicular teratoma (germ cell tumour)

33
Q

Why are high levels of PSA not very specific? What is a better indicator of prostate carcinoma?

A
  • Can be raised in multiple non-cancerous states e.g. BPH, prostatitis
  • Overall trend of PSA more useful i.e. if increases over time
34
Q

Name an oncofetal antigen released by hepatocellular carcinoma.

A

Alpha fetoprotein (AFP)

35
Q

Name an oncofetal antigen released by colorectal carcinoma.

A

Carcinoembryonic antigen (CEA)

36
Q

CA-125 is a mucin/glycoprotein produced by which type of cancer?

A

Ovarian carcinoma

37
Q

Who is screened for breast cancer in the UK, and how often?

A

Women aged 50-70 invited every 3 yrs.

Pilot extending from 47 to 73

38
Q

Who is screened for cervical cancer in the UK, and how often?

A
  • Women aged 25-64
  • Invited every 3 yrs until 50
  • Then every 5 yrs until 64
39
Q

Which patient group is screened for colorectal cancer in the UK, and how often?

A

Men and women aged 60-74 invited every 2 years

40
Q

How is colorectal screening performed?

A

Bottle for faecal occult blood test is sent in post

41
Q

List 3 problems with screening

A
  1. Lead time bias
  2. Length bias
  3. Over-diagnosis
42
Q

What is lead time bias of screening?

A

Screening detects cancers earlier, so increases perceived survival rate without changing the disease course

43
Q

What is length bias of screening?

A

Screening is biased towards detecting slower-growing, less aggressive tumours, so appears more effective

44
Q

List some risk factors for HPV

A
  • Early age at first intercourse
  • Low social class
  • Multiple sexual partners
  • Oral contraceptive etc etc
45
Q

What type of tumour is associated with asbestos exposure?

A

Malignant mesothelioma

46
Q

What type of lung tumour is most commonly associated with ectopic ADH production?

A

Small cell carcinoma

47
Q

What type of cancer is associated with EBV?

A

Burkitt’s lymphoma

48
Q

What is a naevus?

A

Benign tumour of melanocytes

Ellie's Path Processes (6 decks)

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