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PP A > Session 10 > Flashcards

Session 10 Flashcards

1
Q

Which cancers account for over half of all new cancers in the UK?

A

Breast, lung, prostrate and bowel carcinomas

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2
Q

When are most cancers diganosed?

A

Most diagnoses are made in people aged over 65

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3
Q

What cancers are diagnosed in people younger than 14?

A

Leukaemia, central nervous system tumours and lymphomas

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4
Q

What is the biggest case of cancer-related deaths in the UK?

A

Lung cancer

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5
Q

What factors influence the outcome for different cancers?

A

Age, general health status, tumour site, type, grade, stage and availability of effective treatments

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6
Q

What is tumour stage a measure of?

A

Measure of the malignant neoplasm’s overall burden

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7
Q

How is tumour staging assessed?

A

Using the TNM model

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8
Q

What is the TNM model?

A

Size of tumour, regional node metastasis and M denotes the extent of metastatic spread

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9
Q

Describe stage I cancer

A

Early local disease

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10
Q

Describe stage II cancer

A

Advances local disease

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11
Q

Describe stage III cancer

A

Regional metastasis

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12
Q

What is stage 4 cancer?

A

Advanced disease with distant metastasis

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13
Q

What special staging system do lymphomas use?

A

Ann Arbor staging

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14
Q

What does stage 1 from the Ann Arbor staging indicate?

A

Lymphoma in a single node region

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15
Q

What does stage II lymphoma from the Ann Arbor staging mean?

A

Two separate regions on one side of the diaphragm

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16
Q

What does stage 3 lymphoma on the Ann Arbor staging indicate?

A

Spread to both sides of the diaphragm

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17
Q

What does stage 4 lymphoma from the Ann Arbor staging indicate?

A

Diffuse or disseminated involvement

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18
Q

What is staging a powerful predictor of?

A

Powerful predictor of survival

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19
Q

What staging is used for colorectal carcinoma?

A

Dukes staging

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20
Q

What does dukes’ A indicate?

A

Invasion into but not through the bowel

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21
Q

What dos Dukes’ B indicate?

A

Invasion through the bowel wall

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22
Q

What does Dukes’ C indicate?

A

Involvement of lymph nodes

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23
Q

What does Dukes’ D indicate?

A

Distant metastases

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24
Q

What is the preferred system of staging worldwide?

A

TNM staging

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25
Q

What does the tumour grade describe?

A

The degree of differentiation of a neoplasm

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26
Q

What does G1 describe?

A

Well differentiated

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27
Q

What does G2 describe?

A

Moderately differentiated

28
Q

What does G3 describe?

A

Poorly differentiated

29
Q

What does G4 describe?

A

Undifferentiated or anaplastic

30
Q

What is the standard grading system used for?

A

Squamous cell carcinoma and colorectal carcinoma

31
Q

For some cancers, an internationally recognised formal grading system is used. Give an example of this

A

Breast carcinoma uses the Bloom-Richardson system

32
Q

What does the Bloom-Richardson system use?

A

This assess tubule formation, nuclear variation and number of mitoses

33
Q

What is tumour grading important for?

A

Important for planning treatment and estimating prognosis in certain types of malignancy

34
Q

When is tumour grade particularly important?

A

In soft tissue sarcoma, primary brain tumour, lymphomas and breast and prostrate cancer

35
Q

How can cancer be treated?

A

Surgery, radiotherapy, chemotherapy, hormone therapy and treatment targeted to specific molecular alterations

36
Q

What is adjuvant treatment?

A

Given after surgical removal of a primary tumour to eliminate subclinical disease

37
Q

What is neoadjuvant treatment?

A

Given to reduce the size of a primary tumour prior to surgical excision

38
Q

How does radiation therapy work?

A

Kills proliferating cells by triggering apoptosis or interfering with mitosis

39
Q

What is radiotherapy focused on?

A

Focused on the tumour with shielding of surrounding healthy tissues.

40
Q

How is radiation therapy given?

A

Given in fractionated doses to minimise normal tissues damage

41
Q

What type of radiation is used?

A

X rays or other types of ionising radiation

42
Q

Why are these types of radiation used?

A

They kill rapidly dividing cells, especially in G2 of the cell cycle. This is because high dosage causes either direct or free-radical induced DNA damage that is detected by the cell cycle check-points, triggering apoptosis

43
Q

How can chemotherapy drugs affect proliferating cells?

A

Antimetabolites, alkylation, antibiotics and plant derived

44
Q

How do antimetabolites work?

A

Mimic normal substrates involved in DNA replication

45
Q

Give an example of an antimetabolite?

A

Florouracil

46
Q

How do alkylating chemotherapy drugs work?

A

Cross link the two strand of the DNA helix

47
Q

Give some examples of alkylating chemotherapy drugs

A

Cyclophosphamide and cisplatin

48
Q

How do antibiotics work as chemotherapy drugs?

A

Doxorubicin inhibits DNA topoisomerase which is needed for DNA synthesis. Bleomycin causes double stranded DNA breaks

49
Q

How do plant derivative chemotherapy drugs work?

A

Block microtubule assembly and interferes with mitotic spindle formation

50
Q

Give an example of a plant derived chemotherapy drug

A

Vincristine

51
Q

What is a relatively non-toxic treatment for certain malignant tumours?

A

Hormone therapy

52
Q

Give an example of a hormone therapy used for cancer and how does it work?

A

Selective oestrogen receptor modulators (SERMs) such as tamoxifen bing to oestrogen receptors and prevent oestrogen form binding.

53
Q

What is tamoxifen used to treat?

A

Hormone-receptor positive breast cancer

54
Q

What hormone therapy is used for prostrate cancer?

A

Androgen blockade

55
Q

Give two early examples of oncogenes that are targeting be cancer therapy.

A

Trastuzumab (herceptin) and imatinib (gleevec)

56
Q

What does herceptin do?

A

Herceptin can block Her-2 signalling since most breast cancers have over-expression of the Her-2 gene

57
Q

How do nivolumab and ipilimumab work?

A

They are drugs that block immune checkpoints

58
Q

How is cancer burden monitored?

A

Tumour markers

59
Q

Give examples of tumour markers

A

Hormones, oncofetal antigens, specific proteins and muffins/glycoproteins

60
Q

Give example of hormonal tumour markers

A

Human chorionic gonadotropin released by testicular tumours

61
Q

Give examples of oncofetal antigens

A

Alpha fetorptoein released by hepatocellar carcinoma

62
Q

Give examples of specific proteins used as tumour markers

A

Prostrate-specific antigen released by prostrate carcinoma

63
Q

Give examples of muffins/glycoproteins that are used as tumour markers?

A

Ca-125 released by ovarian cancer

64
Q

What is the purpose of cancer screening?

A

They involve looking for early signs of disease in healthy people

65
Q

What problems are associated with cancer screening programmes?

A

Time bias, length bias and over diagnosis

66
Q

In the UK, what are the different established national screening programmes?

A

Cervical, breast and bowel cancer

PP A (13 decks)

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