Session 10-Neoplasia 4 Flashcards
Which carcinomas account for over half of cancers in the UK?
Breast
Lung
Prostate
Bowel
Which malignant neoplasms are more common in children younger than 14?
Leukaemia
Central nervous system tumours
Lymphoma
Which factors are considered when determining which individuals will have a favourable outcome for malignant neoplasms?
Age General health Tumour site Tumour type Grade Tumour stage Availability of effective treatments
What is tumour stage a measure of?
Malignant neoplasm’s overall burden
What does T refer to in TNM staging system?
Size of primary tumour and typically expressed as T1 through to T4
What does N stand for in the TNM staging system?
Extent of regional node metastasis (lymphatics) from N0 to N3
What does M refer to in the TNM staging system?
Extent of distant blood-borne metastatic spread eg M0 or M1
Describe stage I of cancer
Early local disease
Describe stage II of cancer
Advanced local disease (ie N0, M0)
Describe stage III of cancer
Regional metastasis (ie any T, N1 or more, M0)
Describe stage IV of cancer
Advanced disease with distant metastasis (ie any T, any N and M1)
What is the staging system used for lymphoma?
Ann Arbor staging
Describe the stages of the Ann Arbor staging system
Stage I - lymphoma in single node region
Stage II - two separate regions on one side of diaphragm
Stage III - spread to both sides of diaphragm
Stage IV - involvement of one or more extra-lymphatic organs such as bone marrow or lung
Which staging system is used for colorectal carcinoma?
Dukes
Describe the stages of the Dukes staging system
Dukes’ A - invasion into but not through bowel
Dukes’ B - invasion through bowel wall
Dukes’ C - involvement of lymph nodes
Dukes’ D - distant metastases
What does tumour grade describe?
Degree of differentiation of neoplasm
What does the Bloom-Richardson grading system assess?
Tubule formation
Nuclear variation
Number of mitoses
How can cancer be treated?
Surgery Radiotherapy Chemotherapy Hormone therapy Treatment targeted to specific molecular alterations
When is adjuvant treatment given?
After surgical removal of primary tumour to eliminate subclinical disease
When is neoadjuvant treatment given?
To reduce size of primary tumour prior to surgical excision
How does radiation therapy kill proliferating cells?
By triggering apoptosis or interfering with mitosis
Why is radiotherapy given in fractionated doses?
To minimise normal tissue damage
How does radiotherapy (eg x ray) kill rapidly dividing cells?
High dosage causes either direct or free-radical induced DNA damage that is detected by cell cycle check-points, triggering apoptosis
What are the four classes of chemotherapy agents?
Antimetabolites
Alkylating and platinum-based drugs
Antibiotics
Plant-derived drugs
