Session 11 Flashcards
What are the 4 most common cancers?
Breast, lung, bowel and prostate
What are the most common cancers in children
Leukaemia’s, CNS tumours and lymphomas
Which cancers have the highest and lowest 5 year survival rates?
Highest - testicular, melanoma and breast cancer
Lowest - pancreatic, lung and oesophageal
What are important factors to consider when determining an outcome for a patient with cancer?
Age, general health state, tumour site, tumour type, tumour grade, tumour stage and treatments available.
What is tumour stage a measure of?
The malignant neoplasm’s overall burden.
Describe the TNM system for tumour staging
T refers to the size of the primary tumour (T1-4)
N describes the extent of the regional node metastases (N0-3)
M describes the extent of distant metastatic spread (M0-1)
The TNM status is the converted to a stage from I to IV. Early local disease=stage I. Advanced local disease=stage II. Regional metastasis=stage III. Distant metastasis=stage IV.
Describe the staging system for lymphoma
The Ann Arbor staging:
I - lymphoma in a single node region
II - two separate regions on the same side of the diaphragm
III - spread to both sides of the diaphragm
IV - involvement of one or more extra lymphatic organ (lungs/bone marrow)
Describe the staging system for colorectal carcinoma
Dukes staging: Dukes A - invasion into but not through the bowel wall Dukes B - invasion through the wall Dukes C - involvement of lymph nodes Dukes D - distant metastasis
What is the GRADING system used for breast carcinoma?
The Bloom-Richardson system, which assesses tubule formation, nuclear variation and number of mitoses.
What are the different ways that cancer can be treated?
Surgery (main), radiotherapy, chemotherapy, hormone therapy and treatment targeted to specific molecular interactions.
What is the name of the treatment given before and after surgical removal of a tumour?
Before - neoadjuvant treatment to reduce the size of the tumour prior to surgical excision
After - adjuvant treatment to eliminate subcritical disease
How is radiotherapy carried out and how does it help in treating cancer?
Radiotherapy is focused on the tumour with shielding to the surrounding healthy tissue and in fractionated doses to limit tissue damage.
X rays and other ionising radiation kill rapidly dividing cells, especially in G2 of the cell cycle. The high dosage causes either direct or free radical induced DNA damage that is detected by cell cycle check points, triggering apoptosis. Damaged chromosomes resulting from double stranded breaks also prevent the M phase from completing correctly.
What are the various types of chemotherapy agents available?
Antimetabolites - mimic normal substrates involved in DNA replication (e.g. Flurouracil)
Alkylating & platinum based drugs - cross link the two strands of the DNA helix
Antibiotics - act in several ways
Plant derived drugs - can block micro tubule assembly, interfering with mitotic spindle formation
What is the hormone therapy that can be used to treat hormone receptor positive breast cancer?
Selective oestrogen receptor modulators (SERMs), such as tamoxifen, prevent oestrogen from binding to their receptors.
What is the hormone therapy that can be used to treat prostate cancer?
Androgen blockade
