Solid Tumors Flashcards
Prostate cancer
- Risk Factors
Prostate cancer RFs
- Old age
- Black ethnicity
- Obesity
- BRACA 2
- Family history
Prostate cancer
- Histology
Prostate cancer
- Adenocarcinoma
- Peripheral zone
Prostate cancer
- S&S
Prostate cancer
- Frequency/OAB
- Nocturia
- Visible haematuria
- Dribble
- Systemic symptoms
- Back pain
PSA Requisites
PSA
- No sex or anal sex
- No prostate interventions
- Range changes with age
- No UTI
- No vigorous exercise
Prostate cancer screening
Prostate cancer screening
- Most will not die from it
- Slow growing
Prostate cancer grading and staging
Prostate cancer grading and staging
- Gleason grade
- first and second most common - TNM staging
Prostate cancer
- metastasis
Prostate metastasis
1. Bones
2. Lymph nodes
Prostate Cancer
DRE findings
Prostate DRE
- Firm
- Hard
- Asymmetrical
- Irregular
Prostate Referral
Prostate Referral
- Abnormal DRE
- PSA
- VH
Prostate cancer diagnosis
- Process
Prostate diagnosis
- DRE/PSA
- mpMRI (multi parametric)- Likert 5 point scoring
- Biopsy
Prostate cancer
- Management
Prostate cancer
- Supportive
1. Active surveillance (PSA, DRE, MRI) - Medical
2. GnRH Agonist (Goserelin)
3. Androgen receptor blockers (Bicalutimide)
- Surgical (Radical prostatectomy)
- NB Side effects - Radical radiotherapy
- External beam or Brachy therapy - Bilateral orchidectomy
- Chemotherapy
- Docetaxel
Melanoma
- Invasion
Melanoma invasion
- Epidermis
- In situ - Dermis
- Invasive - Metastatic
Melanoma
- Types
Melanoma types
- Superficial spreading melanoma
- 70%
- Young and middle aged lower limbs - Nodular melanoma
- 15%
- Young and middle aged trunk - Acral lentiginous melanoma
- 10%
- Elderly, black and asian palms, soles, nailbeds - Lentigo maligna melanoma
- 5%
- Elderly, face
Superficial spreading melanoma
- Demographic
- Sites
- Natural history
- Superficial spreading melanoma
70% - Demographic
1. Young adults
2. Middle aged
3. Intermittent high intensity UV
Site
1. Commonly lower limbs
Natural history
1. Pigmented lesion
2. Slowly enlarging
3. Irregular colour and border
Nodular melanoma
- Demographic
- Sites
- Natural history
Nodular melanoma
- Demographic
1. Young adults
2. Middle aged - Sites
1. Trunk - Natural history
1. Agressive
2. Rapid, deep growth
3. Early metastasis
Lentigo maligna melanoma
- Demographic
- Site
- Natural history
Lentigo maligna melanoma
- Demographic
1. Elderly
2. Long-term cumulative UV exposure
Site
1. Lentigo maligna
2. Face
Natural history
1. Growth from lentigo maligna
Acral lentignious melanoma
- Demographic
- Site
- Natural history
Acral lentiginous melanoma
- Demographic
1. Black
2. Asian
3. Elderly - Site
1. Palms and soles
2. Nail beds
Pre-cursors for melanoma
Pre-cursors for melanoma
- Benign melanocytic naevus
- Normal mole - Atypical or dysplastic naevus
- Benign but asymetrical
- Increased risk of melanoma - Atypical lentiginous junctional naevus
- Flat naevus in heavily sun-damaged skin - Actinic keratosis
- Yellow-white scaly crusts
- Sun-exposed skin - Bowen disease
- Red, scaly plaque
- Slow-enlarging
- Carcinoma in situ (3.5% progress to SCC)
Actinic keratosis
- Management
Actinic keratosis mx
- Emolient
- Diclofenac (3%)
- Fluorouracil (5%)
+ Hydrocortisone - Imiquimod
- Cryotherapy
- Photodynamic therapy
- Surgical excision and curettage + cautery
Melanoma
- ABCDE
Melanoma
A - ssymetry
B - order
C - olour
D - iameter
E -volving
Melanoma
- Staging and thickness prognostication
Melanoma thickness
- AJCC system
- American joint committee on cancer
- TNM - Breslow thickness
<1mm
1-2 mm
2-4mm
>4mm
Melanoma
- Investigations
Melanoma investigations
- Examination
- Skin
- Lymph nodes - LDH
- Cell turnover
Melanoma
- Mx
Melanoma Mx
- WLE
- Skin+fat+muscular fascia
- Margin determined by Breslow thickness - Adjuvant therapy
- Chemotherapy
- Radiotherapy
- Immunotherapy
Melanoma
- Histology
Melanoma histology
- Growth of melanocytes
- Stratum basale
Breast Cancer
- Grading and staging
Breast Cancer
- Stage 1-4
- Grade 1-3
Bowel Cancer
- Grading
Bowel Cancer
- Grade 1-3
Bowel cancer
- Staging
Bowel cancer staging
- TNM
- Stage 1-4
- Dukes A-D
TNM 1-4 equivalent