T. II Cancer

Question 1

Immunological surveillance

Answer 1

• Response to tumour-associated antigens
• Lymphocytes continually check cell surface antigens and detect and destroy abnormal cells.
Involves cytotoxic T cells, natural killer cells, macrophages, and B lymphocytes

Question 2

Cytotoxic T cells

Answer 2

Kill tumour cells directly

Question 3

Immunological escape

Answer 3

• Mechanism by which cancer cells evade immune system
• Suppression of factors that stimulate T cells
• Weak surface antigens allow cancer cells to “sneak through” surveillance.
Develops tolerance to immune system by some tumour antigens
Suppresses immune response from products secreted by cancer cells
Induction of suppressor T cells
Blocking antibodies bind TAAs, preventing recognition

Question 4

Oncofetal antigens

Answer 4

• tumor markers
• Found on tumour cell surfaces, inside tumour cells, and on and inside fetal cells
• These oncofetal antigens can be used as tumour markers that may be clinically useful to monitor the effects of therapy and indicate tumour recurrence.

Question 5

Anatomical site classification

Answer 5

• Identified by tissue of origin

- looking at tissue of origin, the behaviour of tumor

Question 6

Carcinomas originate from

Answer 6

• Embryonal ectoderm (skin, glands)

* Endoderm (mucous membrane of respiratory tract, GI and GU tracts)

Question 7

Sarcomas originate from

Answer 7

Embryonal mesoderm (connective tissue, muscle, bone, and fat)

Question 8

Lymphomas and leukemias originate from

Answer 8

Hematopoietic system

Question 9

Histological classification

Answer 9

• Appearance of cells and degree of differentiation are evaluated to determine how closely cells resemble tissue of origin.
• Poorly differentiated tumours have a worse prognosis than those closer in appearance to normal cells.
• higher the grade the more differentiated (look less like the original cell)
• graded 1-4

Question 10

TNM classification system

Answer 10

• Tumour size and invasiveness (T)
• Spread to lymph nodes (N)
• Metastasis (M)

Question 11

Palliation

Answer 11

optimizing quality of life. There’s no cure.

Question 12

Chemotherapy

Answer 12

• Used in the treatment of many solid tumors and is the primary therapy for hematological malignancies, including leukemia and lymphoma.
• The two major categories of chemotherapeutic drugs are cell cycle phase–nonspecific and cell cycle phase–specific drugs.
• Chemotherapy can be given by IV, PO with the use of central venous access devices and infusion pumps.
• Chemo drugs given peripherally run the risk of extravasation injury if the medication infiltrates surrounding tissues.

Question 13

Radiation

Answer 13

• The emission and distribution of energy through space or a material medium.
• Produces ionization and excitation when absorbed into tissue.
• Cancer cells are vulnerable to the effects of cumulative radiation
• Can be used to control disease
• Can be combined with surgery to enhance local control of cancer.
• Can be done preoperatively to reduce the size of tumor to make resection easier.
• Can be done postoperatively to destroy remaining tumor cells.
• Can be given during surgery directly to the site.
• Palliative focus to control symptoms such as pain and obstructions.

Question 14

Oncological Emergencies

Answer 14

• Life-threatening events that can occur as a result of cancer or cancer treatment.
• These emergencies can be obstructive, metabolic, or infiltrative.

Question 15

CAUTION

mnemonic can be helpful for the Seven Warning Signs of Cancer.

Answer 15

C	Changes in bowel or bladder habits
A	A sore that does not heal
U	Unusual bleeding or discharge
T	Thickening or lump in the breast or elsewhere
I	Indigestion or difficulty swallowing
O	Obvious change in wart or mole
N	Nagging cough or hoarseness