Tutorials 1 - 4 - Skin, Oral, Colon, Cervical Flashcards
What are the risk factors for melanoma?
M - moles - atypical/over 100 R - red hair/freckles I - inability to tan S - sun burn - >10 severe episodes K - kindred - family Hx
What is a mole?
Why are they described as both precursors of and signposts to melanoma?
Benign melanocytic tumour
Pre-cursor - may turn malignant
Signpost - increased risk of developing de novo melanoma
How does incidence of melanoma vary?
What is different between the two major groups?
- Younger people - trunk - genetic?
- Older people - H+N - sun exposure
What is the diagnostic criteria for melanoma?
Major criteria - 2 points each:
- Change in size, irregular shape, irregular colour
Minor criteria - 1 point each:
- Diameter >7mm
- Inflammation, oozing, change in sensation
What is the Breslow thickness?
Why is it significant?
- Depth of melanoma below skin
- Good prognostic indicator - >4mm
List some possible treatments for melanoma
- Surgical excision
- Adjuvant therapy
- BRAF inhibitors/immune checkpoint inhibitors
What is the most common cancer type in the H+N?
Squamous cell carcinoma
Where is the most common site of H+N cancer?
Tonsils
Tongue
What are the 3 major causes of H+N cancer?
Smoking
Alcohol
HPV
Describe the genetic differences between HPV positive and negative H+N cancers
- HPV -ve - Hras, p53, p16 mutations
- HPV +ve - E6/E7 genes
E6 binds to and inactivates p53
E7 binds to and inactivates Rb protein
Why is drug therapy not that useful in H+N cancers?
Mainly due to knocking out of TSGs rather than activation of oncogenes - no therapeutic target
Which subtype of H+N cancers has a better prognosis?
Why is this somewhat paradoxical?
HPV +ve has better prognosis even though it presents later as deeper into throat
Give 3 risk factors for colorectal cancer
- Environment - diet etc…
- IBD
- Genetic - FAP
Outline the colorectal cancer screening programme
Faecal occult blood
60 - 74 year olds, every 2 years
Colonoscopy if abnormal
Give some possible symptoms of colon cancer
- GI bleeding (PR)
- Anaemia
- Abdo pain
- Change in bowel habit
Describe the adenoma to carcinoma sequence
Methylation/APC inactivation leads to hyperproliferation
Kras/p53 mutation then leads to adenoma
Further accumulation of mutations leads to adenocarcinoma
What are the 2 hereditary conditions which give rise to colon cancer?
- FAP - chromosomal instability
- Lynch syndrome - MMR defiency
Give 2 drugs used in colon cancer
Cetuximab
Bevacizumab
What sort of cancer(s) affect(s) the cervix?
Mainly SSC
Sometimes adenocarcinoma
What is the precursor of cervical cancer?
Cervical intraepithelial neoplasia - CIN
Outline the cervical cancer screening programme
- 25 - 49 - every 3 yrs
- 50 - 64 - every 5 years
- 65+ - only if not been screened since 50
What sort of cancer occurs in the endometrium?
Adenocarcinoma
How is endometrial cancer diagnosed?
Pipelle biopsy
List some possible treatments for endometrial cancer
- Radical hysterectomy
- RT
- Copper coil
