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CCC > Types of cancers > Flashcards

Types of cancers Flashcards

1
Q

What are the RFs for breast cancer?

A

Increasing age, increased periods oestrogen exposure, ionising radiation, FH

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2
Q

Most common type of breast carcinoma?

A

Infiltrating or invasive ductal carcinoma in situ

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3
Q

How is Dx of breast cancer confirmed?

A

Biopsy - FNAC, needle, incisional or excision

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4
Q

A patient has a tumour in her left breast measuring 4cm. She also has involvement of 3 axillary lymph nodes which are fixed to the chest wall. On CT scan there is no evidence of metastases. What is the TNM stage of the cancer?

A

T2 N2 M0

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5
Q

When would you give Tamoxifen?

A

To an oestrogen receptor (ER) positive tumour.

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6
Q

What are the risks assoc with tamoxifen Tx? (2) What could you use to treat breast cancer instead if you were worried about these risks?

A

Thrombotic complications, endometrial cancer. Use aromatase inhibitors e.g. anastazole, letrozole

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7
Q

What mutations are assoc with colorectal cancer?

A

APC, p53, ras, DCC

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8
Q

Most common histological type of colorectal cancer?

A

adenocarcinoma = 90-95%

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9
Q

Patient comes in with altered bowel habits & occasional rectal bleeding. What is your first investigation?

A

DRE - can feel 75% rectal lesions

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10
Q

What chemo is usually used to Tx colorectal Ca?

A

5-FU

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11
Q

When can you use radiotherapy to Tx colorectal cancer?

A

Rectal cancers (colon too close to adjacent organs)

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12
Q

What chromosomal deletion is associated with lung cancer?

A

3p (and 13q, 17p)

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13
Q

What type of lung cancer are EGFR activating mutations associated with?

A

Adenocarcinoma

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14
Q

Types of NSC lung cancers?

A

SCC, adenocarcinoma, large cell

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15
Q

Sx of lung cancer?

A

Chest pain, cough, SOB, haemoptysis, persistent chest infections

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16
Q

Patient presents with Hx of cough and unilateral ptosis & pupil constriction. What is the likely diagnosis?

A

Apical lung tumour on ipsilat side - Pancoast’s tumour

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17
Q

What signs might indicate mediastinal involvement of lung cancer? (2)

A

Recurrent laryngeal N palsy (hoarse voice), SVCO

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18
Q

What sign is associated with SCC of lung?

A

Clubbing

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19
Q

What investigations are available to help Dx lung cancer?

A

CXR, sputum cytology, bronchoscopy & biopsy, CT

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20
Q

What tumour markers can you look for in lung cancer? What might they show?

A

Neuron-specific enolase (SCLC) & LDH - poss indicators of tumour activity

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21
Q

What size primary lung tumour determines if T1/2/3?

A

T1 - 3cm or less
T2 - >3 but <7cm
T3 - >7cm

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22
Q

What is the main Tx used for small cell lung cancer?

A

Chemotherapy. SCLC very chemo-sensitive.

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23
Q

What Tx can you offer to pt with lung cancer to prevent frequency of advancing metastatic disease?

A

Prophylactic cranial irradiation - decreases freq brain mets.

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24
Q

When can you perform surgery in NSCLC?

A

Stage 1 or 2 - 30% of pts

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25
Q

When could imatinib be used to Tx lung cancer?

A

NSCLC with EGFR activating mutations

26
Q

What system is used to grade prostate cancers?

A

Gleason.

27
Q

What might you find on DRE of prostate ca?

A

Enalrged, hard, crazy, obliteration of median sulcus

28
Q

How is a histological Dx made of prostate cancer?

A

Transrectal biopsy with USS guidance. Sample many different areas & assess size of gland

29
Q

What might PSA levels reflect in prostate Ca?

A

Low levels - localised disease, high - systemic mets

30
Q

When is radical prostatectomy performed in prostate Ca?

A

If stage T2 or less.

31
Q

Which cancers commonly metastasise to bone?

A

Rule of two’s: thyroid, lung, breast, renal, prostate + haematological e.g. myeloma

32
Q

What types of radiotherapy are available to Tx prostate ca?

A

external beam irradiation, brachytherapy

33
Q

What alternative Tx (not surgery, chemo or radio) can be used in prostate Ca?

A

LHRH agonists - goserelin, buserelin
Oestrogen therapy
Anti-androgens
Bilateral orchidectomy

34
Q

Which chemo agents are used in prostate Ca?

A

Docetaxel + cabazitaxel

35
Q

Main type of testicular cancer?

A

Germ cell tumour - 95%

36
Q

What type of tumour is a yolk sac tumour?

A

Non-seminomatous germ cell tumour

37
Q

Involvement of para-aortic nodes might suggest what type of primary tumour?

A

testicular

38
Q

What tumour markers are associated with testicular Ca?

A

Beta-human chorionic gonadotrophin - raised in seminoma & non-sen.
A-fetoprotein - non-sem

39
Q

What does the IGCCC system tell you?

A

Prognosis of testicular cancer

40
Q

What test can be done in A&E to aid Dx testicular cancer?

A

Pregnancy test

41
Q

AFP of 700, hCG 4000 and normal LDH might suggest what prognosis of testicular Ca?

A

Good prognosis

42
Q

Main Tx of testicular Ca?

A

Orchidectomy

43
Q

What chemo regime used in non-sem testicular ca?

A

Bleomycin, etoposide & cisplatin (BEP)

44
Q

How might you Tx a stage 1 seminoma after/alongside surgery?

A

1 dose of carboplatin

45
Q

Where might you find SCCs?

A

Lung or head & neck

46
Q

Woman with peritoneal carcinomatosis might have what?

A

Ovarian cancer spread

47
Q

What chemo agent combination is best to Tx a tumour of unknown primary origin?

A

Antracycline + platinum, e.g. epirubcun + cisplatin

48
Q

What Tx option is available for post-menopausal women with breast cancer?

A

Aromatase inhibitors - block peripheral oestrogen production.
Also hysterectomy

49
Q

What is a potential problem assoc with tamoxifen?

A

Increased risk thrombosis + endometrial cancer

50
Q

What is a potential problem associated with aromatase inhibitors?

A

Risk of osteoporosis

51
Q

A patient presents with weight loss, diarrhoea and iron deficiency anaemia. Where might he have a cancer?

A

R side of colon –> iron not being absorbed, and any bleeding may not be as obvious

52
Q

In Dukes staging, what determines whether stage A, B or C?

A 
A = invasion of submucosa or muscularis proprietary
B = invasion subserosa or beyond
C = metastasised to lymph nodes
53
Q

Which types of lung cancer are associated with smokers and non-smokers?

A

Smokers - SCC (clubbing)

Non-smokers + women - adenocarcinoma

54
Q

What are the Sx of Horners syndrome? When might you see this?

A

Seen in apical lung tumours pressing on the sympathetic trunk.

Get ipsilateral mitosis (constricted pupil), partial ptosis (droopy lid), and anhydrosis

55
Q

What is CHART? When is it used?

A

Continuous hyperfractionated accelerated RT.
Given 3x day for 12 consecutive days.

Used in Tx of NSCLC

56
Q

Where in the prostate would you see enlargement due to a tumour as opposed to due to BPH?

A

Tumours - posterior or peripheral parts

BPH - centre

57
Q

What Tx options are available for prostate cancer?

A

Surgery - TURP
RT - external beam RT or brachytherapy
LHRH agonists - goserelin –> decrease testosterone
Chemo - docetaxel + cabazitel

58
Q

What are the main types of testicular cancer?

A

Germ cell tumours –> seminomatous (40%), or non-seminomatous (60%)

59
Q

Where do testicular cancers commonly spread to?

A

Para-aortic nodes –> mid-line disease

60
Q

How can you determine using biochemical tests whether a testicular tumour is seminomatous or non-sem?

A 
Seminoma = raised bHCG
Non-sem = raised bHCG + AFP

CCC (5 decks)

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