Unit 2: Cancer & its classification

Question 1

What are the 4 major solid types of cancers

Answer 1

Breast, lung, colorectal and prostate

Question 2

What are 5 major catatgories of cancer type?

Answer 2

Carcinoma - epithelial tissue
Sarcoma - Mesenchymal tissue e.g
connective/supportive tissue
Leukemia - White blood cells
Lymphoma/myeloma - cells of immune system
Neuroectodermal - CNS derived

Question 3

What is an adenocarcinoma

Answer 3

Arises from SECRETORY GLANDULAR epithelium e.g - lung, breast, prostate, colon

Question 4

What is a squamous carcinoma

Answer 4

Arise from the PROTECTIVE squamous epithelium e.g - keratinocytes from skin

Question 5

List mesenchymal cells/tissue which can give rise to sarcoma’s

Answer 5

Bone (osteoclasts), fat (adipocytes), muscle, tendon, cartilige

Question 6

What are the 4 main characteristics of benign tumours

Answer 6

• Localised to one area usually contained within a
  fibrous, connective tissue capsue.
• Doesnt invade into surrounding tissue or spread
• Slow growing
• Cells are very homogenous within the tuumour

Question 7

What are 6 microscopic characteristics of benign tumours

Answer 7

• Regular organised cell arrangement
• Stain normally
• show some features of normal specialised funtion
• Normal nuclear morphology
• Slow growing (slow mitotic rate)
• NEVER INVADE THROUGH THEIR CAPSULE

Question 8

Name a disease associated with a benign tumour

Answer 8

Cushings disease - Benign tumour in pituitary gland secretes excess Adreno-corticotrophic hormone (ACTH) = produces too much cortisol

Question 9

Name some characteristics of malignant tumours

Answer 9

• No fibrous capsule
• not localised or self contained
• poorly defined borders
• necrotic/ulcerated areas
• highly proliferative
• high metabolic rate
• stimulate angiogenesis
• have invading cells at tumour margin

Question 10

What does pleomorphic mean

Answer 10

Dense nuclei which var in shape and size

Question 11

Is there a stage inbetween benign and malignant? Name an example

Answer 11

Yes = pre-malignant disease

in the transformation zone in the cervix (seen via smear test and PAP stain) is able to identify dysplastic cells (have large neclei and variable size) - when dysplasia becomes severe and proliferative this is known as a pre-malignant phase.

Question 12

List the order of cellular transformation from a benign to malignant state

Answer 12

1. normal cells
2. Hyperplasia (benign)
3. Dysplasia, but cells still within basement membrane
4. Severe dysplasia (pre-malignant)
5. Invasive and malignant = highly proliferative

Question 13

Why is the classification of cancer important

Answer 13

Because tumours of the same organ can vary greatly = inter-tumour heterogeneity

Question 14

What is tumour staging

Answer 14

reflects the tumours spread and size

Question 15

What is tumour grade

Answer 15

Reflects the tumours histological appearences & proliferation capacity when examined unnder the microscope

Question 16

What is staging used for

Answer 16

used to evaluate the extent of the spread (nvasiveness)

Question 17

Why is tumour staging valuble clinically

Answer 17

• Provides common language for clinicians to
  catagorize tumour
• helps with patients prognosis
• helps to decide treatment approach for patient

Question 18

What parameters does staging use

Answer 18

C - clinical (talking to patients/scans)
P - pathological measurments (microscopy)
Surgical parameters - tells us extent of tumour spread

Question 19

What is the TNM classification system

Answer 19

Used for solid tumours
T = Size of primary tumour (1,2,3,4)
N = Extent of spread into neighbouring lymph nodes
(N1,N2,N3)
M = extent of metastasis (M1 - distant metastasis)

Question 20

What is metastatic organotropism

Answer 20

When a specific cancer has a preferred site for metastasis

Question 21

What site does prostate cancer prefer to metastasise to?

Answer 21

Bone and lymph nodes

Question 22

What are common sites of metastasis for cancers

Answer 22

Bone. Lung, Liver

Question 23

What are the staging catagories and what do they mean?

Answer 23

I. Cancer localised to primary site (early)
II. Early locally advanced cancer (spread only to
surrounding tissue)
III. Late, locally-advanced cancer (spread into regional
lymph nodes
IV. Cancer has distant spread (metastasis, advanced)

Question 24

Why is staging important

Answer 24

It helps to gauge a patients prognosis and helps to decide, on treatment. Restaging cancers is also used to help monitor if a cancer has responded to treatment.

Question 25

What staging system is in place for brain tumours

Answer 25

There is no staging system for brain tumours but theyre instead assessed using microscopy of biopsies & using CT/MRI/PET imaging.

Question 26

What staging is in place for leukemia

Answer 26

Involves blood count of the cell shape, whether there is anaemia, types of chromasomes, genetic abnormalities.