what does cancer do to me?

Question 1

what are some main mass effects of cancer?

Answer 1

• local problems because of size
• compression of adjacent structures
• anatomically dependant
• brain - any mass effect is bad
• blocking of blood vessels
• blocking of airways
• blocking of bile ducts

Question 2

what are the 3 B’s for common tumours in paediatrics?

Answer 2

• brain
• bone
• blood

(kids don’t usually get carcinoma - mostly gets more common with age)

Question 3

when can cancers present late & badly?

Answer 3

tumours aren’t near any other structures and can get massive without anyone noticing e.g. ovary

Question 4

what types of cancers are commonly found early?

Answer 4

skin, breast & testes, vocal chord

Question 5

what are some warning signs of cancer?

Answer 5

• loss of function
• energy loss
• weight loss (due to interfered metabolism)

Question 6

what type of colon tumours are found earlier and why?

Answer 6

lower down colon as more likely to bleed

Question 7

why can jaundice be a warning sign?

Answer 7

loss of function -> blocked bile ducts

Question 8

what are some ways lungs can lose function?

Answer 8

• decreased area of healthy lung
• decreased oxygen consumption

*these are often a late occurence and often due to large & multiple tumours

Question 9

what can loss of function in bladder & kidney look like?

Answer 9

• obstruction
• can’t drain urine
• backwards pressure
• kidneys stop function
• build up of toxins & abnormal electrolyte balance

Question 10

what is difference between brain tumours and other tumours?

Answer 10

there’s no such thing as benign - just grade 1,2,3

• as lots of important things in brain (breathing centre, control heart rate, pressure increases) so any tumour can be problem

Question 11

why is there lack of energy in someone with cancer?

Answer 11

• tumours divide frequently compared to normal tissue
• very metabolically active
• require energy

Question 12

a) why does cancer lead to weight loss?

b) how do you treat that weight loss?

Answer 12

a) - metabolic degree is not high enough to cause weight loss
- tumours produce all sorts of molecules that result in increased metabolism (mainly TNF = tissue necrosis factor)

b) diet change - lots of high energy foods and snacks

Question 13

what does infiltration mean?

Answer 13

direct invasion of other structures

e.g. invades other organs, fistulas & sinuses, invade brain, lung cancers through chest wall

Question 14

what can tumour infiltration lead to?

Answer 14

• nerves infiltration = loss of function
• motor infiltration = swallowing & diaphragm
• sensory = pain or loss of sensation

Question 15

what happens when tumours infiltrate blood vessels?

Answer 15

• already commented on hemorrhage within tumours as sign of malignancy
• larger vessels are big problem - catastrophic
• often cause sudden death in patients with known cancer, autopsy

Question 16

what happens when tumours infiltrate bone marrow?

Answer 16

• bone marrow failure means doesn’t do job - white blood cells, red blood cells, platelet
• folate required by all dividing cells - tumours use up a lot, less for other cells

Question 17

what is paraneoplastic symptoms?

Answer 17

symptoms not directly related to tumour - often unusual

Question 18

what causes paraneoplastic symptoms?

Answer 18

tumours can produce hormones

• can result in electrolyte disturbances →high calcium, low sodium
• osteoarthropathy →big fingers
• unusual neurological symptoms

Question 19

what are some paraneoplastic syndromes?

Answer 19

• skin rashes - very common, unknown cause
• fever - most common symptom related tumours - related to abnormal production of endogenous pyrogens
• pyrexia of unknown origin - fever and you can’t find infection = lots of causes, but important one not to miss is cancer

Question 20

what often causes more problems than the primary tumour itself?

Answer 20

metastases
- liver mets = loss of function
- bone mets = pathological fracture, calcium metabolism - high levels -> means bones are weak & easily broken

Question 21

what does iatrogenic mean?

Answer 21

caused by a doctor

Question 22

what are examples of iatrogenic?

Answer 22

• surgical complications
• radiotherapy
• chemotherapy (can have implications for bone marrow & gut)
• systemic anticancer therapy (SACT)
• palliative care

Question 23

what is SACT? (systemic anticancer therpay)

Answer 23

• not just traditional cytotoxics
• targeted treatments
• immune check point inhibitors - lets immune system target the cancer = but can lead to endocrine disorders, colitis