What are 5 preventions of cancer?
Diet Smoking Screening Genetics Medication
What part of diet can CRC be linked to?
Red meat consumption
What part of diet can breast cancer be linked to?
Saturated fat intake
What can decrease risk in terms of diet?
Physical activity
Diet has lots of ______ factors.
Confounding
What is the current advice for diet?
Eat 5 or more portions of fruit and veg Avoid obesity Regular exercise (30mins/day)
What is the screening for cervical cancer?
Smear test
What is the screening for CRC?
Faecal occult blood
What is the screening for breast cancer?
Mammography
What is the screening for prostate cancer?
PSA blood test
What is the screening for lung cancer?
MR/CT scanning
Why is prostate screening controversial?
Many people will have prostate cancer and will have lived with it for years with no effects.
All screenings have the chance of false ______.
Negatives.
What would families with genetically inherited CRC and FAP get? (4 points)
Autosomal dominant
Screening for APC mutations
Regular colonoscopy
Offer panproctocolectomy when adenomas found
What are the 2 genes which increase risk of breast cancer?
BRCA1
BRCA2
What is used to treat primary oesophageal cancer?
Supplementing diet with antioxidants (no effect)
What is used for people with a risk of primary breast cancer?
Prophylactic tamoxifen
What is used for people who have had previous lung cancer and have a risk of secondary lung cancer?
Give antioxidants (no effect)
What are the 4 local/regional treatments?
Surgery
Radiotherapy
Ablation
Isolated limb perfusion
What are the 4 systemic treatments?
Hormonal therapy
Chemotherapy
Immunotherapy
Whole body irradiation (Bone marrow transplant)
What 2 things are needed to determine where the cancer is?
Examination
Radiology/Imaging
What is needed to determine what type of cancer it is?
Classification (Pathology)
Genomics
Surgery needs anatomical ______.
Clearance
In %, how many cancers are cured by surgery?
50
Radiotherapy needs anatomical ______.
Coverage
What can radiotherapy treat?
Inoperable lesions
What can be maintained in radiotherapy?
Function and/or appearance.
What are the 5 Rs of radiobiology?
Radiosensitivity Repair Repopulation Reoxygenation Reassortment
In cancer cells, are the high or low in oxygen concentration?
Low
If cells are low in oxygen they are sensitive/resistant to radiotherapy.
Resistant
What phase is very resistant to radiotherapy?
Late S
What % of cancers are treated by radiotherapy?
40
What are the 3 main cancers treated by radiotherapy?
H&N
Cervix/Uterus
Skin
What plays an important role in palliation (e.g pain, bleeding, swollen limbs)?
Radiotherapy
What is the advantage of systemic treatment?
Beneficial for widespread disease.
What is the disadvantage of systemic treatment?
Can result in widespread toxicity.
What percentage of cancers does chemotherapy treat?
3%
What does systemic treatment have potential to do?
Be very specific.
What is the ideal difference on a graph between anti-tumour effect and normal tissue toxicity in therapeutic index?
As far apart as possible.
What are the 4 indications for the use of cytotoxic drugs?
Curative
Palliative
Adjuvant
Neoadjuvant
What is adjuvant chemotherapy?
The use of multiple ways of healing i.e chemotherapy and radiotherapy. Balance between healing and pain.
What does neoadjuvant help decide?
How the cancer is going to behave.
What are the 2 main cancers treated by curative chemotherapy?
Testicular cancer
Lymphomas
What can curative chemotherapy be used along with?
Radiotherapy
e.g anal cancer
What is the aim of adjuvant chemotherapy?
Improve survival
What does adjuvant chemotherapy follow?
Surgery
What are the 2 decisions to look at for adjuvant chemotherapy?
Toxicity vs Benefit
Cost vs Benefit
What is the main aim of palliative chemotherapy?
Relieve symptoms
What are the 2 aims of neoadjuvant chemotherapy?
Improve survival
Reduce morbidity
What 2 cancers does hormone therapy benefit?
Breast cancer
Prostate cancer
What are the 3 specific immune therapies?
Monoclonal antibodies
Programmed cell death pathway
Chimeric antigen receptor T-Cells
What does programmed cell death pathway use the immune system to do?
Attack foreign cancer cells.
What is the 4th type of immune therapy?
Non specific
What are designer therapies?
Specific therapy based on molecular science (intracellular growth control points).