Cancer Case Study – Flashcards
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How many women in the UK will develop breast cancer? How long is the median survival? When does it normally present?
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1/9 2 years As a large growth (slow growing)
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What are the three methods of screening? Which is the only modality proven to decrease mortality? Who is it recommended for? How does it affect mortality?
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Self Physician Mammogram: only one to decrease mortality ACS: annually >40 and NICE every 3 years >50 50s decreases mortality by 25-30% and 40s by 18%
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Give some risk factors for breast cancer
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Age, family history, oestrogen exposure, 1st pregnancy after 30, diet and lifestyle, radiation exposure <40, prior cancer
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Give some signs and symptoms of breast cancer
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Mass/pain in axilla Thickening Nipple discharge/retraction Edema/erythema of skin
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What are the three histological types of breast cancer along with prevalence?
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Ductal: 80% Lobular: 10% Medullary: 5%
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What are the three types of biopsy?
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Excisional Core Fine needle aspiration
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Where can breast cancer spread to? Why is this so bad?
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Brain, lymph, skin, liver, bone, pleura, lung Cannot be cured
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Give some treatments for metastasis of breast cancer.
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Radiotherapy (if the patient is in pain and not responding to analgesics) HRT Bis-phosphonates (in bone disease) Chemotherapy
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When is chemo useful for women with metastatic breast cancer? What drugs are used?
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Improves survival in patients who are symptomatic and won't be hormone responsive Anthracyclines and Taxanes (capecitabine and vinorelbine are also used)
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Give some post-operative therapies and describe why they are used for breast cancer.
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Radiotherapy Chemotherapy (reduces chance of relapse) HRT Herceptin > HER2 increases; homo or hetero dimerisation causes tumour cell survival or proliferation > Is a humanised IgG1 (an antagonist) > Ab dependent cell mediated toxicity > Good TI and increases overall survival
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What investigations are used for testicular cancer?
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U/S CT Bloods Tumour markers: b-HCG alpha feto protein lactate dehydrogenase
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What are the two types of testicular cancer?
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1. Non seminomas germ cell tumour - earlier age of diagnosis - 25-30% relapse if no chemo - 2 cycle relapse rate is 2-3% - split into high and low risk groups dependent on vascular invasion 2. Seminomas germ cell tumour
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What are the advantages of surveillance for testicular cancer? And disadvantages?
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Only patients who need chemo will get it Rigorous follow up and chemo for mets is more intense
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Can metastatic testicular cancer be cured?
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Yes
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Describe how chemotherapy may not be a benefit for someone with testicular cancer What side effects can it produce? Give an example of a drug used
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99% of stage 1s are cured whether they have chemo or not after surgery Lung toxicity Infertility Increased risk of leukaemia Cisplatin - cytotoxic drug - 80% with disseminated mets are cured - can cause ototoxicity and neuropathy
