Cancer and Its Risk Factors Quiz

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Questions and Answers

Which type of cancer is most commonly linked to chronic infection with Helicobacter pylori?

Liver cancer

Colon cancer

Breast cancer

Stomach cancer (correct)

Which type of human papillomavirus (HPV) is primarily linked to cervical cancer?

HPV type 16 (correct)

HPV type 6

HPV type 11

HPV type 34

What is a significant risk factor for breast cancer in women related to reproductive factors?

Low estrogen levels

Early menopause

High physical activity

Late age at menopause (correct)

Which type of meat is classified as Group 1 carcinogenic by IARC?

Processed meat Signup and view all the answers

What factor is NOT known to significantly increase the risk of cancer?

Regular exercise Signup and view all the answers

Which form of radiation is classified as Group 1 carcinogenic by IARC?

X-rays Signup and view all the answers

What is one of the main established causes of human cancer related to lifestyle factors?

Excessive alcohol drinking Signup and view all the answers

What health behavior is linked to an increased risk of developing cancers of the digestive system?

Alcohol drinking Signup and view all the answers

What does the term 'neoplasia' refer to in the context of cancer?

Abnormal and uncontrolled proliferation of cells Signup and view all the answers

Which cancer type primarily affects blood and lymphatic systems?

Lymphomas Signup and view all the answers

What characteristic is associated with malignant tumors?

They can invade neighboring structures Signup and view all the answers

Which prefix indicates a tumor related to cartilage?

chondro- Signup and view all the answers

What distinguishes benign tumors from malignant tumors?

Benign tumors generally do not cause the patient’s death Signup and view all the answers

Which of the following prefixes refers to 'fat' in cancer terminology?

lipo- Signup and view all the answers

What type of carcinoma is specifically related to the lungs?

CA Lung Signup and view all the answers

Which of the following is a feature of malignant tumors?

They can metastasize to distant organs Signup and view all the answers

What is the primary danger of malignant tumors?

They can invade neighboring tissues and metastasize. Signup and view all the answers

What does the 'T' in TNM staging represent?

Tumor size and extension into nearby tissues Signup and view all the answers

How do metastatic cells typically spread throughout the body?

By entering blood vessels and traveling to other organs Signup and view all the answers

What does the term 'in situ cancer' refer to?

Cancer cells that are still confined to the original site Signup and view all the answers

Which of the following describes the 'M' category in TNM staging?

It assesses whether the cancer has metastasized to distant organs. Signup and view all the answers

What is a characteristic of cancer stem cells?

They have the ability to self-renew and generate diverse cell types. Signup and view all the answers

What does a higher 'N' number in TNM staging indicate?

Greater spread to nearby lymph nodes Signup and view all the answers

What is the main cause of death from cancer?

Metastatic disease Signup and view all the answers

What does an M0 classification indicate in cancer staging?

No distant cancer spread was found. Signup and view all the answers

Which stage of cancer is characterized by abnormal cells that have not spread to nearby tissues?

Stage 0 Signup and view all the answers

In the TNM staging system, what does a higher N number indicate?

There is more cancer spread to nearby lymph nodes. Signup and view all the answers

What is a characteristic of Stage 4 cancer?

The cancer has spread to distant parts of the body. Signup and view all the answers

Which cancer type is the leading cause of cancer in males in Hong Kong?

Lung cancer Signup and view all the answers

Which cancer type has the highest mortality rate among males in Hong Kong in 2020?

Lung Signup and view all the answers

In 2020, which cancer type had a similar relative frequency for both genders in Hong Kong?

Colorectum Signup and view all the answers

What percentage of cancer deaths in Hong Kong for females in 2020 was attributed to breast cancer?

12.2% Signup and view all the answers

Which of the following cancer types had the lowest number of cancer deaths in males in Hong Kong in 2020?

Oesophagus Signup and view all the answers

What was the relative frequency of liver cancer mortality in females in Hong Kong in 2020?

10.3% Signup and view all the answers

Which symptom is NOT commonly associated with cancer-related fatigue?

Increased energy levels Signup and view all the answers

What is a primary goal of palliative care?

To relieve suffering and improve quality of life Signup and view all the answers

Which of the following is a common adverse effect of pain mentioned in the content?

Anxiety and depression Signup and view all the answers

In the context of pain management, what does pharmacotherapy include?

Opioids, nonopioids, and adjuvant co-analgesics Signup and view all the answers

What is a psychological treatment approach for managing pain?

Pain acceptance and coping strategies Signup and view all the answers

Which factor is NOT linked to symptoms of fatigue according to the ICD-10 criteria?

Increased physical strength Signup and view all the answers

Which of the following is NOT typically included in symptomatic treatment of fatigue?

Cognitive behavioral therapy Signup and view all the answers

What role does rehabilitation play in cancer pain management?

It helps patients live with their pain Signup and view all the answers

Which of the following is a common physiological response to pain?

Increased respiratory rate Signup and view all the answers

What is one of the effects of pain on daily functioning?

Reluctance to move or engage in activities Signup and view all the answers

Study Notes

Clinical Sciences: Medical and Neurological Conditions - Cancer

Cancer develops from cells with altered growth and proliferation mechanisms.
Carcinogenesis is a multistage, genetically regulated process.
Normal cell growth is different from cancerous cell growth. Normal cells shed and new cells replace them. In contrast, cancer cells rapidly divide, damage tissues, and enter the bloodstream, metastasizing to other organs and sites.
Tumors can develop from four tissue types: epithelial, connective (muscle, bone, cartilage), lymphoid, and nerve tissue.
Cancer initiation requires exposure of normal cells to carcinogenic substances (chemical, physical, or biological).
Oncogenes and tumor suppressor genes are key in carcinogenesis.
Tumors typically invade and destroy surrounding tissue, are genetically unstable, and lose their usual functions..
Metastasis and recurrence are common after primary tumor removal.
Known carcinogens include: tobacco smoking (passive and active), chronic infections (Hepatitis B, HPV, H. pylori), alcohol drinking, imbalanced diet/obesity/inactivity, hormones, and ionizing radiation (e.g., UV light, occupational exposures).

Lecture Outline

Etiology of Cancer
Terminology and Classifications
Cancer Statistics
Cancer Diagnosis
Cancer Treatment
Cancer Pain and Fatigue
Palliative Care

What is "Cancer"?

Cancer develops from a cell in which the normal mechanisms for controlling growth and proliferation are altered.
Current evidence supports the concept of carcinogenesis as a multistage process that is genetically regulated.

How are Normal and Cancer Growth Different?

Normal growth is day-to-day replacement of old cells with new.
Cancer cells grow into surrounding tissues (invasion), enter blood vessels, and spread to other sites (metastasis).

How are Normal and Cancer Cell Division Different?

Normal cell division follows a controlled and regulated pattern, ending with cell suicide or apoptosis.
Cancer cell division is not controlled or regulated, and damaged, unrepaired cells continually reproduce.
Cancer cell division may have multiple mutations.

Pathology of Cancer

Tumors arise from four basic tissue types.
The first step is initiation, which requires exposure to carcinogenic substances.
Major classes of genes involved in carcinogenesis are oncogenes and tumor suppressor genes.

Tumor Characteristics

Invade and destroy surrounding tissue.
Genetically unstable cells.
Loss of normal cell architecture, atypical cells.
Lose ability to perform normal functions (e.g., organ failure).
Metastasize and recur commonly after primary tumor removal.

Carcinogens

An agent (mixture or exposure) that increases the age-specific incidence of human cancer.
Known carcinogenic factors include tobacco smoking, passive smoking, chronic infections, alcohol drinking, hormones, imbalanced diet/obesity/inactivity, ionizing radiation (including UV light), and occupational exposures.

Carcinogenic Agents (WHO IARC)

Group 1: Carcinogenic to humans (e.g., Tobacco smoking).
Group 2A: Probably carcinogenic to humans.
Group 2B: Possibly carcinogenic to humans.
Group 3: Not classifiable as to its carcinogenicity to humans.
Group 4: Probably not carcinogenic to humans.

Tobacco Smoking (Group 1)

Causes 13 different cancers (lung, oral cavity, etc.)
Largest increase in tobacco-related cancers in China and other Asian countries.
Passive smoking also causes cancers and other health problems.

Electronic Cigarettes

Contain harmful substances.
Limited research on long-term health risks.
FDA regulates e-cigarette products.
Outbreaks of lung illnesses connected to vaping reported.

Chronic Infections

Approximately 15-20% of cancers worldwide are attributed to infectious agents.
Examples include Hepatitis B (liver cancer), Epstein-Barr virus (lymphomas), H. pylori (gastric cancer), and HPV (cervical, mouth, throat, penis, or anus cancer).

Chronic Infection and Cancers

Graphs show number of cancer causes from different types of chronic infections.

Alcohol Drinking

A major cause of human cancer.
Established causal association between alcohol drinking and multiple cancers (oesophageal, colorectal, liver, breast, oral cavity, pharynx, larynx).

Hormones

Reproductive factors and endogenous hormones influence cancer risk.
Late age at menopause increases the risk of breast cancer.
Hormone replacement therapy (e.g., estrogen) increases the risk of breast cancer.
Estrogen/progestogen oral contraceptive reduces ovarian cancer risk.

Imbalanced Diet, Obesity, and Physical Inactivity

Processed meat and Chinese salted fish are Group 1 carcinogens.
Red meat is Group 2A.
Overweight/obesity increases cancer risk, especially colorectal and stomach cancers.
Fruit/vegetable intake and physical activity reduce cancer risk.

Ionizing Radiation

Group 1 in all kinds of ionizing radiation.
Radiation sources include natural (space/materials), solar (UV), industrial, nuclear power plants, and medical (X-rays).

Occupational Exposures

Certain occupations expose workers to carcinogens, increasing cancer risk
(e.g., flight personnel, hairdressers/barbers, painters, petroleum refining, rubber industry, steel foundry workers, tin miners, welders).

Aetiology of Cancer (Summary)

Risks and causes of cancer are not fully understood.
Known factors include heredity factors, exposure to carcinogens, and lifestyle factors.
Table showing classifications of carcinogens according to IARC.

Genetic Susceptibility

BRCA1/BRCA2 with breast cancer
APC with colorectal cancer
Individuals with these gene mutations may have higher chances of developing these types of cancers than those without these gene mutations.

Angelia Jolie's Story

Angelina Jolie's public disclosure of genetic testing and preventive surgery for cancer risk heightened societal awareness of genetic risk factors.

Terminology in Cancer

Neoplasia—abnormal and uncontrolled proliferation of cells in a tissue or organ.
Most neoplasms form distinct masses called tumors.
Cancer (CA) e.g. colon, lung

Different Kinds of Cancer

Carcinomas (lung, breast, colon, bladder, prostate).
Leukemias (bloodstream).
Lymphomas (lymph nodes).
Sarcomas (fat, bone, muscle).

Classifications: Benign & Malignant

Benign tumors remain confined to the original tissue.
Malignant tumors show anaplasia (immature cell form).
Malignant tumors invade nearby tissues, and metastasize (spread to other organs).

Cancer Metastasis

Metastasis is the spread of cancer cells from their original site to distant organs and tissues, often causing death.
Organ distribution of metastasis depends upon the primary tumor type and location.
Metastasis development depends upon "cancer stem cells", which self-renew and evolve according to their environment.

Why are Malignant Tumors Dangerous?

Cancer cells can travel through the bloodstream and invade distant organs and tissues.
Cancer cells have varying levels of aggressiveness, resulting in diverse symptoms and outcomes.

Classification: TNM Staging

T: describes the size and extent of the primary tumor.
N: describes the involvement of nearby lymph nodes.
M: describes the presence of distant metastases.
Stages are important for treatment planning and prognosis.

Staging by Roman Numeral System

Stage 0: abnormal cells present, not spread.
Stages 1-3: cancer is present, higher stages indicate larger tumor and more spread.
Stage 4: cancer has spread to distant parts of the body.

Global Statistics

Global incidence and mortality of cancers by region and type.
Key Cancer types by incidence and mortality in different regions.
Local/Hong Kong specific data.

Local Statistics by Gender 2020

Cancer occurrence rates in Hong Kong, broken down by gender and specific cancer types.

Mortality in 2020 - Both Sexes

Mortality rates in cancers in Hong Kong and globally

Mortality rate in Hong Kong 2020

Male and female-specific mortality rates, ranked by highest to lowest rates for cancer.

How to Make a Diagnosis of Cancer?

Various diagnostic tests, including blood tests, X-rays, ultrasounds, CT scans, MRIs, PET scans, and biopsies are used.
These tests help determine the type, stage, and location of the primary tumour and metastasis.

Chest X-ray with Lung Cancer

X-ray Images showing lung mass.

CT & PET Scan

Imaging techniques showing metabolic activity and sites of metastasis in lung cancer.

MRI Scan of Spinal Cord Tumor

MRI image showing spinal cord tumor.

Non-traumatic Spinal Cord Injury (NTSCI)

Heterogeneous conditions causing spinal cord injury, including degeneration, metastasis, vascular issues, and inflammation.
Conditions can cause varying symptoms and levels of impairment in patients.

Biopsy Needle Test for Breast Cancer

Procedure to obtain a breast tissue sample for analysis.

What Does a Pathologist Look For When Examining Biopsy Tissue?

Comparing biopsy tissue with normal cells to identify abnormal characteristics (size, shape, pattern) associated with cancer.

Cancer Treatment

Methods to treat cancer, including radiotherapy, chemotherapy, surgery, bone marrow transplant, psycho-oncology therapy, and rehabilitation.

Early Intervention

Early identification and intervention are crucial for better treatment outcomes.
Cancer cell adaptation to the organism's defenses is important.
Cancer cells become adept at adapting to treatments early in the disease.

Radiotherapy

High doses of radiation used to destroy cancer cells.
Often used in combination with other treatments (chemo, surgery).
Can be applied before or after surgery.
Modern radiotherapy uses linear accelerators and CT-guided 3D planning for better accuracy.
Different types of radiotherapy are used for different types of cancer.

Chemotherapy

Drugs used to slow cancer growth or prevent recurrence.
Often used in combination with other treatments.
Chemotherapy drugs are effective but are usually associated with a range of side effects such as hair loss, gastrointestinal issues, and blood disorders.

Surgery

Procedure to remove cancer and related cancerous tissue or growths.
Used for both diagnostic and therapeutic purposes.
Can also be used preventatively.

Surgery cont'd

Emergencies for saving lives by alleviating pain, preventing organ failure, and reconstructive surgery for aesthetics.
Important for improving quality of life with palliative care and wound management or ulcer care.

Bone Marrow Transplant

Treatment used for leukemia and lymphoma.
Types of transplant include autologous (using the patient's own stem cells), syngeneic (using identical twins' stem cells), and allogeneic (using stem cells from a donor like a relative).

Psycho-oncology Therapy

Therapy for patients and their families with psychological distress (anxiety, depression).
Interventions, education, counseling, cognitive and mind-body techniques, and group/family therapies are important supportive measures.

Rehabilitation in Oncology

Comprehensive approach to recover physical, social, and psychological functioning.
Interdisciplinary teams, physical therapy, occupational therapy, pain management, exercise, lifestyle redesign, and psychosocial counseling are important.

Cancer Pain and Fatigue

Signs, symptoms, and treatment approaches for cancer pain and fatigue.
Various treatments and therapies are used for managing the symptoms.

Palliative Care

Compassionate care for people with incurable illnesses focuses on improving quality of life through symptom management and emotional/spiritual support.
Goal is to support patient's and families during all stages of illness, and/or at end of life.
Palliative strategies are available for use alongside curative treatments.

Local Resources and References

Links to organizations and resources regarding cancer treatment in Hong Kong.

Useful Web Sources

Links to various sources of information on cancer, useful for training material.

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Description

Test your knowledge on different types of cancer and their associated risk factors. From infections to lifestyle habits, this quiz covers a variety of important cancer-related topics. Discover key facts and increase your understanding of cancer prevention and characteristics.