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Questions and Answers
What is the 5-year survival rate for lung cancer in females?
What is the 5-year survival rate for lung cancer in females?
Small-cell lung cancer accounts for 50-75% of lung cancer cases.
Small-cell lung cancer accounts for 50-75% of lung cancer cases.
False
Name one risk factor for lung cancer.
Name one risk factor for lung cancer.
Smoking
Adenocarcinoma is the most common type of lung cancer in ______.
Adenocarcinoma is the most common type of lung cancer in ______.
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Match the following lung cancer types with their characteristics:
Match the following lung cancer types with their characteristics:
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Which of the following statements about lung cancer is true?
Which of the following statements about lung cancer is true?
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Chemotherapy is a common treatment option for small-cell lung cancer.
Chemotherapy is a common treatment option for small-cell lung cancer.
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Which treatment can be used for metastatic prostate cancer?
Which treatment can be used for metastatic prostate cancer?
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Type II endometrial cancer usually arises in women with estrogen excess.
Type II endometrial cancer usually arises in women with estrogen excess.
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What is the most common invasive cancer of the female reproductive tract?
What is the most common invasive cancer of the female reproductive tract?
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____ is a benign neoplasm of smooth muscle in the uterus, commonly referred to as fibroids.
____ is a benign neoplasm of smooth muscle in the uterus, commonly referred to as fibroids.
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Match the type of breast cancer to its description:
Match the type of breast cancer to its description:
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Which type of lung cancer is most commonly associated with paraneoplastic syndromes?
Which type of lung cancer is most commonly associated with paraneoplastic syndromes?
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Lung cancer metastasis occurs in all patients by the time of diagnosis.
Lung cancer metastasis occurs in all patients by the time of diagnosis.
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What diagnostic method involves examining cells in sputum for lung cancer?
What diagnostic method involves examining cells in sputum for lung cancer?
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The prognosis for lung cancer is considered very __________.
The prognosis for lung cancer is considered very __________.
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What is the primary treatment for non-small cell lung cancer?
What is the primary treatment for non-small cell lung cancer?
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Adenomatous polyps are benign neoplasms that can evolve into cancer over time.
Adenomatous polyps are benign neoplasms that can evolve into cancer over time.
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Name one characteristic of small cell carcinoma.
Name one characteristic of small cell carcinoma.
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Parathyroid hormone syndromes associated with lung cancer can lead to __________.
Parathyroid hormone syndromes associated with lung cancer can lead to __________.
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Match the following lung cancer types with their treatment:
Match the following lung cancer types with their treatment:
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Which diagnostic procedure directly examines lung tissue?
Which diagnostic procedure directly examines lung tissue?
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What is a characteristic of Large Cell Carcinomas in lung cancer?
What is a characteristic of Large Cell Carcinomas in lung cancer?
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Hemoptysis is a common manifestation of lung cancer.
Hemoptysis is a common manifestation of lung cancer.
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Name one early manifestation of lung cancer.
Name one early manifestation of lung cancer.
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Pleural effusion is a collection of fluid that develops when the __________ layers are involved.
Pleural effusion is a collection of fluid that develops when the __________ layers are involved.
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Which of the following is NOT a symptom of lung cancer?
Which of the following is NOT a symptom of lung cancer?
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Metastasis in lung cancer occurs early in the disease progression.
Metastasis in lung cancer occurs early in the disease progression.
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What complication arises from the compression of the superior vena cava by tumors?
What complication arises from the compression of the superior vena cava by tumors?
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The prognosis for Large Cell Carcinomas is considered __________.
The prognosis for Large Cell Carcinomas is considered __________.
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Match the following symptoms to their corresponding manifestations found in lung cancer:
Match the following symptoms to their corresponding manifestations found in lung cancer:
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What is a significant risk factor for the development of colorectal cancer?
What is a significant risk factor for the development of colorectal cancer?
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Colorectal cancer can only be diagnosed through a tissue biopsy.
Colorectal cancer can only be diagnosed through a tissue biopsy.
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What is the most common cancer in males aged 15-35?
What is the most common cancer in males aged 15-35?
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The __________ test detects hidden blood in the stool and is a common screening method for colorectal cancer.
The __________ test detects hidden blood in the stool and is a common screening method for colorectal cancer.
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Match the following testicular cancer types with their characteristics:
Match the following testicular cancer types with their characteristics:
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Which of the following is NOT a protective factor against colorectal cancer?
Which of the following is NOT a protective factor against colorectal cancer?
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Testicular cancer has a low survival rate of less than 50%.
Testicular cancer has a low survival rate of less than 50%.
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What is the primary treatment option for colon cancer?
What is the primary treatment option for colon cancer?
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Individuals at high risk for colorectal cancer should begin screening before age __________.
Individuals at high risk for colorectal cancer should begin screening before age __________.
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Which symptom is commonly reported first in testicular cancer?
Which symptom is commonly reported first in testicular cancer?
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Study Notes
Selected Cancers
- Lung, prostate, breast, and colorectal cancer account for 50% of all new cancer cases each year.
- Breast cancer accounts for 28% of new cases in women, while prostate cancer accounts for 27% in men.
- One in four Canadians die from cancer.
- Individuals over 70 account for 60% of cancer deaths.
- Lung cancer accounts for 27% of all cancer deaths annually.
- Five-year survival rate is approximately 60%.
Cancers in Young Adults (15-25y)
- Lymphomas (Hodgkin and Non-Hodgkin) are the most common cancer type.
- Thyroid, testicular, and melanoma cancers also occur.
- Approximately 10,000 new cases are diagnosed each year, with two-thirds occurring in young women.
- Mortality is decreasing, but approximately 2,000 still die annually.
- Key prevention strategies include smoking cessation, avoiding sun exposure, Pap tests, and HPV vaccination.
Cancers in Children (0-15y)
- Little is known about the causes of childhood cancer.
- Theories include genetics, environmental factors, and exposure to radiation/drugs.
- Childhood cancer is a leading cause of non-injury related deaths.
- Approximately 850 children are diagnosed yearly, with 135 deaths.
- The 5-year survival rate is 82% but declining.
- Males are 1.2 times more likely to develop this cancer than females.
- The highest incidence is in children aged 0-4 years.
Why are childhood cancers often overlooked?
- Common types of childhood cancers include leukemia, CNS cancers, and lymphomas.
- Childhood tumors typically have shorter latency periods, faster growth, and are more aggressive and invasive.
- They often spread quickly to other parts of the body.
Cancer in Childhood- Warning Signs & Diagnostics
- Warning signs include prolonged fever, unexplained weight loss, and growing masses.
- Diagnostic methods and treatments are similar to those used for adult cancers, but doses may need adjustment.
- Long-term follow-up is needed for survivors to monitor for late effects.
Lung Cancer
- It is classified as the 2nd leading cancer type.
- The 5-year survival rate is 13% for men and 17% for women.
- Risk factors include smoking and occupational exposures.
- The cancer arises from the epithelial cells lining the lungs.
- It is characterized by being aggressive, invasive, and able to metastasize.
- There are four sub-types: Small cell, Non-small cell (Large cell carcinoma, Squamous cell, Adenocarcinoma).
- All types can cause paraneoplastic syndromes.
Small Cell Lung Cancer
- Distinctive cell type, small, round, oval cells growing in clusters.
- Highly linked to cigarette smoking.
- Highly malignant and spreads early on.
- Metastasis is often present at diagnosis.
- Treatment often does not include surgery, with chemotherapy and/or radiation therapy being the primary approach.
- A 50% mortality rate is observed within 12-15 weeks following diagnosis.
Non-Small Cell Lung Cancers- Squamous Cell Carcinoma
- Predominantly found in male smokers.
- Associated with smoking.
- Originates in the central bronchi and spreads centrally within the lung.
- Often detected through sputum cytology.
- More treatable compared to other cancer types.
Non-Small Cell Lung Cancers- Adenocarcinoma
- Most common type in women and non-smokers.
- Arises in bronchioles or alveoli, located peripherally in the lung.
- May be associated with lung scarring from other conditions such as tuberculosis.
- Has a poorer prognosis compared to other lung cancers.
Non-Small Cell Lung Cancers- Large Cell Carcinomas
- Characterized by large, irregular polygonal cells.
- Difficult to determine underlying cell type.
- Arises in peripheral lung tissue, eventually invading bronchi and large airways.
- Metastasis often occurs early.
- Possesses a poor prognosis.
Lung Cancer Manifestations
- Often subtle until late stages.
- May mimic other respiratory illnesses.
- Symptoms vary based on tumour location, spread, and paraneoplastic syndromes.
- Earliest symptoms include chronic cough, shortness of breath (SOB), wheezing, hemoptysis (coughing up blood), pain, hoarseness, and dysphagia (difficulty swallowing).
- Other common symptoms include fatigue and weight loss.
Lung Cancer Complications
- Superior vena cava syndrome occurs when a tumor or lymph nodes compress the SVC, hindering blood flow from the head, neck, and chest.
- Pleural effusion is a buildup of fluid around the lungs.
- Paraneoplastic syndromes, such as hypercalcemia and Cushing syndrome, are also possible complications.
- Metastasis spread, involving lymph and vascular systems, is observed in 50% of cases at diagnosis, growing to 90% prevalence at some point.
Diagnostics: Lung Cancer
- Diagnosis relies on history, physical examination, CXR, bronchoscopy, sputum cytology, and percutaneous lung tissue biopsy.
- Additional tests like CT, MRI, and ultrasound assist in identifying and staging tumours and metastasis.
Treatment- Lung Cancer
- Treatment depends on the specific type of cancer.
- Small cell lung cancer typically doesn't involve surgery, focusing instead on chemotherapy and radiation therapy.
- Non-small cell lung cancer may involve surgery, radiation therapy, and chemotherapy.
- Palliative care is considered in advanced stages.
- Prognosis is generally poor.
Colorectal Cancer- Adenocarcinoma
- Risk factors include age over 50, family history, GI conditions (like ulcerative colitis), polyps, and diet.
- Approximately one-third of individuals with colorectal adenocarcinoma die from the disease.
- Symptoms include abnormal bowel habits and potentially blood in the stool; these symptoms require medical attention.
Diagnostics: Colorectal Cancer
- Diagnosis involves history and physical exams (DRE - digital rectal exam).
- Tests include occult blood stool tests, sigmoidoscopy/colonoscopy, barium X-rays, tumour biopsy, blood tests for tumour markers (e.g., CEA), and other tests to assess spread (e.g., CT scans).
Colorectal Cancer Screening
- Cancer Care Ontario recommends screening starting at age 50.
- Annual occult blood stool tests and sigmoidoscopy or barium enema every five years are recommended.
- High-risk individuals may require earlier screening.
Treatment- Colon Cancer
- Treatment often involves surgical removal of the affected colon/ bowel segments; colostomies may also be employed.
- Pre-surgical radiation and post-operative chemotherapy can be used.
- Chemotherapy and/or radiation may be used as palliative treatments in advanced cases.
- Prognosis depends on the stage of the cancer, the amount of bowel involved, and the presence of metastasis at diagnosis.
Testicular Cancer
- Most frequent cancer in males aged 15-35.
- High 5-year survival rate (over 95%).
- Etiology is unknown; predisposing factors include cryptorchidism (undescended testes) and genetics.
- Disorders in testicular development increase risk, particularly among Caucasians.
Testicular Cancers
- Typically originate from germ cells.
- Germ cells have the ability to differentiate into various cell types and secrete hormones.
- Can be classified into seminomas and non-seminomas based on cell type and differentiation.
- Seminomas exhibit uniform cell types; non-seminomas display varied cell types.
Manifestations- Testicular Cancer
- Usually indicated by a noticeable enlargement of the testicle, along with potential discomfort.
- Additional symptoms may include groin or abdominal pain, scrotal heaviness, and gynecomastia (breast enlargement in males).
- Severe pain is more prevalent in late-stage cancers.
Diagnostics- Testicular Cancer
- Early detection is crucial; diagnosis involves a physical exam, history taking, ultrasound, CT/MRI scans, blood tests for tumour markers (e.g., AFP, HCG), and histology of tumour samples.
Treatment- Testicular Cancer
- Treatment typically involves orchiectomy (removal of the testicle), chemotherapy, radiation therapy, and continuous follow-up care.
- Prognosis is generally favorable if detected early.
- Metastasis is possible.
Benign Prostatic Hyperplasia
- Age-related, non-cancerous enlargement of the prostate gland.
- Characterized by large, discrete lesions in the periurethral region of the prostate.
- Prostate cancer more commonly affects the peripheral zones of the prostate gland.
Prostate Cancer
- Cause remains unknown; risk factors include age, race, heredity, hormone levels, and environmental influences.
- Most common type is prostatic adenocarcinoma.
Prostate Cancer- Manifestations
- Often asymptomatic at early stages.
- Metastatic spread is a common symptom.
- Symptoms include urinary frequency, nocturia (frequent urination at night), hesitancy (difficulty starting urination), and eventual urinary retention.
- DRE (digital rectal exam) may reveal a nodular or fixed prostate.
Prostate Cancer- Diagnostics & Treatment
- Biopsy, Gleason score, and tumor markers are used for diagnosis.
- Treatment options include watchful waiting, surgical removal (radical prostatectomy), radiation therapy, high-intensity focused ultrasound (HIFU), chemotherapy, cryosurgery, hormonal therapy, or combinations.
Prostate Cancer Staging
- Computed tomography (CT) scans of the chest, abdomen, and pelvis.
- Ultrasound imaging to detect bulky inferior nodal metastases.
- Lymphangiography
- Radiographic methods to spot metastatic spread.
Prostate Tumor Grading System
- T1: Primary-stage tumors often asymptomatic, discovered through histological examination.
- T2: Palpable during digital exam; confined within the prostate gland.
- T3: Tumors extended beyond the prostate gland.
- T4: Tumors have advanced beyond the prostate boundaries.
Treatment
- Surgery (radical prostatectomy).
- Radiation therapy.
- Hormonal manipulation (e.g., androgen deprivation therapy for metastatic disease).
Factors Protective Against Prostate Cancer
- Dietary factors like lycopene, selenium, and vitamin E.
- Chemoprevention – using drugs to prevent the disease.
- Finasteride (a 5α-reductase inhibitor) can help prevent prostate cancer (in men without BPH)
Endometrial (Uterine) Cancer- Adenocarcinomas
- Common invasive cancer affecting the female reproductive tract.
- Represents 7% of all invasive cancers in women.
- Primarily affects post-menopausal women (55-65 years old).
- 15-25% of post-menopausal women with bleeding experience endometrial cancer; Less common in women under 40 years.
Types of Endometrial Cancer- Adenocarcinoma
- Type I: accounts for 80% of cases; linked to estrogen excess and characterized by well-differentiated cells..
- Type II: arises in women with endometrial atrophy and without estrogen excess; usually associated with age-related mutations and carries a poorer prognosis.
Risk Factors for Endometrial Cancer
- Prolonged estrogen stimulation leading to endometrial hyperplasia.
- Conditions affecting estrogen levels (e.g., obesity, anovulatory cycles, estrogen-secreting neoplasms, unopposed estrogen therapy).
- Age.
Endometrial Cancer- Manifestations & Diagnostics
- Manifestations include abnormal, painless bleeding.
- Later symptoms can include cramping, pelvic pain, lower abdominal discomfort, post-coital bleeding, and enlarged lymph nodes.
- Diagnostics include transvaginal ultrasound, endometrial biopsy (D&C procedure), and other tests to detect spread.
Endometrial Cancer- Treatment & Prognosis
- Treatment often involves surgery and/or radiation therapy.
- Five-year survival rate is approximately 90% with early diagnosis and treatment.
Breast Cancer
- Leading cause of cancer in women.
- High rate due to better detection methods.
- 5-year survival rate: 87%.
Breast Cancer- Risk Factors
- Gender.
- Age.
- Family history of breast cancer (5-10%).
- Prior breast cancer.
- History of benign breast disease.
- Hormonal influences (e.g., early menarche, late menopause, pregnancies - first birth after 30, no term births).
Breast Cancer- BRCA1 & BRCA2
- Mutations in these genes (tumor suppressor genes) increase breast and ovarian cancer risks.
- 80% of cancers in women under 50 are associated with BRCA1 or BRCA2 mutations.
Breast Cancer- Hormone Receptor Role
- Estrogen plays a role.
- Estrogen and other growth factors cause breast cells to divide.
- Cells with numerous estrogen or growth factor receptors are more likely to become cancerous.
- HER1, HER2 receptors are important for treatment and improved prognosis.
Breast Cancer- Types & Diagnostics
- Different types, differentiated by locations, invasiveness, and hormone receptor presence/absence.
- Diagnostics: physical exam, mammogram, ultrasound, needle aspiration/excisional biopsy (lumpectomy), cytology/histology studies, hormone receptor status, and supplementary tests like CT and MRI if BRCA+ for spread investigation and lymph node biopsy.
Breast Cancer- Treatment & Prognosis
- Treatments include surgery, radiation, chemotherapy, and hormonal manipulation (e.g., Tamoxifen).
- Prognosis linked to lymph node involvement.
Hormonal Therapy- Tamoxifen
- Nonsteroidal anti-estrogen drug.
- Binds to estrogen receptors, blocking estrogen's effect on malignant cell growth.
- Improves survival rates, reduces recurrence, and decreases mortality.
Nevi & Skin Cancers
- Nevi are benign, congenital, or acquired skin tumors.
- Melanocytic nevi are pigmented lesions.
- Junctional nevi feature melanin-containing cells.
- Compound nevi merge epidermis and dermis layers.
- Dysplastic nevi have increased risk of melanoma transformation (larger, more irregular, less distinct than other nevi).
- Vast majority of dysplastic nevi are stable and do not transform into melanoma.
Malignant Melanoma
- Malignant tumor of melanocytes.
- Rapid increase in cases due to amplified exposure to UV radiation.
- Risk factors include family history, fair hair/skin, tendency toward freckling, history of sunburns as a child.
Malignant Melanoma- Types
- Classified based on radial and vertical growth patterns.
- 4 major types: Superficial spreading (most common), nodular, lentigo maligna, and acral lentiginous.
Malignant Melanoma- Diagnosis & Treatment
- Diagnosis through biopsy, TNM staging system (0-4).
- Treatment usually consists of surgical excision (and possible lymph node removal), though no effective chemotherapy is currently available.
Basal Cell Carcinoma
- Carcinoma of the non-keratinizing cells of the epidermis' basal layer.
- Most common invasive form of cancer in humans.
- More common among fair-skinned individuals who are prone to prolonged exposure to the sun.
- Normally slow-growing and often doesn't metastasize widely, though this can depend on tumour location and size.
Basal Cell Carcinoma- Risk Factors & Types
- Risk factors include large tumor size, central locations (e.g., ears, face), lengthy duration of exposure, and incomplete excision/perivascular or perineural involvement.
- 2 main subtypes: Nodular and superficial.
Basal Cell Carcinoma- Treatment & Prognosis
- Treatment aims for complete removal of the lesion.
- Highly curable if detected early through examination and biopsy.
Squamous Cell Carcinoma
- Second most common skin malignancy.
- More frequent in older individuals and those exposed to prolonged sun exposure.
- Occupational hazards, such as exposure to industrial tars and coal, can also increase risk among certain groups (i.e., males).
- Two primary subtypes: Intraepidermal and Invasive.
Squamous Cell Carcinoma- Manifestations
- Red scaling, keratotic, slightly raised lesion with a non-uniform border (chronic ulcer).
- Growing outward, often with large ulcerations, persistent crusts, and raised thickened edges/borders.
- Found predominantly on sun-exposed areas such as the nose, forehead, lower lip, helix of ear, and back of the hand.
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Description
Test your knowledge on various types of cancer, including lung and endometrial cancer. This quiz covers survival rates, types of cancer, risk factors, and treatment options. Challenge yourself with matching types of cancer to their characteristics and identifying common diagnostics.
