Neoplasms 2 (new)

Question 1

what is the difference between cancer grade and cancer stage

Answer 1

Grade = level of differentiation

Stage = malignant neoplasm’s overall burden - size and level of invasion

Question 2

which 4 features does cancer grade assess

Answer 2

1. nuclear:cytoplasm ratio
2. hyperchromasia (nuclear staining)
3. pleiomorphism (variation in size and shape of cells/nuclei)
4. presence of mitotic figures

G1 = well differentiated, G4 = undifferentiated/anaplastic

Question 3

describe the system used to grade breast cancer

Answer 3

Modified Bloom-Richardson grading:

• tubule formation
• nuclear features
• mitotic activity

Determines G1-G3.

Question 4

which staging system is used to describe most cancers

Answer 4

TNM Staging:

• T = size of primary tumour (T1-4)
• N = extent of regional node metastasis (N0-N3)
• M = extent of distant metastatic spread (M0-M1)

Question 5

describe the 4 possible cancer stages according to TNM system

Answer 5

Stage I

• T1/2, N0, M0
• small and remains at primary site

Stage 2

• T3/4, N0, M0
• more locally advanced, no spread

Stage 3

• any T, N>1, M0
• regional metastasis

Stage 4

• any T, any N, M1
• advanced disease with distant metastasis

Question 6

what are paraneoplastic syndromes

Answer 6

Systemic effects of a neoplasm due to increasing tumour burden, secreted cytokines, hormones, etc.

E.g. reduced appetite, cachexia, immunosuppression…

Question 7

what is Trousseau’s syndrome

Answer 7

thrombosis due to hypercoagulability (e.g. mucin production)

Question 8

name the 4 most common cancers in UK

Answer 8

1. breast
2. prostate
3. lung
4. bowel

Question 9

which cancers are most common in children

Answer 9

leukaemias, CNS tumours, lymphomas

Question 10

name the 4 most deadly cancers

Answer 10

1. lung
2. bowel
3. breast
4. prostate