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30 Pathophysiology of Oncology Cheat Sheet by

Lung, breast, colon & prostate cancer

Lung cancer

Risk factors & causes:
- Smoking & 2nd hand smoking
- Exposure to industrial carcin­ogens & air pollution, scarring from previous lung disease, FHx & past cancer treatment
- Age
- UK: 8/10 cases occurring people aged 60+
Signs & symptoms:
- Difficulty breathing
- Coughing up blood
- Chest pain
- Loss of appetite
- Weight loss
- Fatigue
- Having a cough most of the time
- Change in a cough you have had for a long time
- Ache or pain when breathing or coughing
- Hoarseness
- Small cell lung cancers
- Non-small cell lung cancer: squamous cell carcinoma, adenoc­arc­inoma, large cell carcinoma
Stages of non-small cell lung cancer:
- Occult (hidden)
- Stage 0
- Stage I
- Stage II
- Stage III
- Stage IV
- Standard treatm­ents: surgery, radiation therapy, chemot­herapy, targeted therapy, immuno­the­rapy, laser therapy, photod­ynamic therapy (PDT), cryosu­rgery, electr­oca­utery, watchful waiting
- New treatm­ents: chemop­rev­ention, radios­ens­iti­zers, new combinations
- Treatment for non-small cell lung cancer may cause side effects
- Pts may want to think about taking part in a clinical trial
- Pts can enter clinics trials before, during, or after starting their cancer treatment
- Follow-up tests may be needed
Small cell lung cancer:
- Grows faster
- Spreads faster
- 70 of people with SCLS will have cancer that has already spread at the time they're diagnosed
- Tends respond well to chemot­herapy & radiot­herapy
- Recurrence
Other types:
- Metastatic cancer
- Pleural mesoth­elioma

Colon cancer

Develop frommucosa &may end upon invasive lesion
Colono­scopy to find polyps (different types), occur in families, 5 stages
Stage I localised, grow into colon & through the wall of colon leading reach lymphatics & blood vessels, may be distri­buted into other organs through lympha­tics, the more distal the higher chance of cancer (also easier to reach and diagnose)
Change of lifestyle, avoiding types of food

Breast cancer

- Inflam­matory disorders
- Benign tumours of the breast
- Malignant tumours of the breast
Acute mastitis (not cancer):
- Compli­cation of lactation, local pain, swelling, hardening, tender­ness, redness
- Fissures or abrasions of the nipple enable entry of staphylococci
- Abscesses
Fibroc­ycstic change:
- Pre-me­nop­ausal women, lumps
- Fibrosis
- Cyst formation
- Adenosis
- Sclerosing adenosis
- Epithelial hyperp­lasia, increased riskier cancer
Benign breast tumours:
- Fibroa­denoma: commonest, single tumour, young women, firm mobile lump
- 25 of normal breasts at autopsy
- Package 20-30
- More common in African American women
- Multiple in -15-20
- Most growth arrested by 2-3cm; may reach >10cm
- Sponta­neous infarction - pregnancy/lactation
- Reports of regression 20-25
Carcinoma of the breast:
- Commonest malignancy in women
- Rarely occurs in men
- Upper outer quadrant
- Uncommon before 30s
- Risk increases with age & after menopause
- Genetics
- Commoner in nullip­arous women
- Early menarche & late menopause
- Breast feeding reduces risk
Carcinoma of the breast: [cntd]
- Infilt­rating ductal carcinoma
- commonest form
- firm to hard lump
- peau d'orange
- nipple retraction
- tumour fixed to underlying muscle

Prostate cancer

Risk factors:
- Race (African American), FHx, High testosterone
- Age
- Saturated fat diet
- Prostatic intrae­pit­helial neoplasia (PIN)
- Genome changes
Signs & symptoms:
- More frequent ruination (during night)
- Difficulty starting to urinate
- Taking a long time to urinate or a weak flow urine
- Blood in your ruiner semen
- Back pain, hip pain or pelvis pain
- Unexpl­ained weight loss
Can be diagnosed early


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