MIRA - Wk 10

What is cancer

A disease caused by an uncontrolled division (proliferation) of abnormal cells in a particular part of the body

Hundreds of different diseases in dozens of anatomical sites

Tumour Types

Benign: non-cancerous, encapsulated cluster of cells

Malignant: cells can invade surrounding tissue by breaking loose and entering blood stream or lymph nodes

Metastasis

invasion of malignant cancer cells into other cellular territories

Most common cancers

prostate, breast, melanoma, colorectal, lung

Cancer Death Stats

Leading cause of death in Australia (3 in every 10)

Who has highest incidence of cancer in WA?

85+ year olds

men

What factors may influence increased WA cancer incidence

Aging population

Population growth

Improved awareness and early detection modalities

What causes cancer

Mostly unknown

Factors may cause cancer (correlation vs causation):

•Smoking

•Alcohol

•UV radiation

•Asbestos

•Ionising radiation

•Physical inactivity

•Low fibre, high fat diet

•Faulty genes

How is cancer diagnosed?

Commonly, GP refers patient for:

Pathology test: blood, urine, biopsy

MI (must be paired with biopsy): X-ray, CT, MRI, PET/SPECT, ultrasound

Endoscopy

Colonoscopy

What are some common, credible treatment options?

Surgical oncology - tumour and surrounding tissue removal

Medical oncology (chemotherapy) - administration of drugs to depress or destroy abnormal cells

Radiation oncology - radiation used damage DNA of cancer cells, preventing them from growing or dividing

Fractionation

Total patient dose is evenly divided amongst ‘fractions’ (treatment appointments) so patient recieves small dose regularly instead of one large, dangerous dose

RT patinets can be treated for up to 6 weeks

Fractionation protects normal tissue, allows repair, and improves tumour control

What happens if patient is incorrectly positioned

Irradiation of normal tissue, causing severe sife-effects

Tumour is not destroyed, ineffective treatment

Side effects

localised response to treatment (if treatment delivered to abdomen patient likely to experience digestive symptoms)

Mostly not noticed for 2-3 weeks

Impact of many predicted side effects can be reduced by treatment

Reaction to radiation by normal tissues depends on cell type

Cancer pathway

Patient notices signs/symptoms

Patient monitoring - check if symptoms occur again, research, talk to family/friends

Visit GP - discuss full clinical history, signs/symptoms, family history, and may perform physical examination

Referral for Investigations

Biopsy used for diagnosis

MRI or CT to determine cancer stage

Treatment

Disease Free Survival (DFS)

time after treatmemt where patient has no signs/symptoms of the treated cancer

used to define outcome and treatment success

When is a patinet ‘cured’ from cancer?

Generally, after no evidence of that disease for 5 years

Palliative Treatment

Pain/symptom relief to improve quality of life

Specifically not curative

Commonly 1-15 treatment sessions

Radical Treatment

Aim is to cure disease

Commonly >15 treatment sessions