11 good questions and answers: "General Medicine - Gluconeogenesis, PPP"

Risk factors for cancer are...
  • Tabacco use
  • alcohol consumption
  • unhealthy diet
  • physical inactivity
  • air pollution
  • chronic infections
    • heliobacter pylori
    • HPV
    • hepB
    • hepC
    • Epstein-Barr virus
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Cancer risk can be reduced by..
  • Not using tabacco
  • maintaining a healthy weight
  • eat healthy, including fruits and veggies
  • be physically acitve
  • avoid/reduce alcohol consumption
  • get vaccinated against HPV and hepB
  • avoid UV radiation and/or use sun protection
  • ensure safe and appropriate use of radiation in health care
  • minimize ionizing radiation
  • reduce exposure to outdoor and indoor air pollution
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How do you diagnose cancer early?
When identified early, cancer is more likely to respond to treatment and can result in better survival. It can consist out of three components;
  1. being aware of symptoms of different forms of cancer and importance of seeking medical help when abnormalities are present
  2. access to clinical evaluation and diagnostic services
  3. timely referral to treatment services
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Explain what happens in cancer screening:
Screening aims to identify individuals with findings suggestive of a specific cancer or pre-cancer before developing symptoms. Screening programs are effective for some but not all cancer types. Early diagnosis programmes are still necessary to identify cancer.

Patient selection for screening programs is based on age and risk factors to avoid excessive false positive studies.

Examples of screening methods are...
  • HPV test
  • mammography screening for breast cancer for women 50-59 yrs    
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How to treat cancer?
A correct cancer diagnosis is essential for appropriate treatment.
  • surgery
  • radiotherapy
  • systemic therapy (chemo, hormona, targeted biological therapies)

Goals of treatment are...
- cure the cancer
- prolong life
- improve quality of life
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What is palliative care?
Treatment to relieve, rather than cure, symptoms and suffering caused by cancer and to improve he quality of life of patients.
Needed in places with a high proportion of patients in advanced stages of cancer, where there is little chance of cure.
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Anatomy of breast? 2 types of breast cancer:
Breast consists of secretory lobules (produce milk) and ducts (collect milk).

  1. non-invasive breast cancer
    1. carcinoma in situ
    2. earliest and most treatable
    3. doesn't spread beyond basement membrane wall
  2. invasive breast cancer
    1. spread beyond basement membrane wall
    2. can spread to nearby lymph nodes
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Ductal vs lobular carcinoma
Both non-invasive and invasive breast cancer can affect both the lobules and the ducts. Ductal
carcinoma in situ is the most common type of non-invasive breast cancer, while invasive (a.k.a.
infiltrating) ductal carcinoma is the most common cause of breast cancer. Lobular carcinoma in situ and invasive (a.k.a. infiltrating) lobular carcinoma are also possible, but both are less common than
their respective counterparts.
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Symptoms of breast cancer are...
  • Hard as opposed to firm or rubbery masses
  • Painless lumps. Benign lumps are often painful instead
  • fixed and immobile lumps. Benign tumors are usually easily moved about
  • Bloody discharge from the nipple from one side. Benign masses have no bloody discharge and if they do, it is more green/yellow
  • margins of the mass are irregular. Non-cancerous lumps have smooth borders
  • dimpling of skin, changes in skin color, inverted nipple
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Risk factors for colon cancer:
Adenomas/polyps can develop in cancer. So this is a warning sign, but can be removed.
90% of cases occur after age 50, which number 1 risk factor. Also family history plays a huge part. And: inflammatory bowel disease, smoking, man, diets high is red meat and low in fiber, drinking alcohol.
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How to diagnose and treat colon cancer?
Diagnosis:
  • colonoscopy with biopsy
  • blood tests
  • CT scan, PET scan, MRI
  • Faecal Occult Blood (FOB) tests are ussed for mass screening
  • tumours are stages using TNM-staging (T=size, N=involvement lymph nodes, M=metastasis)
Treatment:
  • surgical excision
  • chemo
  • radiation therapy
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