Cancer

• What is the definition of cancer?

  Cancer is a collection of related diseases that involve the uncontrolled division of the body's cells.
• How does a cell become cancerous?

  A cell becomes cancerous when it is not subject to normal restraints on cell division and begins to proliferate abnormally.
• What is a tumour?

  A tumour is an abnormal mass of tissue whose rate of growth exceeds and is uncoordinated with that of normal tissue.
• What is 'in situ' cancer?

  'In situ' cancer refers to a tumour that remains within the tissue in which it originated.
• What is malignant cancer?

  Malignant cancer is when a tumour invades nearby tissues.
• Why do tumours threaten an individual's life?

  Tumours threaten an individual's life when their growth disrupts tissues and organs needed for survival.
• What is metastasis in cancer?

  Metastasis is when cells shed into the blood or lymph from a malignant tumour and establish new tumours throughout the body.
• How do malignant tumours differ from benign tumours?

  Malignant tumours are more likely to metastasise, grow faster, and invade and destroy native organs.
• What are benign tumours?

  Benign tumours do not generally invade other tissues and push normal tissue to the side.
• What are the characteristics of cancer cells according to Hanahan and Weinberg?

  • Uncontrolled cell proliferation
  • Resistance to cell death
  • Induction of angiogenesis
  • Activation of invasion and metastasis
  • Deregulation of cellular energetics
  • Avoidance of immune destruction
• What are the references cited in the study material regarding cancer?

  • Cancer Treatment Centers of America (2017)
  • Hanahan, D. and Weinberg, R. A. (2000)
  • National Institutes of Health (US) (2007)
  • Neal, A. J. and Hoskin, P. J. (2009)
• What is the maximum wait time to see a specialist for patients referred for investigation of breast symptoms?

  A maximum two-week wait
• What is the maximum wait time for patients referred with suspected cancer symptoms to see a specialist?

  A maximum two-week wait
• What is the maximum wait time from the date a decision to treat is made to the first definitive treatment for all cancers?

  A maximum one month (31-day) wait
• What is the maximum wait time for subsequent treatment where the treatment is surgery?

  A maximum 31-day wait
• What is the maximum wait time for subsequent treatment where the treatment is a course of radiotherapy?

  A maximum 31-day wait
• What is the maximum wait time for subsequent treatment where the treatment is an anti-cancer drug regimen?

  A maximum 31-day wait
• What is the maximum wait time from urgent referral for suspected cancer to the first definitive treatment for all cancers?

  A maximum two month (62-day) wait
• What is the maximum wait time from referral from an NHS cancer screening service to the first definitive treatment for cancer?

  A maximum 62-day wait
• What is the maximum wait time for the first definitive treatment following a consultant’s decision to upgrade the priority of the patient?

  A maximum 62-day wait
• What is a common sign of cancer that involves a physical change in the body?

  A lump that is rapidly increasing in size anywhere on the body
• What symptom may indicate lung cancer if it lasts more than three weeks?

  Coughing
• What are some changes in bowel habits that may indicate cancer?

  Bloating; feeling that bowels aren’t empty after passing faeces; pain in the abdomen/anus
• What are some types of bleeding that may indicate cancer?

  Blood in urine, between periods, from the anus, blood in sputum, haematemesis (vomiting blood)
• What changes in moles may indicate skin cancer?

  Change in shape/size, crusting/flaking/itching/bleeding, becomes more raised from the skin
• What is a common symptom of cancer related to body weight?

  Unexplained weight loss
• How does the diagnosis of cancer vary?

  It varies dependent on the suspected disease
• How many new cancer cases are diagnosed per year in the U.K.?

  367,000 new cases per year
• What are some methods used for diagnosing cancer?

  Clinical history, physical exam, tests, breast screening, bowel screening, blood tests, lumbar puncture, X-ray, CT scans, MRI, PET scan, tumour markers, cytology/histology of sputum/urine/faeces, biopsy
• How many new instances of cancer are diagnosed each day in the U.K.?

  1,000 new instances per day
• How often is someone diagnosed with cancer in the U.K.?

  Every two minutes
• What is a biopsy?

  A small amount of tissue is harvested during a medical procedure
• What does cytology examine in a biopsy?

  Examination of the cells
• What percentage of cancer cases are diagnosed in people aged 75 and older?

  36% of cases
• What does histology examine in a biopsy?

  Examination of cells and tissues
• In which age group is the incidence of all cancers combined highest?

  People aged 85-89
• What does a biopsy determine regarding the primary lesion?

  It determines the nature of the primary lesion
• What percentage of cancer cases occur in children?

  Less than 1%
• How does a biopsy shape the approach to treatment?

  It shapes the approach to treatment based on the nature of the lesion
• What fraction of all deaths in the U.K. are due to cancer?

  1 in 4 deaths