7 Diagnosis and treatment of cancer

Question 1

What proportion of new cancers are diagnosed in the over 75s?

Answer 1

1/3

Question 2

What proportion of all cancers do breast, prostate, lung, and bowel cacners accouunt for?

Answer 2

53%

Question 3

How many cacners deaths are there per year in the UK?

Answer 3

160 000

Question 4

What proportion of cancer patients survive over 10 years?

Answer 4

50%

Question 5

What are the 3 main different diagnostic pathways?

Answer 5

Symptomatic
Screening
Incidental

Question 6

What types of cancers are a change in bowel or bladder habits indicative of?

Answer 6

stomach
pancreatic
colon
ovarian

Question 7

What are some of the key common cancer symptoms?

Answer 7

change in bowel or bladder habits
a sore that does not heal
unusual bleeding
breast lump or thickening
indigestion or difficulty swallowing
extreme fever with night seats
persistent cough or hoarseness

Question 8

What are the 5 most common symptoms of lung cancer?

Answer 8

breathlessness
cough
pain
loss of appetite
coughing up blood

Question 9

What is explored in history of lung cancer patients?

Answer 9

smoking and occupational exposure

characteristics of symptoms

Question 10

What carcinogens in the workplace might pre-dispose to lung cancer?

Answer 10

chromium
arsenic
asbestos

Question 11

what do you look for on examination for lung cancer?

Answer 11

signs of metastasis
signs attributable to local spread
signs attributable to ectopic hormone production
non-specific cancer-related symptoms

Question 12

What 5 signs might you look for attributable to local spread of lung cancer?

Answer 12

superior vena cava osbtruction
horner's syndrome
pancoast syndrome
pleural effusion
lymph node swelling

Question 13

What is explored when taking a history for colorectal cancer?

Answer 13

family history
characterise presenting symptoms
ask about specific symptoms

Question 14

What major presenting symptoms are associated with colorectal cancer?

Answer 14

change in bowel habit
bright red / dark stool
discomfort in abdomen
unexplained weight loss / anorexia

Question 15

what might dark black stool suggest?

Answer 15

blood higher up in Gi tract

Question 16

What do you look for when examining for colorectal cancer?

Answer 16

palpable mass in abdomen
palpable mass / blood per-rectum
enlarged (lumpy liver)

Question 17

Name 3 types of radioisotope scans

Answer 17

Bone scans
PET scans
MIBG scans

Question 18

When are MIBG scans used?

Answer 18

neuroblastoma in paeds

Question 19

name one tissue marker for paediatric liver cancers

Answer 19

alpha-fetoprotein

Question 20

What are the 3 WHO steps to improving early diagnosis?

Answer 20

increasing awareness and accessing care
clinical evaluation, diagnosis and staging
access to treatment

Question 21

How can early diagnosis be encouraged?

Answer 21

national screening programmes
early recognition of cancer-related symptoms
rapid referral and access to diagnostics

Question 22

What challenges are faced by GPs with regards to cancer diagnosis?

Answer 22

non-specific symptoms

cancer signs not always clear and obvious

Question 23

What staging system do we use for cancer?

Answer 23

TMN
T - size of primary tumour
N - status of lymph node metastases
M - presence or absence of metastases
G - histological grade of tumour

Question 24

What proportion of Ewing’s Sarcoma are metastatic at diagnosis?

Answer 24

25%

Question 25

What proportion of Ewing’s Sarcoma cases lead to death without treatment?

Answer 25

90%