August 12, 2015 - Introduction to Oncology

Question 1

Hallmarks of Cancer

Answer 1

1. Evading apoptosis
2. Self-sufficiency in growth signals
3. Insensitivity to anti-growth signals
4. Tissue invasion and metastasis
5. Limitless reproductive capability
6. Sustained angiogenesis

Question 2

Principles for an Effective Screening Program

Answer 2

1. Disease has serious consequences
2. Disease is relatively common
3. Test detects disease before a critical point
4. Test is accurate
5. Test causes little morbidity/mortality
6. Test is affordable and available
7. A treatment exists that is more effective when applied before symptoms appear and is relatively safe

Question 3

Cancer Screening in Canada

Answer 3

1. Cervical cancer (PAP smear)
2. Breast cancer (mammograms)
3. Colorectal cancer (colonoscopy)
4. Lung cancer (low-dose CT)
5. Prostate cancer (DRE and PSA)

Question 4

Non-Specific Symptoms of Cancer

Answer 4

1. Weight loss
2. Fever
3. Night sweats

Question 5

TNM Staging System

Answer 5

T - Size of the tumour and degree of spread

N - spread of cancer to nearby lymph nodes

M - presence or absene of metastasis

Question 6

T Staging System

Answer 6

T0 - No evidence of primary tumour

T1 - Tumour invades submucosa

T2 - Tumour invades muscularis propria

T3 - Tumour invades through the muscularis propria into the subserosa, or into non-peritonealized pericolic or perirectal tissues

T4 - Tumour directly invades other organs or structures, and/or performates visceral peritoneum.

Question 7

N Staging System

Answer 7

N0 - no regional lymph node metastasis

N1 - Metastasis in 1 to 3 regional lymph nodes

N2 - Metastasis to 4 or more regional lymph nodes

Question 8

M Staging System

Answer 8

M0 - no distant metastasis

M1 - distant metastasis

Question 9

Colorectal Cancer: Stage 1

Answer 9

T1N0M0 or T1N0M0

Question 10

Colorectal Cancer: Stage 2

Answer 10

T3N0M0 or T4N0M0

Has not spread to regional lymph nodes yet.

Question 11

Colorectal Cancer: Stage 3

Answer 11

Cancer has spread to regional lymph nodes.

T3N1M0 or T4N1M0

Question 12

Colorectal Cancer: Stage 4

Answer 12

Cancer has spread to other areas of the body.

T3N2M1 or T4N2M1

Question 13

Age as a Prognostic Factor

Answer 13

Younger people typically have a worse prognosis. For a cancer to develop in young people, typically bad things need to happen.

Question 14

ECOG Performance Status

Answer 14

Grade 0 - able to carry on with all pre-disease performance without restriction

Grade 1 - Restricted in physically strenuous activity, but ambulatory and able to carry out work of a light or sedentary nature

Grade 2 - Ambulatory and capable of all self-care, but confined to bed or chair for more than 50% of waking hours

Grade 3 - Capable of only limited self-care, and confined to a bed or a chair for more than 50% of waking hours

Grade 4 - Completely disabled. Cannot carry out self-care. Totally confined to a bed or chair