Cancer

Question 1

What is the aetiology of cancer?

Answer 1

genetic disposition
environment
cell mutation
uncontrolled cellular proliferation
cancer

Question 2

What are exogenous sources re. cancer?

Answer 2

UV and other radiation

Chemicals

Question 3

What are endogenous sources re. cancer?

Answer 3

alkylation
hydrolysis
ROS-reactive oxygen species

Question 4

what are the pathophysiological stages in metastases?

Answer 4

primary tumour
proliferation
detachment/ invasion
transport
arrest in organs
adhere to vessel wall
extravasion

Question 5

What can be systemic clinical features of cancer?

Answer 5

cachexia- weight loss, anorexia, muscle weakness
ectopic hormone production- hypercalcaemia (PTH), cushings disease (ACTH)
paraneoplastic syndromes

Question 6

When is screening offered re. cervical cancer?

Answer 6

every 5 years for women aged 20-60

Question 7

How is a diagnosis made?

Answer 7

history
examination
blood test
imaging
fibre optic technologies

Question 8

What does staging of cancers allow?

Answer 8

helps clarify prognosis

defines appropriate treatment

Question 9

What treatment options are available re. cancer?

Answer 9

surgery
chemotherapy
radiotherapy
novel therapies
palliative care

Question 10

how is surgery used in cancer treatment?

Answer 10

removal of solid organ
Can be curative if complete exision
can be combined with other treatments
can be used re. symptom control in palliative care.

Question 11

How does chemotherapy work?

Answer 11

interferes with cellular replication- DNA and cell division

Question 12

What side effects are inevitable re. chemotherapy?

Answer 12

affects rapidly dividing cells:
oral and GI mucosa
reproductive cells
bone marrow
hair

Question 13

For what cancers can chemotherapy be used as a cure?

Answer 13

hodgkins lymphoma
testicular teratoma
acute childhood leukemia

Question 14

What can be short term side effects re. chemotherapy?

Answer 14

nausea and vomiting
mucosal - oral and gut
alopecia
bone marrow supression

Question 15

what can be long term side effects?

Answer 15

impaired fertility
teratogenic
cancer- leukemia
organ damage

Question 16

How does radiotherapy differ to chemo?

Answer 16

targets specific areas of the body

Question 17

what are modes of delivery re. radiation therapy?

Answer 17

external- electrons or xrays

internal- implants or systemic

Question 18

what are systemic options of radiation therapy?

Answer 18

strontium re. bone

iodine 131 re. thyroid

Question 19

What can be short term side effects re. radiotherapy?

Answer 19

oral mucositis
diarrhoea
nausea
tiredness
hair loss
bone marrow suppression
sunburn

Question 20

What can be long term effects of radiotherapy?

Answer 20

osteoradionecrosis
xerostomia- due to irradiation of salivary glands
skin ulcers
fibrosis
secondary malignancy

Question 21

What are novel therapies re. cancer treatment?

Answer 21

immunotherapy- vaccines, cytokines
angiogenesis inhibators
signal inhibators
phototherapy

Question 22

what is the biggest cancer killer?

Answer 22

lung cancer

Question 23

how can lung cancer present?

Answer 23

cough, chest pain, breathlessness,

Question 24

where are likely metastases re. lung cancer?

Answer 24

bones, brain, liver

Question 25

how is lung cancer diagnosed?

Answer 25

CXR CT scan bronchoscopy sputum cytology

Question 26

What is colorectal cancer associated with?

Answer 26

high fat, low fibre diets familial element - gene identified inflammatory bowel disease

Question 27

how does colorectal cancer present?

Answer 27

anaemia altered bowel habits acute abdominal pain

Question 28

where are likely metastisis re. colorectal cancer?

Answer 28

liver, lungs, ascites

Question 29

how is colorectal cancer diagnosed?

Answer 29

sigmoidoscopy colonoscopy barium enema

Question 30

how is colorectal cancer screened for?

Answer 30

faecal occult bloodss

Question 31

what are associations with breast cancer?

Answer 31

familial | hormonal- no children, early menopause, HRT

Question 32

how is breast cancer diagnosed?

Answer 32

mammogram fine needle aspiration biopsy

Question 33

how is breast cancer screened for?

Answer 33

mammography offered to all women aged 50-64 evry 3 years

Question 34

how does prostate cancer present?

Answer 34

urinary | detected on prostate examination

Question 35

where are likely metastases re. prostate cancer?

Answer 35

bone and lung

Question 36

what are associations with oesophageal cancer?

Answer 36

smoking, alcohol, reflux

Question 37

how does oesophageal cancer present?

Answer 37

dysphagia, pain, anaemia

Question 38

where are likely metastases re. oesophageal cancer?

Answer 38

lymphadenopathy- cervical, supraclavicular | liver

Question 39

how is oesophageal cancer diagnosed?

Answer 39

barium swallow | endoscopy