Cancer

Question 1

Give the intrinsic risk factors for cancer

Answer 1

Genetic makeup
Increased age
Immune system
Chronic irritation 
Endogenous exposure to hormones

Question 2

Give the extrinsic risk factors for cancer

Answer 2

Environment
Infectious agents
Diet

Question 3

What ratio of people does cancer affect

Answer 3

1 in 2 in a lifetime

Question 4

How many cancer cases can be prevented?

Answer 4

4 in 10

Question 5

What is the main risk factor for cancer?

Answer 5

Increasing age

Question 6

What are the 4 most common cancers?

Answer 6

Breast
Prostate
Lung
Bowel

Question 7

Which scan exposes the patient to the worst dose of radiation?

Answer 7

CTPA

Question 8

What is the radiation dose of CTPA equivalent to?

Answer 8

750 Xrays

Question 9

Name some common metastatic sites

Answer 9

Lymph nodes
Bone
Liver
Lungs
Brain

Question 10

How do cancers metastasise?

Answer 10

Lymphatic system

Blood system

Question 11

Which cancers commonly spread to the brain?

Answer 11

Lung
Brain
Melanoma

Question 12

Which cancers commonly spread to the liver?

Answer 12

Bowel
Breast
Lung

Question 13

Which cancers commonly spread to the bone?

Answer 13

Lung
Breast
Prostate

Question 14

In what different ways do cancers present?

Answer 14

Primary - lump, pain, bleeding. Direct local spread causing compression/invasion of adjacent structures
Spread to draining lymph nodes - lump, pain, lymphoedema - compression/invasion of adjacent structures

Question 15

What are some symptoms due to metastatic disease

Answer 15

General non specific symptoms - cachexia, fatigue, malaise, fever, itch
or specific to location

Question 16

What symptoms indicate bony mets

Answer 16

Pain, pathological fractures, spinal cord compression, hypercalcaemia

Question 17

What symptoms indicate liver mets

Answer 17

Pain, early satiety, easy bruising, jaundice

Question 18

What symptoms indicate lung mets

Answer 18

SoB, cough, haemoptysis

Question 19

What symptoms indicate brain mets?

Answer 19

Confusion, nausea, headache, motor/sensory symptoms, fits

Question 20

What is cancer staging?

Answer 20

Investigations to determine the extent of local spread of primary tumour and presence of distant metastasis

Question 21

What does the cancer staging imaging depend on?

Answer 21

The specific cancer

Question 22

What is required for a lymphoma cancer staging?

Answer 22

USS, CT, MRI, PET-CT, bone marrow biopsy +/- lumbar puncture for CSF

Question 23

Why is cancer staging done?

Answer 23

To estimate prognosis and help plan treatment

Question 24

Describe the TNM staging

Answer 24

Tumour/node/metastases
Tumour size
Involvement of regional lymph nodes
Presence of metastases

Question 25

Describe the FIGO staging

Answer 25

International federation of gynaecology and obstetrics

All gynae tumours

Question 26

Describe Dukes staging for colorectal cancer

Answer 26

A,B,C - unfortunately too simple, use TNM instead

Question 27

What influences cancer treatment decisions?

Answer 27

Cancer factors - Histology, stage, grade, ER status, HER2 status for breast cancer, is it curable?
Patient factors - frailty, location, patient wishes

Question 28

Which cancer is alpha FP and hCG raised in?

Answer 28

Testicular/germ cell

Question 29

Which cancer is CEA raised in?

Answer 29

Colorectal cancer

Question 30

Which cancer is CA125 raised in?

Answer 30

Ovarian cancer

Question 31

Which cancer is CA19-9 raised in?

Answer 31

Pancreatic

Question 32

Which cancer is CA15-3 raised in?

Answer 32

Breast

Question 33

Which cancer are paraproteins raised in?

Answer 33

Myeloma

Question 34

Which cancer is calcitonin raised in?

Answer 34

Medullary thyroid

Question 35

Which cancer is alpha fetoprotein raised in

Answer 35

Hepatocellular