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4th Year > Cancer and Oncology > Flashcards

Cancer and Oncology Flashcards

1
Q

Systemic Side Effects of Chemotherapy

A 
Lung Fibrosis
Nephrotoxicity
Hypomagnesaemia
Coronary Artery Spasm
Cardiomyopathy
Haemorrhagic cystitis
Ototoxicity
Peripheral Neuropathy
Reduced fertility
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2
Q

What is the single most common, but treatable, side effect of chemotherapy?

A

Nausea and vomiting

Use Ondansetron/ Haloperidol palliatively

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3
Q

Other important patient-reported side effects of chemotherapy to discuss

A 
Alopecia
Mucositis
Candida infection
Photosensitivity
Extravasation
Palmar- Plantar Erythema
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4
Q

Fractions vs Grays in radiotherapy

A

Fractions: number of times radiotherapy is delivered

Grays: total dose of radiation

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5
Q

Important side effects of Radiotherapy to tell patients about

A 
Fatigue/ somnolence
Mucositis (plus thrush, dysphagia, xerostomia)
Nausea and vomiting
Diarrhoea
Cystitis (± urinary frequency)
Brachial Plexopathy
Spinal Cord Myelopathy
Lung Fibrosis
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6
Q

Breast cancer: most common type

A

Invasive Ductal Carcinoma

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7
Q

Stage 1 Breast Cancer

A

Mobile lump confined to breast

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8
Q

Stage 2 Breast Cancer

A

Mobile lump confined to breast

Axillary node involvement

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9
Q

Stage 3 Breast Cancer

A

Fixed to muscle
Axillary nodes matted and fixed
Skin involvement (larger than the tumour)

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10
Q

Stage 4 Breast Cancer

A

Completely fixed to chest wall

Distant metastases

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11
Q

Indications for 2 week urgent referral for breast cancer

A

30+ with unexplained breast/ axillary lump
50+ with unilateral nipple changes of concern
Skin changes

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12
Q

Cancers most commonly associated with bone metastases

A

1: Prostate
2: Breast
3: Lung

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13
Q

Most common sites of bone metastases

A
  1. Spine
  2. Pelvis
  3. Ribs
  4. Skull
  5. Long bones
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14
Q

Indications for neoadjuvant chemotherapy in breast cancer

A

Post-menopausal ER+ women
HER2+ / ER- women
Triple negative women

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15
Q

Who receives biological therapy for breast cancer

A

Women who are HER2+

Trastuzumab (Herceptin)

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16
Q

Who receives Tamoxifen as an endocrine treatment for breast cancer?

A

Pre-Menopausal women who are ER/PR +

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17
Q

Who receives Aromatase Inhibitors as a treatment for breast cancer?

A

Post-menopausal women who are ER/PR+

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18
Q

Tamoxifen side effects

A

Blocks oestrogen receptors, so SEs similar to menopause:

  • Hot flushes/ sweating
  • Vaginal atrophy
  • Tiredness
  • Period changes
  • Nausea
  • Oedema
  • Increased Endometrial cancer risk
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19
Q

Trastuzumab side effects

A 
Effects cardiac function (chest pain, SOB, syncope, palpitations)
Neutropenia- infection risk
Feeling sick
Loss of appetite
Bitter taste
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20
Q

Aromatase inhibitors sside effects

A

Menopausal symptoms
Myalgia/ joint pains
Hair and skin changes
Carpal tunnel syndrome

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21
Q

Genetic mutations associated with prostate cancer

A

BRCA2

pTEN

22
Q

Ethnicity most at risk of prostate cancer

A

Afro-Caribbean

23
Q

T1 staging of prostate cancer

A

Clinically inapparent tumour

- Not palpable/ visible

24
Q

T2 Staging of prostate cancer

A

Confined within the prostate

25
Q

T3 staging of prostate cancer

A

Extends through capsule ± into bladder

26
Q

T4 staging of prostate cancer

A

Fixed tumour OR

invades rectum/ levator muscles/ pelvic wall

27
Q

Most common type of prostate cancer

A

Adenocarcinoma

28
Q

Criteria for 2 week referral for prostate cancer

A

Malignant feeling prostate on examination

PSA levels above age-specific reference range

29
Q

Indications for radiotherapy in prostate cancer

A

T1/T2 cancers with a low PSA (low risk)

Use Volumetric Modulated Arc Therapy

30
Q

Hormonal therapies for prostate cancer

A

Used as an adjunct for RT or in advanced disease

  • LHRH agonists e.g. Leuprorelin, Goserelin
  • GRH agonists e.g. Degarelix
  • Anti-androgens
  • Bilateral orchidectomy
31
Q

Which IBD is more strongly associated with colorectal cancer development

A

Ulcerative colitis

32
Q

Distribution of CRC in the colon

A

1/3 rectal
1/3 left side
1/3 rest of colon

33
Q

Who is elligble for the NHS bowel screening programme

A

Men and women 60-75

34
Q

2 Week referral criteria for colorectal cancer

A

40+ with unexplained weight loss and abdo pain
50+ with unexplained rectal bleeding
60+ with anaemia or change in bowel habit
Unexplained FOBT result
Unexplained anal mass/ ulceration

35
Q

Which NSCLC type is associated with Parathyroid Hormone related peptide secretion and subsequent hypercalcaemia?

A

Squamous cell carcinoma

36
Q

Cell origin of SCLC

A

Kulchitsky cells

37
Q

Pulmonary Hypertrophic Osteoarthropathy

A

Squamous cell lung cancers

Clubbing, periostitis of small joints, bone deposition of long bones

38
Q

Syndrome of Inappropriate ADH

A

Small cell lung cancers

Hypo-osmolar, hyponatraemic state
Nausea and vomiting, reduced oral intake, fatigue

39
Q

Lambert-eaton syndrome

A

Small cell lung cancers

Antibodies against calcium channels
Muscle weakness

40
Q

Troussea’s Syndrome

A

VTE- clots/ thrombophlebitis palpable under the skin in lung cancer

41
Q

Ectopic ACTH syndrome

A

Small cell lung cancers

Get Cushing’s Syndrome

42
Q

NICE red flags for lung cancer

A 
Unexplained Cough ± haemoptysis
SOB
Weight loss
Fatigue
Reduced appetite
43
Q

NICE CXR indications in lung cancer

A

2 unexplained red flags

1 red flag + patient is a smoker

44
Q

Key indications for surgery in lung cancer

A

T1-2 NSCLC

No mediastinal involvement

45
Q

Indications for G-CSF in neutropenic sepsis

A

Neutrophils <0.1 x 10 ^9
Lasts longer than 10 days
Severe sepsis or multi-organ failure
Co-morbidities

46
Q

WHO Performance Status 0

A

Fully active, able to carry on all pre-disease performance without restriction

47
Q

WHO Performance Status 1

A

Restricted in physically strenuous activity but ambulatory and able to carry out work of a light/ sedentary nature e.g. light house work, office work

48
Q

WHO Performance Status 2

A

Ambulatory and able of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours

49
Q

WHO Performance Status 3

A

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

50
Q

WHO Performance Status 4

A

Completely disabled and unable to carry out any self care. Totally confined to bed or chair.

51
Q

WHO Performance Status 5

A

Dead

4th Year (7 decks)

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