Cancer - the big 4

Question 1

Define Cancer

Answer 1

An uncontrolled growth of tissue that is non-physiological, has the capacity to invade and spread from point of origin, and that has a detrimental affect on the patient

Question 2

What are the big 4 most common cancers? (In order)

Answer 2

• Breast
• Prostrate
• Lung
• Bowel (colorectal)

Question 3

What is the Kaplan-Meier estimate?

Answer 3

A method is estimate survival rates
Graph of proportion of a study still alive over time
allows comparisons of prognosis and treatment options

Question 4

How does the 2-week wait work?

Answer 4

Starting from the time of seeing (for example the GP), a patient will have been seen with a specialist inside of 2 weeks

Question 5

What are the general red flag warning signs for cancer?

Answer 5

• unexplained, unintentional weight loss
• anaemia
• lymphadenopathy
• loss of appetite

Question 6

What are the specific signs and symptoms for lung cancer?

Answer 6

• coughing up blood, persistent cough
• fatigue
• shortness of breath
• finger clubbing
• supraclavicular lymph node

Question 7

What are the specific signs and symptoms for breast cancer?

Answer 7

• lump in the breast
• lump in the armpit
• bleeding/discharge from the nipple

Question 8

What are the signs and symptoms for prostrate cancer?

Answer 8

• higher urinary frequency
• urine hesitancy
• not being able to urine, have urine urgency (includes having to get up in the night)
  can test with PSA (prostrate specific antigen)

Question 9

What are the signs and symptoms for colorectal cancer?

Answer 9

• changes in bowel habit
• rectal bleeding
• abdominal pain
• positive FIT test (RBCs in feces)

Question 10

What are the conditions for screening?

Answer 10

• disease is important
• natural condition history is understood
• there’s a recognisable latent/early stage
• the test is acceptable for the population
• case finding is continuous

Question 11

What is the reason for a PSA test and what are some problems with it?

Answer 11

[Prostrate antigen test]
other conditions make the levels increase, common in older men to have some level of prostrate hypertrophy

Question 12

What is the follow-up from a 2WW referral?

Answer 12

2-week wait, 31 days for Tx plan, start treatment within 62 days
14:31:62

Question 13

_ _ _ is a way of screening cancer

Answer 13

TNM (Tumour, Nodes, Metastases)

Question 14

How are tumours stages in TNM staging?

Answer 14

1-4
T1 = up to 2cm
T2 = 2-5cm
T3 = >5cm
T4 = broken through skin, attached to other structures

Question 15

How are Nodes staged in TNM cancer staging?

Answer 15

N0-N3, presence and number of associated lymph nodes

Question 16

How are metastases staged in TNM cancer staging?

Answer 16

if the cancer has spread, tested for with a PET scan

Question 17

What is brachytherapy?

Answer 17

Type of radiotherapy with a radioactive implant is placed into the tumour to provide localised radiation