Common Cancer and staging

Question 1

Most common cancers?

Answer 1

Non melanoma skin cancer
Leukaemia
Breast
Colon and rectal
Melanoma

Question 2

How many new cancers were diagnosed in 2016?

Answer 2

130 000
67 % surviving after at least 5 years
46000 deaths

Question 3

The top 3 cancers?

Answer 3

Breast
Lung
Prostate

Question 4

Most common sites that cause spinal cord compression?

Answer 4

Breast
Lung
Prostate

Question 5

Treatment for breast cancer?

Answer 5

Surgery is primary intervention for cancer

Chemotherapy can be used as an adjuvant treatment with or without RT

Question 6

What type of RT is used for breast cancer?

Answer 6

EBRT with tangential fields

Brachytherapy IMRT or VMAT

Question 7

What equipment is used for immobilisation of a breast patient?

Answer 7

Prone breast board- allows for treatment of larger breasts

Knee bolster
Butt stop

Question 8

Does carbon fibre heat up in MRI

Answer 8

Yes

Question 9

Goal of immobilisation?

Answer 9

Maximum comfort

Reproducibility

Question 10

Make to female ratio of breast cancer?

Answer 10

106 to 1

Question 11

Does the size of tissue affect the risk of cancer?

Answer 11

The number of cells in breast tissue does affect the risk of breast cancer

Question 12

Degrees of risk of breast cancer?

Answer 12

First degree- immediate
Second degree- aunt

Increase of 25-40 % of risk

Question 13

What is P53?

Answer 13

Leads to apoptosis, natural killing

Question 14

Cancer cells inactivate or do not have what gene ?

Answer 14

P53 grow how ever they want

Question 15

What is the air gap between breast and jaws?

Answer 15

2.5cm due to breathing

Swelling

Question 16

Do breast patients treat some of lung?

Answer 16

Yes try to limit to 1-1.5cm of lung

Question 17

Stages of breast cancer?

Answer 17

Stage 1-tumour confined to breast
Stage 2- spread to axillary lymph nodes
Stage 3-spread to superficial structures of chest wall and mammary lns
Stage 4- advanced metastatic disease

Question 18

Cancer stages are based on 4 characteristics?

Answer 18

Size of cancer
Invasive or non invasive
Lymph nodes
Spread to other body parts

Question 19

What is the TNM staging system?

Answer 19

T-describes primary tumour
N-number of lymph nodes
M-metastises

Question 20

T staging?

Answer 20

TX-can’t be evaluated
T0-no evidence of primary tumour
‘Tis-carcinoma in situ
T1-T4- size and/or extent of the primary tumour

Question 21

N staging?

Answer 21

NX-regional nodes cannot be evaluated
N0-no regional lymph node involvement
N1-N3-involvement of regional lymph nodes

Question 22

M staging?

Answer 22

M0- no distant metastasis

M1-Distant metastasis

Question 23

Sizes of breast cancer tumours?

Answer 23

T1a-1-5mm
T1b-5-10mm
T1c-10-20mm
T2-20-50mm
T3-greater than 50mm
T4a-direct extension to chest wall not including pectoralis major

Question 24

What is lung cancer?

Answer 24

Leading cause of cancer death amongst men and women

Question 25

How to treat lung cancer?

Answer 25

Posterior oblique and anterior beams

Question 26

Conformal therapy?

Answer 26

Get the dose to conform to cancer

-palliative maybe just an anterior and posterior beam

Question 27

What is DCAT

Answer 27

Dynamic conformal arc therapy

Question 28

What is SABR

Answer 28

Stereotactic ablative beam therapy

Question 29

What is cyber knife?

Answer 29

Very fine beam

Question 30

Pl1 or Pl2 for lungs?

Answer 30

Damage to pleura

Question 31

Staging for lung cancer?

Answer 31

T1- tumour greater than 3cm surrounded by lung
T2-tumour greater than 3-7cm-invades pleura
T3-greater than 7cm invades abdominal wall
T4- invades mediastinum

Question 32

Is cancer more aggressive for younger patients of lung and testicular cancers?

Answer 32

Yes

Question 33

Detection of prostate cancer?

Answer 33

Digital rectal exam-DRE
Blood test- prostate specific antigen
TRUS Biopsy