DPD: Cancer presentations

Question 1

What are the 4 most common sites of solid malignancies in the UK?

Answer 1

Breast
Prostate
Lung
Bowel

Question 2

List 9 acute presentations of cancer

Answer 2

Weight loss/ loss of appetite
Confusion/ fitting
SOB
Cough
Altered bowel habit
Swollen abdomen
Pain
Lumps + bumps
Feeling "off legs"

Question 3

Which cancers can cause confusion/ fitting? What investigation should you perform?

Answer 3

Primary brain cancer
Brain mets.
CT Head

Question 4

What symptoms may be experienced due to tumours causing cord compression?

Answer 4

Weakness
Numbness
Urological dysfunction
Faecal dysfunction
Sexual dysfunction

Question 5

What respiratory pathology risk is increased by both malignancy and chemotherapy?

Answer 5

PE

Question 6

Why should chest imaging be repeated 6 weeks post pneumonia when you suspect underlying malignancy?

Answer 6

Consolidation may hide malignancy

Question 7

Which 4 cancers need a particularly fast diagnosis?

Answer 7

Small cell cancer
Lymphoma
Germ cell tumours
Cord compression of any cause

Question 8

What drug must you avoid if you suspect lymphoma?

Answer 8

NO STEROIDS

Question 9

What is the CEA tumour marker associated with?

Answer 9

Lower GI tumours

Question 10

What is the Ca 19-9 tumour marker associated with?

Answer 10

Pancreatic cancer

Question 11

What is the Ca 15-3 tumour marker associated with?

Answer 11

Breast cancer

Question 12

What is the PSA tumour marker associated with?

Answer 12

Prostate cancer

Question 13

What is the Ca 125 tumour marker associated with?

Answer 13

Ovarian cancer

Question 14

What are the 4 sources of cancer causing symptoms?

Answer 14

1. Primary tumour
2. Distant metastases + paraneoplastic syndromes
3. Body’s response to 1 + 2
4. Treatment given for any of the above