General Oncology Flashcards
What is meant by radical treatment
Treatment given with curative intent.
What is meant by concurrent treatment
Giving two modes of treatment at the same time e.g. chemotherapy with radiotherapy.
Usually this is with radial (curative) intent.
What is adjuvant therapy
Treatment given following radical therapy, with the intention of reducing the risk of disease recurrence.
This may be given “Neo” adjuvantly i.e. prior to the radical treatment, rather than afterwards.
What is palliative treatment
Treatment given to ease symptoms and possibly to extend life, but with no intention of curing the disease.
What is XRT
Radiotherapy, usually external beams of ionising radiation directed to the tumour site,
Prescribed in Gray ( 1 Gy – 1 Joule /kg).
What is brachytherapy
When the source of radiation is implanted or inserted in the patient to deliver a dose of radiotherapy to local tumour.
What is performance status and how is it used
To express a patient’s level of fitness in relation to treatment options
Can be used to determine which treatments are suitable
If a patient is PS 0-1 they are usually fit for radical treatment.
If they are PS 0-2 they are usually fit for chemotherapy, be it palliative or radical.
List the Performance Status levels
0 – Fully active, no restrictions on activities
1 – Unable to do strenuous activities, but ambulatory and able to carry out light housework and sedentary activities
2 – Able to walk and manage self-care, but unable to work. Out of bed more than 50% of waking hours
3 – Confined to bed or a chair more than 50% of waking hours. Capable of limited self-care
4 – Completely disabled. Totally confined to a bed or chair. Unable to do any self-care
5 – Death
How does a PET scan work
A radioactive tracer is injected - radioactive isotope joined to a carrier molecule
Carrier molecules are designed to bind to specific proteins or sugars - commonly glucose for cancer
A CT scanner and gamma ray detector will together allow you
to identify areas of higher than expected metabolic activity.
What are PET-CT scans used for
They are good at identifying mets
If a superior vena cava obstruction is caused by an intrinsic clot, which treatments can be given
Anticogaulation and oxygen
Do not use a stent or steroids
Which type of back pain should alert you to possible malignant spinal cord compression
Radicular
Pain that radiates from your back and hip into your legs through the spine
In a patient with hypercalcaemia due to cancer what would the initial management be
IV fluids to start
Follow with bisphosphonates if fluids do not correct the calcium
Which type of lung cancer is most likely to cause hypercalcaemia
Squamous cell
Other cancers which commonly cause hypercalcemia include myeloma and breast
Which virus causes a significant proportion of oesophageal cancers
HPV
Which cancers are commonly screened for in the UK
Breast
Colorectal
Cervical
Ovarian cancer usually presents early - true or false
It typically presents late
Often with abdominal discomfort
Malignant spinal cord compression typically has better outcomes if treated surgically - true or false
True
Cervical cancer can only be treated surgically - true or false
False
Whilst surgery is often used, non-surgical management includes external beam radiotherapy and brachytherapy
Where does prostate cancer commonly metastasise to
Bones
List treatment options for prostate cancer
Watchful waiting or active surveillance
Hormone therapy - androgen deprivation therapy
Brachytherapy - smaller tumour with less LUTS
Radical radiotherapy
Surgery - removal of prostate
What is the most common cancer in females
Breast cancer
List signs of opiate toxicity
Drowsiness
Pin point pupils
Renal impairment increases risk of opiate toxicity - true or false
True
List the different types of anaemia
Microcytic Hypochromic Anaemia
Normocytic Normochromic Anaemia
Macrocytic Anaemia
Aplastic anaemia
Haemolytic anaemia
What can cause microcytic anaemia
Haem deficeincy
Iron deficiency anaemia
Anaemia of chronic disease
Sideroblastic Anaemia
Globin deficiencey
Sickle cell disease
Thalasseamias
What can cause normocytic anaemia
Acute blood loss
Early iron deficiency anaemia
Chronic inflammatory, infective or malignant disorders
Renal failure
What can cause megaloblastic macrocytic anaemia
B12/Folate deficiency
What can cause non-megaloblastic macrocytic anaemia
Liver Disease
Alcohol
Hypothyroidism
What can cause spurious macrocytic anaemia
Cold agglutinins disease: Mycoplasma
Reticulocytosis
What are the subtypes of macrocytic anaemia
True - induces megaloblastic and non-megaloblastic subgroups
Spurious
Anaemia is a symptom not a diagnosis - true or false
True
Must investigate and find the underlying cause
Which features of cancer can lead to anaemia
Chemotherapy
Bone marrow failure and invasion
Sepsis
How can marrow infiltration by cancer lead to anaemia
It causes reduced erythropoiesis - have less red cells
Which test is best for determining the major group of anaemia the patient has
MCV
Will tell you if it is micro-, normo- or macrocytic
