Intro to Heme - Onc

Question 1

What are proto-oncogenes?

Answer 1

Genes that normally help cells grow

Signals lead to normal cell division

Question 2

What are oncogenes?

Answer 2

Proto-oncogenes which is mutated or increased number of copies

Abnormally permanently turned on or activated

Leads to uncontrolled cell growth

Question 3

What are tumor suppressor genes?

Answer 3

Code for proteins that normally operate to restrict cellular growth and division or even promote programmed cell death (apoptosis)

Question 4

Median age of diagnosis of cancer?

Answer 4

65

Question 5

Age group that has highest cancer incidence (new cases)?

Answer 5

65-74, then 55-64

Question 6

What vaccines are recommended to prevent cancer?

Answer 6

Hep B and HPV vaccine

Question 7

Chemoprevention for high risk patients?

Answer 7

Tamoxifen

Raloxifene

Question 8

Who should be screened for breast cancer?

Answer 8

Ages 50-74 - biennial mammogram (every other year)

Question 9

Who should be screened for cervical cancer?

Answer 9

Ages 21 to 65 women should receive pap smear every 3 years

Age 30 to 65 may screen both Pap and HPV testing every 5 years

Question 10

Who shoud be screened for colorectal cancer?

Answer 10

50-75 using fecal occult blood testing, sigmoidoscopy, or colonoscapy

Colonoscopy is the gold standard every 10 years

Question 11

Who should be screened for prostate cancer?

Answer 11

No guidelines for this ish

Question 12

Who should be screened for lung cancer?

Answer 12

Age 55-80 with 30 year pack year and currently smokes or quit smoking within the last 15 years

Yearly low dose CT scan

Question 13

What are the 7 early warning signals in adults?

Answer 13

CAUTION

Change in bladder or bowel habits
A sore throat that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in mole or wart
Nagging cough or hoarseness

Question 14

What are the 11 early warning signals in children?

Answer 14

CHILD CANCER

Continued unexplained weight loss
Headaches, often with early morning vomiting
Increased swelling or persistent pain in bones, joints
Lump or mass, especially in abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash
Constant infections
A whitish color behind the pupil
Nausea which persists or vomiting without nausea
Constant tiredness or noticeable paleness
Eye or vision changes which occurs suddenly and persist
Recurrent or persistent fever of unknown origin

Question 15

How do PET scans work?

Answer 15

Glucose is injected, scanner shows areas inside the body where the glucose is taken up
Cancer cells take up more glucose

Question 16

Name the solid cancer types

Answer 16

Carcinoma (skin or tissues that line organs)
Sarcoma (bone, cartilage, muscle, or other connective tissue)
Central nervous system (brain or spinal cord)

Question 17

Name the hematologic cancer types

Answer 17

Leukemia (bone marrow, blood cells)
Lymphoma (lymphatic system)
Myeloma (plasma cells)

Question 18

Describe TNM staging for solid tumors

Answer 18

T = tumor, ranges T1-T4 determines location/if it’s resectable

N = Lymph node
Regional spread of disease, N0 = no nodes involvement, N1-3 depending on extent of nodal involvement

M = Metastasis
M0 = none
M1 = metastases occurred

Question 19

What is stage 0?

Answer 19

Carcinoma in situ (precancerous

Question 20

What is Stage I, II, and III cancer?

Answer 20

Based on tumor size, spread of cancer to nearby lymph nodes and/or organs adjacent to the location of the primary tumor

Question 21

What is Stage IV cancer?

Answer 21

Metastatic cancer that has spread to other organs

Usually not curable

Question 22

How is Lymphoma staged?

Answer 22

Ann Arbor staging

Question 23

How is Leukemia staged?

Answer 23

FAB and WHO classification (based on morphology and cytogenetics)

Question 24

How is multiple myeloma staged?

Answer 24

Staging based on Beta-2 microglobulin and albumin levels

Question 25

What is induction? Consolidation?

Answer 25

Induction = initial treatment with goal of making cancer undetectable

Consolidation = goal is to kill cancer cells that are undetectable

Question 26

What is Neo-adjuvant therapy?

Answer 26

Goal: Shrink tumor prior to primary treatment such as surgery

Applies only to solid tumors

Question 27

What is Adjuvant therapy?

Answer 27

Short courses of combination therapy after primary treatment like surgery

Goal is to destroy low number of residual cells

Question 28

What is maintenance treatment?

Answer 28

Therapy over specific period of time in remission

Goal is prevent progression of disease

Question 29

What is salvage therapy?

Answer 29

Last line of therapy, initiated when there is no initial response or a relapse after response for certain period of time

Goal is to induce remission

Question 30

What is palliative therapy?

Answer 30

Cancers in which cure is unlikely, goal is to relieve symptoms and improve QOL

Question 31

What is a clinical benefit response?

Answer 31

Improved quality of life or performance status

Question 32

What is a partial response?

Answer 32

Over 30% decrease in the sum of lesions from baseline

decrease of size of tumor or extent of cancer

Question 33

What is stable disease?

Answer 33

Cancer is neither growing or shrinking