Oncology

Question 1

CRC

Answer 1

malignancy of GI and rectum
second most common cancer in UK
peak incidence is 70-80
women > men

Question 2

CRC RF

Answer 2

sporadic
diet: lack of fibre, high fat diet, high levels of bile acids, high meat diet,
genetic: APC, p53, oncogenes like RAS, mismatch repair genes
cancer syndromes: HPNCC, FAP
IBD
irradiation
uretosigmoidostomy

Question 3

HNPCC

Answer 3

inherited colon cancer
caused by mutations in mismatch repair genes which repair damanged DNA
4 genes: hMSH2, hMLH1, hPMS1 and hPMS2
develop in proximal portion of cancer
rapid transforamation
associated with other cancers: brain, gastric, biliary, small bowel, urinary, ovarian, endometrial
dx: molecular testing

Question 4

Pathophysiology of CRC

Answer 4

damange to multiple tumour supressor genees and DNA repair genes an activatio of oncogenes
growth of dysplasia–> adenematous polyp
spread:
- direct usually laterallly
- lymphatic spread
- hematogenous spread via portal vein to liver
- transcolemic spread: through peritoneal cavity

Question 5

Sites of CRC

Answer 5

rectum and sigmoid > descending/transverse/caecum/ascending

Question 6

Staging of CRC

Answer 6

TNM
DUkes
- A: bowel wall==> TNM 0, TNM 1
- B: through bowel wall ==> TNM 2
- C: through bowel wall + LN ==> TNM 3
- D: distant metastases ==> TNM 4

Question 7

CA-125

Answer 7

Ovarian cancer tumour marker. Range is 0-35units/ml

Question 8

PSA

Answer 8

prostate cancer TM

Question 9

CEA

Answer 9

TM for Colorectal cancer
Non-specific for: pancreatic, prostate, ovary, lung, thyroid, liver

Question 10

Ca-19-9

Answer 10

Pancrease and biliary ducts

Question 11

AFP

Answer 11

Liver and testes TM

Question 12

CA 15-3

Answer 12

Breast and lung cancer