Oncology

Question 1

Brca 1 vs brca 2

Answer 1

Both associated with breast cancer but ovarian cancer in more common in brca1. Earlier diagnosis of breast ca in brca 1. Brca1 has worse survival than brca 2 in breast ca.
both associated with prostate cancer

Question 2

Tumour market in testicular cancer

Answer 2

AFP is not found in pure seminoma testicular cancer. B-hcg is found in both.

Question 3

What else do you need to give in abiraterone therapy? What are the common side effects?

Answer 3

Abiraterone is a new androgen receptor antagonist. Inhibits 17-alpha- hydroxylase. Can cause high mineralocorticoid issues such as hypertension, hypokalaemia, peripheral oedema. Give low dose pred/steroids to reduce mineralocorticoid.

Question 4

Why do you add mek inhibitor to braf inhibitors in braf mutated melanoma?

Answer 4

Braf resistance occurs in almost all patients and mek inhibitors works downstream in the MAPK pathway. This acts to lengthen the period of time between onset of treatment response and onset of resistance, prolonging the PFS and OS. This decreases the side effects from braf inhibitors due to a decrease in the paradoxical activation of the mapk pathway.

Question 5

Dabrafenib + trametinib vs vemurafenib + cobimetinib side effects

Answer 5

D+T has more fevers, tachycardia, sweats vs V+C has more photosensitivity.

Question 6

What cancers are associated with Lynch syndrome?

Answer 6

1. Colorectal cancer
2. Endometrial
3. Smal bowel
4. Ureter
5. Renal pelvis

Question 7

Lynch syndrome 3-2-1 rule

Answer 7

3 relatives associated with lynch syndrome associated cancer
First degree relative of the other 2
2 successive generations affected
One diagnosed before age 50
FAP excluded