Oncology Flashcards
Small cell and adenocarcinoma are two types of lung cancer, name 4 more.
Large cell
Alveolar cell carcinoma
Squamous cell carcinoma
Bronchial adenoma
Persistent cough, haemoptysis and dyspnoea are three features seen in lung cancer, name 4 more.
Weight loss
Hoarse voice
Chest pain
SVCO
Clubbing and a monophasic wheeze are two examination findings for a patient with lung cancer, name one more.
Supraclavicular lymphadenopathy
OR
Persistent cervical lymphadenopathy
What are the paraneoplastic features associated with small cell lung cancer?
ADH - SIADH
ACTH - Cushings or Addisons
Lambert-Eaton syndrome
Metastases common
What are the paraneoplastic features associated with squamous cell carcinoma of the lung?
PTH-rp - Hypercalcaemia
Clubbing
Hypertrophic Pulmonary Osteoarthropathy
TSH - hyperthyroidism
What are the paraneoplastic features associated with adenocarcinoma of the lung?
Gynaecomastia
Hypertrophic Pulmonary Osteoarthropathy
What is the investigation pathway for lung cancer?
CXR
CT
Bronchoscopy
PET CT (usually non-small cell for management guidance).
What are the features of adenocarcinoma lung cancer?
Typically peripheral
Most common type of lung cancer in non-smokers (majority still smokers).
Late metastases.
What are the features of large cell carcinoma of the lung?
Typically peripheral
Anaplastic lymphoma - poorly differentiated tumours with poor prognosis.
May secrete beta-hCG.
When should a patient be referred on a 2-week wait referral for lung cancer?
Xray changes that are of suggestive of cancer
40 or over with unexplained haemoptysis.
When should a patient be offered an urgent CXR (within 2 weeks)?
40 or over with two or more of:
- cough
- fatigue
- shortness of breath
- chest pain
- weight loss
- appetite loss
OR
if they have ever smoked and have one or more of those sx.
OR
In anyone 40 or over with any of the following:
- persistent or recurrent chest infection
- finger clubbing
- supraclavicular or cervical lymphadenopathy
- chest signs consistent with lung cancer
- thrombocytosis
What ages does breast cancer screening start and end? What is the frequency of screening?
50-71
Every 3 years.
When should patients be referred for 2WW for breast cancer?
Aged 30 and over with an unexplained breast lump with or without pain.
Aged 50 and over with any of the following in one nipple only:
- discharge
- retraction
- other changes of concern (bleeding, padgets).
When should patients be considered for a 2WW for breast cancer?
Skin changes that suggest breast cancer (peau d’orange)
Aged 30 or over with an unexplained lump in the axilla.
When should a patient be considered for a non-urgent referral for breast cancer?
30 and under with an unexplained breast lump with or without pain.
Nulliparity, early menarche, late menopause, past hx and obesity are 5 risk factors for the development of breast cancer, name 8 more.
BRCA gene mutations
1st degree relative with perimenopausal breast cancer
First child over 30
COCP and HRT (combined)
Not breastfeeding
Ionising radiation
p53 gene mutations
Previous surgery for benign breast lump
What are the 4 common types of breast cancer?
Invasive ductal carcinoma
Invasive lobular carcinoma
Ductal carcinoma in-situ
Lobular carcinoma in-situ
Medullary, tubular and mucinous are 3 types of rarer breast cancers, name 4 more.
Padgets disease (may be associated with other underlying breast cancer if there is an associated lump)
Inflammatory breast cancer
Adenoid cystic
Lymphoma
Metaplastic
Basal type
Surgery and radiotherapy are two of the management options for breast cancer, name 3 more.
Hormone therapy
Biologival therapy
Chemotherapy
Multifocal tumour and central tumour are two of the indications for mastectomy, name 2 more.
Large lesion in small breast
DCIS >4cm
Peripheral tumour and small lesion in large breast are two of the indications for a wide local excision, name two more.
DCIS <4cm
Solitary lesion
What can be used to manage metastatic bone pain?
Analgesia
Bisphosphonates
Radiotherapy
What is the mechanism of action of the drug most likely to be given to a premenopausal woman with an oestrogen-receptor positive breast cancer?
Oestrogen-receptor selective antagonism (tamoxifen)
Nulliparity, early menarche, late menopause, unopposed oestrogen are 4 risk factors for endometrial cancer, name 7 more.
Obesity
Diabetes
PCOS
Tamoxifen
Hereditary non-polyposis colorectal carcinoma
Polyps
BRCA - previous breast or ovarian cancer
