Oncology Flashcards
What guides your judgment on whether you should do an axillary lymph node dissection in a patient with breast cancer?
Sentinel lymph node biopsy
What is the best initial therapy for breast cancer?
Lumpectomy with radiation treatment
In what situations are tamoxifen or raloxifene used for breast cancer?
If either positive for estrogen or progesterone receptors. Even better if both are positive
What can be given for breast cancer prevention in patients with multiple first degree relatives diagnosed?
Tamoxifen
What is anastrozole?
An aromatase inhibitor (pure estrogen antagonist) that can be used in breast cancer treatment. They don’t lead to DVT but can cause osteoporosis
In what situations is adjuvant chemotherapy used for breast cancer?
I) Axillary spread
II) Larger than 1 cm
- More efficacious if women still menstruating
Generally, how is colon cancer treated?
Surgical resection
Chemo with 5-fluorouracil
Is there any screening done for lung cancer?
Long-term smokers with > 30 pack-year history can received screening CT chest at 55 but no regular follow-up after
What are some reasons a lung cancer is not resectable?
Mets Close to carina Involvement of vena cava, heart, or aorta Pleural effusion Bilateral disease
What do you do for abnl Pap with low grade or high grade dysplasia?
Colposcopy and biopsy
What do you do for ASCUS on Pap?
Get HPV testing
What do you do for ASCUS and HPV positive?
Colposcopy
Then repeat Pap in 6-12 months
What is prostate cancer screening?
PSA and digital rectal exam. BUT the physician is not to routinely recommend these, its really if the patient is concerned
What are equally effective options for treatment of localized prostate cancer?
Surgery with either external radiation or implanted radioactive pellets
What is treatment for metastatic prostate cancer?
Androgen blockage using flutamide (T receptor blocker) and leuprolide/goserelin (GnRH agonists)
*Remember GnRH is meant to be pulse-secreted, so continuously giving is inhibitory
What is finasteride used for and how does it work?
A 5-alpha reductase inhibitor used in BPH
NOT USED IN CANCER
How is the management of ovarian cancer unique?
Even if there is a large volume of tumor spread through pelvis and abdomen you can still treat it surgically and get out all you can
What is done to diagnose testicular cancer?
Inguinal orchiectomy
Nonseminoma tumors secrete ….
AFP
What should be measured if concerned about testicular cancer? What is used to stage?
AFP, LDH, B-hCG
CT pelvis to stage
Treatment of testicular cancer is very good. How are local and widespread disease treated, respectively?
Local: Radiation
Widespread/Metastatic: Chemo
