Oncology Flashcards
Cancer incidence in both sex
Male: prostate>lung>colorectal>bladder
Female: breast>lung>colorectal>endometrial
Most prevalent cause of Cancer death for both sexes
Lung
Most significant risk factor for cancer
AGE
Second most common cancer
Breast
Diagnosis of cancer relies heavily on
Tissue biopsy
Curability of a tumor is usually inversely proportional to
Tumor burden
Cancer Staging based on PE, radiographs, isotopic scans, other imaging procedures
Clinical staging
Cancer staging based on information obtained during a surgical procedure( intrsoperative palpation, resection of regions lymph nodes and/ or +issue adjacent to the tumor, inspection and biopsy of Organs commonly involved in disease spread)
Pathologic Staging
most widely used staying System for Cancer
T N M ( tumor, node, metastasis) System
EC06 Grade For a patient capable only of limited self - care I confined to bed or chair more than 50% of waking hours
ECO6 Grade 3
Administration of chemotherapy or chemotherapy- radiation therapy BEFORE definitive surgery
Neoadjuvant therapy
most common sidereffects of Cancer Therapy
N and V, Febrile neutropenia, myelosuppression
> 50% reduction in the sum of the products of the perpendicular diamete rs of all measurable lesions
Based on RECIST:>/30% decrease in the suns of the longest diameters of lesions
Partial response
Appearance of any new lesion or an increase of> 25% in the Sum Of the products of the perpendicular diameters ok all measurable lesions
REG ST:> Or= 20% increase in the Sums of the longest diameter
progressive disease
Tumor marker For Gestational trophoblastic disease, gonadal germ tumor
HCG
Tumor marker for Hepatocellular CA, GonadsI germ cell tumor
Alpha Fetoprotein
CA - 125
Ovarian cancer, some lymphomas
CA 19-9
Pancreatic, Colon, Breast
CD 30
Hodgkin’s disease, anaplastic large cell lymphoma
C D 25
Hairy cell leukemia, Adult Tall leukemia/ lymphoma
most avoidable risk Factor for pulmonary, cardiovascular disease and cancer
Smoking Cessation
Cancers associated with smoking
Larynx, oropharynx, esophagus, kidney, bladder, pancreas stomach
Smoking cessation reduces lover lung cancer mortality by how much
30-50% compared to continued smoking
Decrease risk or colon and breast cancer
physical Activity
High Fat diet increases the risk for what cancer
Breast, colon, prostate, endometrium
BMl> 25kglm2
Increases Cancer Risk
induces non melanoma skin cancer (basal Cell And squamous cell)
Cumulative exposure to UV radiation
Linked to melanoma
Intermittent acute sun exposures and sun damage
Benefits of Sunscreens
Decrease the risk of actinic keratosis. precursor Of Squamous cell skin cancer
Increases lung Cancer incidence and mortality
Beta carotene
Most common causes Of SVC
malignant Tumors ( Lung cancer, lymphoma sand met astatic tumors)
most common etiology of SVC in young adults
Malignant lymphoma
Poor prognosticators for S V C
Cerebral and or laryngeal edema
most significant CXR Finding in SVC
Widened superior mediastinum
may have concurrent right sided pleural effusion
Provides the most reliable view of mediasfinal anatomy in SVC
chest CT scan
Life threatening complication of s V C
Tracheal Obstruction
Role of glucocorticoids in lymphoma
Only in Lymphoma but no benefit if with Lung LA
Primary tvestment For SVC
Radiotherapy
Most Frequent cancer etiologies associated with pericardial effusion
Thoracic malignancies: lung, breast, Lymphomas, Leukemia
Most helpful diagnostic test for patients with pericardial effusion associated cwith malignancy
2D echo
Best diagnostic yield For pericardial effusion in cancer patients
Cytology + pericardial and epicardial biopsy+ guided pericardioscopy
pericardial Fluid with malignant cells on cytology has
Poor survival at 7 weeks
Recurrence rate of pericardial effusion in cancer patients
20% reduced with sclerotherapy( bleomycin, mitomycin C tetracycline)
complication of drainage of pericardial effusion
post operative low cardiac output syndrome
most common Cause of MSCC
Lung Cancer
Most common site of MSCC
Thoracic spine ( 70% )
Tingling or electric sensation down the back and limbs upon neck Flexion or extension
Lhermitte’s sign
Earliest radiologic finding of vertebral tumor
Erosion of the pedicles ( winking owl sign)
Imaging procedure of choice for MSCC
MRI
Initial Treatment of Choice for MSCC
Radiation therapy+glucocorticoid ( Dexa)
Most common cancer etiologics For Intestinal Obstruction
Colorectal, Ovarian
Most common cause of small bowel obstruction in cancer patients
Melanoma
Due to Infiltration of the mesentery or bowel muscle by tumor involvement of celiac plexus, or paraneoplastic neuropathy( SCLC)
intestinal bsendoobstruction
IgG antibodies reactive to neurons of the myenteric and submucosal plexuses of the jejunum and stomach
Paraneoplastic neuropathy
Most common metastatic tumors causing biliary obstruction
Gastric, colon, breast, lung cancers
persistent hypoglycemia in cancer patients
Pancreatic islet Cell tumors, tumors Of mesenchymal origin, hepatomas, or adrenocortical tumors
Features of Tumor Lysis Syndrome
Hyperuricemia, Kalemia, phosphatemia
Hypocalcemia
Drugs associated with HUS - TTP
Mitomycin, gemcitabine, cisplatin, bleomYcin, VEGF inhibitors
HUS as a complication usually occurs how many weeks after chemo
4-8
Features of HUS
microangiopathic hemolytic anemia, thrombocytopenia, renal failure
Chemo drugs associated with hemorrhagic cystitis
Cyclophosphamide or ifosfamide
Treatment for chemo induced hemorrhagic cystitis
MESNA
