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Oncology > Oncology Exam > Flashcards

Oncology Exam Flashcards

1
Q

2 most common presentations of breast cancer

A 
mammographic abnormality (screening)
palpable mass in breast (provider/pt)
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2
Q

2 main types of breast cancer

A

ductal: most common*

lobular

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3
Q

how are ductal carcinoma in situ most often identified on mammograms?

A

clustered microcalcifications w/ or w/o a palpable mass

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4
Q

Paget’s disease of breast*

A

changes at nipple; early: scaling, later: red lesion, flattening of nipple
95% assoc w/DCIS

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5
Q

inflammatory breast cancer

A

cancer cells block lymph vessels, causing severe swelling/redness
can cause peau d’orange

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6
Q

chemotherapeutic agents for breast cancer

A

Cyclophosphamide
Methotrexate
5-FU

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7
Q

tamoxifen

A

selective estrogen receptor modulators

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8
Q

testosterone is metabolized to dihydrotestosterone (DHT)

A

5 alpha reductase

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9
Q

70% of prostate cancer and most infections in which zone?**

A

peripheral zone

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10
Q

most common prostate cancer cell type**

A

adenocarcinoma 95%

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11
Q

most common cancer in males

A

prostate cancer

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12
Q

SxS of prostate cancer*

A

may be asymp or mimic BPH

dysfunct urinating, can mets to bone*

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13
Q

what PSA level warrants referral for biopsy?

A

> /= 4.0

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14
Q

when do you treat high PSA values?

A

only if symptomatic
abnormal DRE
AND likely to cause morbidity/mortality

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15
Q

difference in PSA values between ca and BPH

A

Ca: lower free PSA

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16
Q

what TNM scores indicate invasion or metastasis?

A

T3, 4 - no cure

T1,2- curable by surgery

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17
Q

growth speed of prostate ca

A

slow growing

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18
Q

how to cancer cells kill?

A

compete w/normal cells for nutrients

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19
Q

oncogenes

A

mutated version of proto-oncogenes (promote cell growth)

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20
Q

how does radiation therapy work?

A

damage DNA directly or create free radicals

kills ca cells and damage normal cells

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21
Q

1 symptom of esophageal ca*

A

dysphagia; feels like food stuck going down

Esophageal ca until proven otherwise

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22
Q

most common type of external radiation therapy

A

3-dimensional conformal radiation therapy (3D-CRT)

but IMRT less S/E

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23
Q

when is total body irradiation used?

A

Hematopoietic cell transplantation for leukemias and lymphomas - immunosuppression and eradication of malignant cells

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24
Q

brachytherapy

A

internal radiation therapy using “seeds”

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25
Q

what cancer is radioresistant to radiation

A

melanoma

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26
Q

Radiation Pneumonitis

A 
Onset 4-12 week after chest radiation
Cough, nonproductive
Dyspnea
Fever, low grade
Chest pain
Malaise
Weight loss
Hypoxemia
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27
Q

known risk factor of testicular ca*

A

undescended testicle (cryptorchidism)

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28
Q

screening for uterine or ovarian ca*

A

no specific screening; based on pt education

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29
Q

False positive of blood in stool*

A

Vit. C, red beets, Pepto Bismol, red licorice, iron supplements

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30
Q

Most common new cancer dx (men)**

A

prostate > lung > colorectal

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31
Q

Most common new cancer dx (women)**

A

Breast > lung > colorectal

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32
Q

Alternative Tx to nausea and vomiting*

A

ginger, acupuncture

and THC in cannabinoids; smoked best

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33
Q

role of dietary fiber*

A

bulks up waste, moves it along faster, reduce contact time with intestinal wall, butyrate by-product, reduce inflammation

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34
Q

Antioxidants*

A

scavenge free radicals
foods: Plant-based foods; Fruits, veg, and their juices, whole-grain, nuts, seeds, herbs and spices. chocolate!
protective against cell mutations

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35
Q

Vit D in cancer*

A

low in cancer

indicator of overall health**

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36
Q

Garlic in cancer*

A

immune boosting

unprocessed form

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37
Q

L-glutamine*

A

effective for chemo-induced peripheral neuropathy

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38
Q

Ganoderma lucidum*

A

mushroom - inhibit the growth and invasiveness of some cancer cells (lab studies)
effects studied in breast ca

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39
Q

butyrate*

A

by product of fiber break down by bacteria in lower intestines
inhibits growth of tumors in the colon and rectum

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40
Q

High fiber diet in ca

A

protective against colon ca!

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41
Q

carcinoma of lung types

A

small cell

non-small cell

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42
Q

primary type of non-small cell lung carcinoma*

A

adenocarcinoma (from mucus secreting glands)

other type: Squamous CC

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43
Q

imaging modality of choice for smokers or >50yo*

A

High resolution low dose CT

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44
Q

leading cause of ca death both men and women

A

lung ca

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45
Q

epidermal growth factor receptor (EGFR)*

A

tumor marker currently studied as targeted therapy
mutation can cause lung ca in non-smokers
predominant in adenocarcinoma

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46
Q

5 year survival rate for lung ca <2cm

A

95%!

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47
Q

non-small cell lung ca tend to metastasize to…

A

adrenals, lymphatics in mediastinum, bony mets

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48
Q

small cell lung ca tend to metastasize to…

A

brain

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49
Q

mesothelioma

A

pleural-based lung ca

from asbestos

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50
Q

pancoast tumor

A

tumor at pulmonary apex
can cause horner’s syndrome (bc sympathetic chain; miosis, ptosis, anhidrosis)
usu. NSCLC

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51
Q

primary cause of small cell lung cancer*

A

smoking

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52
Q

Small Cell Lung Cancer (oat cell)

A

Derived from remnants of fetal lung in neuroendocrine cells (Kulchitsky cells)
25% of all primary lung cancers
pt can present as hyponatremic

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53
Q

how does smoking cessation help risk of primary lung ca

A

rate decreases to that of nonsmokers within 10 to 15 years of quitting

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54
Q

What dietary supplement should you avoid in lung ca?

A

Vit A Carotenoid

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55
Q

What do carcinoid tumors secrete (lung ca)

A

bronchial gland tumors that secrete serotonin
pts can exhibit GI Sx (n/v/d)
often in pts w/malignant dz in thorax

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56
Q

superior vena cava syndrome

A

partial or complete obstruction of blood through SVC

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57
Q

emergency Tx of superior vena cava syndrome

A

prednisone: reduce swelling

radiation therapy to decrease bulk of mass

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58
Q

how can lung ca present as pneumonia?

A

Tumor in bronchus and not exchanging o2 and co2; lung past tumor is not being ventilated –> get atelectasis (collapse of lung tissue) –> get pneumonia
Fever, chills, night sweats, lung sounds
Need repeat CXR after pneumonia for lung ca; can mask ca

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59
Q

Endocrine presentations of SCLC

A 
Hypercalcemia
SIADH
Cushing's
Hypoglycemia
Galactorrhea
Carcinoid syndrome: serotonin
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60
Q

Neuromuscular presentation of SCLC

A

eaton-lambert syndrome: autonomic neuropathy* weak muscles, tingling, etc

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61
Q

staging for SCLC

A

No TNM, just A or B (limited or extensive)

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62
Q

distance from incisors to E-G Junction*

A

35 - 40 cm

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63
Q

Esophageal benign tumors

A

leiomyomas: mid/distal; don’t need therapy unless >5cm or symp
polyps: usu. cervical; regurgitating Sx

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64
Q

types of esophageal cancer

A

squamous cell: achalasia (dysmotility), nicotine, tylosis, injury
adenocarcinoma: Barrett’s esophagus (GERD); dista; more common now
Adenosquamous, Lymphoma, Melanoma, Oat-cell, Sarcoma

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65
Q

esophageal cancer prognosis

A

depends on lymph involvement

but usu. <10-15% 5 year survival bc found late

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66
Q

gastric cancer prognosis

A

dismal. unless caught early but unlikely

>50% have spread at time of Dx

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67
Q

most common type of gastric ca

A

adenocarcinoma 95%

most common: Polypoid or ulcerative

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68
Q

Gastric ca SxS

A

early satiety
Often asymptomatic until advanced
Anorexia and weight loss most common
abdominal mass 50%

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69
Q

what side is virchow’s node on

A

left, take supply from lymph of abdominal cavity

70
Q

Gastric ca Tx

A

only surgery for cure or palliation

Sufficient margins: 6cm distal, 3cm proximal (bc lymph)

71
Q

Gastrointestinal Stromal TumorGIST

A

thought to arise from smooth muscle cells

no TNM staging

72
Q

adjuvant Tx for gastric ca**

A

Gleevec – 54% partial response
Extremely helpful in Locally invasive tumor
5 year survival 48%, recurrence 1st 2 years

73
Q

biggest factor for colon ca

A

family hx but sporatic 75%

74
Q

Lynch Syndrome

A

Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
Replication error
95% chance of developing colon ca

75
Q

Gardner’s syndrome - Familial Polyposis

A

Osteomas
Epidermoid cysts
Cutaneous fibromas
cancer by age 40, autosomal dominant

76
Q

MUTYH Associated Polyposis (MAP)

A

Autosomal Recessive
Multiple polyps
40-60 years old
80% will develop colon ca

77
Q

Peutz-Jeghers Syndrome

A

Autosomal Dominant
Mostly benign hamartomas
Develop Small intestine most common

78
Q

Ulcerative Colitis

A

Precancerous condition

Need frequent colonoscopy

79
Q

Colon ca sx

A

alternating constipation and diarrhea

hematochezia

80
Q

70 yo w/”appendicitis” or left “inguinal hernia”…

A

r/o colon ca

81
Q

what should you always do on someone w/rectal bleeding?

A

digital rectal exam

82
Q

Left colon ca Sx

A

Constipation
Diarrhea
Hematochezia
Tenesmus

83
Q

Right colon ca Sx

A

Vague abdominal pain

Palpable mass in 33%

84
Q

image modality of choice of colon ca

A

Barium enema w/distal endoscopy

85
Q

most common area of distribution

A

distal left/sigmoid 29%

cecum 26%

86
Q

most common type of colon ca

A

adenocarcinoma (columnar –> gland)

87
Q

most commonly used chemotherapeutic agent for colon ca**

A

Antimetabolites (5-flourouracil)**

88
Q

most common form of cancer in children

A

acute leukemia (particularly acute lymphoblastic leukemia)

89
Q

induction chemotherapy

A

reduce tumor load w/o intention of cure

1st line

90
Q

consolidation chemotherapy

A

induce remission; also not cure

91
Q

intensification

A

chemo after complete remission w.higher doses to inc cure rate/prolong remission

92
Q

adjuvant

A

short course chemo after RT/chemo/surgery to destroy low number of residual ca cells

93
Q

neoadjuvant

A

chemo in pre or post operative period

94
Q

salvage

A

potentially curative, high dose combo regime for someone who failed a prior regimen or had recurrence

95
Q

flow cytometry

A

identify circulating myeloblasts (stem cell of granulocytes) through surface antigens
determine if it’s ca

96
Q

gold standard for Dx of leukemias*

A

bone marrow biopsy/aspiration

at posterior superior iliac spine

97
Q

best drug for nausea and vomiting**

A

dexamethasone (Decadron)

ondansetron (Zofran) also works well - 5-HT3 recep antag

98
Q

what should you check stool for pts who receive chemotherapy?

A

C. diff (pts have diarrhea)

99
Q

ANC* (absolute neutrophil count)

A

Total WBC x (% of segs + bands)

100
Q

neutropenia

A

ANC <1500

101
Q

febrile neutropenia

A

pt undergoing chemo who develops temp but not enough WBC to fight infection; susceptible to infection

102
Q

Tx for pseudomonas in febrile neutropenia

A

Cefepime (4th gen cephalosporin) - gram neg

103
Q

Tumor lysis**

A

complication of chemo, can lead to kidney failure
tumor lysis releases K, PO4, nucleic acids into systemic circulation. Break down of nucleic acid to uric acid and precipitation in renal tubules
occurs in rapidly dividing ca like lymphomas
Sx: N/V/D, anorexic lethargy, hematuria, HF, renal failure, arrhythmias, etc.

104
Q

how to prevent tumor lysis

A

pre-chemo IV hydration and Tx of elevated uric acid

pt clotting and bleeding at the same time

105
Q

most common acute leukemia

A

acute myelogenic leukemia

106
Q

Acute Myelogenic Leukemia

A

rapidly lethal unless Tx w/intensive chemo or other targeted therapies together w/supportive care
Sx: weakness, infection, bleeding
bone marrow blood smear: dark purple AML cells
risk: exposure to radiation or chemo*, rare familial Dz

107
Q

presenting Sx of AML

A

Sx usu. minimal
Fatigue most common and precedes diagnosis by a number of months
Weakness, shortness of breath, DOE,
Complications of pancytopenia (anemia, infections, bleeding [gingival, ecchymosis, epistaxis or menorrhagia])
Pallor
Fever (usually caused by actual infection)
Splenomegaly or hepatomegaly (present 10% in each)
Up to 10% patients with AML, will have extramedullary disease - cutaneous or gingival infiltration

108
Q

Lab findings in AML**

A

Auer Rods** 50% on smear (fused lysosome rod in myeloblast)

WBC <5 50%

109
Q

AML Tx

A

7+3 (7 days of cytarabine (cytosine arabinoside), and 3 days daunorubicin)

110
Q

CNS leukemia commonly affect which cranial nerves?**

A

CN 3, 6**

>5% of AML

111
Q

AML prognosis

A

<60 yo: 5 yr survival rate 48% w/&+3 tx

0 SURVIVAL IN PTS >60yo w/chemo

112
Q

Acute v Chronic leukemia

A

acute: inpatient, aggressive IV Tx, fast growing
chronic: outpatient, pill Tx, slow growing

113
Q

Acute Promyelocytic Leukemia (APL)

A

HEMATOLOGIC EMERGENCY, TX RIGHT AWAY
form of AML, most malignant
hemorrhage in brain or lungs untreated
Tx: &+3 and ATRA (88-94% complete remission)

114
Q

Differentiation Syndrome**

A

aka Retinoid Acid Syndrome or cytokine storm
Tx complication of APL
can mimic sepsis or PE
Tx: dexamethasone
don’t treat w/leukapheresis - inc coagulopathy

115
Q

Chronic Myelogenous Leukemia

A

uncontrolled production of maturing and mature granulocytes predominately neutrophils, but also basophils and eosinophils
rarely seen in children, avg age 64yo

116
Q

HALLMARK OF CML**

A 
Absolute basophilia (> 20% on diff) 
Absolute eosinophilia is seen on 90% of cases 
Absolute = total # x total WBC
117
Q

Untreated CML leads to…

A

Triphasic course:

  1. chronic
  2. accelerated: B symptoms (fever, sweats, weight loss)
  3. blastic: resember acute leukemia; die w/o Tx; 20% blasts peripheral/marrow
118
Q

what occurs in 95% of Chronic Myelogenous leukemia***

A

Philadelphia Chromosome: BCR-ABL fusion gene* (between chromosome 9 and 22)

119
Q

Philadelphia chromosome indicates poor prognosis in what dz?

A

acute lymphocytic leukemia

Acute Lymphoblastic Leukemia/LBL

120
Q

CML Tx

A

TKI: disease control, eg Gleevec (imatinib, Spyrcel, Taiga, Bosulif) - only affects ca cells, NOT cure
potential cure w/allo hematopoietic transplant

121
Q

Acute Lymphoblastic Leukemia/Acute Lymphoblastic Lymphoma

A 
more common in children
>85% overall 5 year survival rate 
types:
B Cell: most common***
T cell: more favorable prognosis
Tx depends on cell type (All B cell same, All T same)*
122
Q

Difference between ALL, LBL

A

ALL: >25% bone marrow blasts
LBL: <25% bone marrow blasts with a mass lesion

123
Q

Most common childhood malignancy**

A

ALL/LBL (75% in children), peak 2-5yo

124
Q

ALL/LBL presentation in children

A 
hepatomegaly, splenomegaly
fever
lymphadenopathy, painless
bleeding
PLT <100,000
pallor, fatigue from anemia
musculoskeletal pain
125
Q

What lab test is assoc w/ALL/LBL

A

Eosinophilia

126
Q

Philadelphia neg ALL/LBL Tx adult

A

Hyper CVAD (cytoxan vincristine, daunorubicin, dexamethasone, alternating with methotrexate, cytarabine), nasty tx
Tx CNS w/methotrexate and cytarabine
G-CSF daily injection

127
Q

Philadelphia pos ALL/LBL adult tx*

A

Add TKI*

128
Q

How to Dx ALL/LBL

A

Lumbar puncture

129
Q

New treatments for relapsed or refractory B-Cell ALL

A

CART-T: Chimeric antigen receptor T cells

130
Q

most common leukemia in the western world*

A

Chronic Lymphocytic Leukemia

131
Q

The only leukemia that is not associated with exposure to radiation***

A

Chronic Lymphocytic Leukemia

132
Q

Chronic Lymphocytic Leukemia (CLL) presentation

A

Waxing and waning painless lymphadenopathy (often in cervical area)*; Enlarged nodes firm, rounded, discrete, non tender, and mobile (50-90%)

133
Q

CLL Labs

A

smear: “basket” or “smudge” cells
Hypogammaglobulinemia
lymphocytosis

134
Q

CLL malignant transformation

A

Richter’s transformation: transformation to a highly aggressive non-Hodgkin lymphoma

135
Q

CLL Tx

A

depends on indolent or active progression
cannot be cured
radiation therapy if localized
no single agreed upon Tx
70-95% CR (complete remission) rate with Fludarabine, cyclophosphamide, rituximab/Rituxan
and ibrutinib/Imbruvica

136
Q

types of lymphomas

A

Non Hodgkin Lymphoma (NHL): 5yr survival 75%
Hodgkin Lymphoma (HL): 11%
95% in adults, 65-74yo

137
Q

Non-Hodgkins Lymphoma

A

Viral etiology implicated in Burkitts, Mediterranean, and T cell, B cell lymphoma/leukemia
chromosome 8, 12

138
Q

NHL presentation

A

aggressive: B symptoms (47%), rapidly growing mass, elevated LD or LDH, elevated uric acid; 50% in western
or indolent: eg hairy cell leukemia
painless lymphadenopathy –> check***

139
Q

NHL complications

A

Epidural spinal cord compression (up to 6%)
Pericardial tamponade
Superior or inferior vena cava obstruction (3-8%)
Hypercalcemia (adult T-cell lymphoma/leukemia)
Acute airway obstruction (mediastinal)
Obstructive uropathy/Renal involvement (2-14%)
Lymphomatous meningitis
Hyperurcemia
Severe autoimmune hemolytic anemia
Hyperviscosity syndrome
Intestinal obstruction, intussusception
Venous thromboembolic disease

140
Q

PE of hairy cell leukemia

A

80-90% splenomegaly

141
Q

hairy cell leukemia Labs

A

anemia
low PLT
dec WBC
monocytopenia

142
Q

Tx of Hairy cell leukemia

A

no cure, just observe initially
Chemo with cladribine (preferred) or pentostatin
interferon alfa if severe
good response

143
Q

Hairy Cell Leukemia

A

B cell lymphoproliferative disorder
almost never in children, usu. 50-55y; more males
indolent lymphoma

144
Q

Diffuse large B-cell**

A

Aggressive NHL
35% of all lymphomas (40% of NHL in central/south america)
AIDS defining malignancy
median age 64

145
Q

Highly Aggressive NHL

A

Adult T-cell lymphoma/leukemia caused by HTLV1 virus

Burkitt’s lymphoma (B-cell)

146
Q

Burkitt Lymphoma

A

Three forms
1. Endemic (African): jaw or facial bone tumor; EBV
2. Non-endemic (sporadic): USA usually in abdominal; 30% pediatric lymphomas
3. Immunodeficiency-related (AIDS, immunodeficiency or solid organ transplantation)
involves lymph, nasopharynx, GI
rapid growing tumor, tumor lysis
LDH elevated
rapid tumor doubling time

147
Q

NHL ChemotherapyIndolent lymphomas*

A

CHOP or R-CHOP*** (rituximab/Rituxan, Cyclophosphamide, doxorubicin, vincristine, prednisone)

148
Q

NHL ChemotherapyAggressive Lymphomas

A

R-CHOP (FIRST LINE) rituximab, cyclophosphamide, doxorubicin, vincristine & prednisone
First line treatment for Activated B cell DLBCL: R-CHOP plus lenalidomide or ibrutinib or bortezomib
GAZYVA/(Obinutuzumab): showing better results than Rituxan

149
Q

what do you have to evaluate for before using Rituxan

A

Hep B or C, can reactivate

150
Q

Hodgkin Lymphoma*

A

75% curable worldwide
10% of all lymphomas
familial Hx HIGH INHERITANCE*
Reed-Sternberg cells*

151
Q

Peak age of Hodgkin Lymphoma*

A

Two peak ages: approximately 20 yo, and 65 yo*

152
Q

Cellular distinction of hodgkin lymphoma*

A

Reed-Sternberg cells: “bull’s eyes”

153
Q

Hodgkin lymphoma presentation

A

asymp lymphadenopathy, rubbery nodes 70%, most common cervical or supraclavicular
nephrotic syndrome
hypercalcemia
anemia
eosinophilia
Leukocytosis, thrombocytosis, lymphopenia
Hypoalbuminemia

154
Q

most common type of classic Hodgkin Lymphoma

A

nodular sclerosis 70%

155
Q

Hodgkin Lymphoma Tx

A

-Radiation therapy (stage I & II and some stage IIIa)ABVD (doxorubicin, bleomycin, vinblastine, decarbazine)
-Chemo for stage III b and IV
ABVD* (BIG DRUG THAT IS USED)
FAVORABLE PROGNOSIS; more relapse in stage 3,4

156
Q

Largest non-cancerous cause of death in Hodgkin survivors.**

A

Cardiac deaths 3.9% with an average of 9.5 years of follow up

157
Q

Hodkin Lymphoma tx longterm toxicities

A

MDS/Myelodysplastic syndrome (maximum risk occurs between 5-9 years)
Infertility (80% males, 50% females)
Pulmonary toxicity (bleomycin) 37% decline in pulmonary function
Cardiomyopathy (doxorubicin) but rarely seen in patients treated with less than 400mg/m2
Cardiac deaths 3.9% with an average of 9.5 years of follow up. Largest non-cancerous cause of death in Hodgkin survivors.
Stroke risk in increase to 2 to 6 fold compared to general population. Risk of stroke in lifetime of a person >25 yo is 25%.
Radiation induced hypothyroidism (30-60%)
Mental health issues, neurocognitive problems, & impaired quality of life are prevalent in survivors

158
Q

Multiple Myeloma*

A

malignancy of the plasma cell (produce immunoglobulins)
5yr survival 52%
median age 66yo
overproduction of a single antibody
proliferate in bone marrow, often results in extensive skeletal destruction w/osteolytic lesions, osteopenia and/or pathological fractures.

159
Q

SxS multiple myeloma

A

Pallor (most frequent physical finding)

hypercalcemia 28%

160
Q

Dx criteria of Multiple myeloma***

A

CRAB

  1. HyperCalcemia (Ca++ >11)
  2. Renal insufficiency (creatinine >2 or creatinine clearance <40)
  3. Anemia (hemoglobin <10)
  4. Bone lesions >4mm in size on Xray/CT/MRI
161
Q

Dx test for multiple myeloma**

A

S-PEP (serum protein electrophoresis

162
Q

DDx of multiple myeloma

A

Acute renal failure

Monoclonal gammopathy of undetermined significance or MGUS

163
Q

Tx of multiple myeloma

A

if “smoldering”, observe
normally, immediate tx required or die in 6mon**
eval for transplantation
3 drug regime: Bortezomib/Velcade, plus Lenalidomide/Revlimid plus dexamethasone/Decadron (VRd)

164
Q

complications of multiple myeloma inducing death

A

Most common bacterial (50%) and renal failure (28%)

165
Q

POEMS SYNDROME(Osteosclerotic Myeloma)

A

Associated with Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin changes.
NOT associated with multiple myeloma
plasma cell dysplasia
liver, lymph, spleen involved

166
Q

“apple core” lesion on film in abdomen

A

near complete obstruction of large bowels; need surgical intervention

167
Q

small cell lung cancer

A 
15% of all lung ca
rapidly metastasizes
brain mets 50% at Dx
cure rate 5%
need chemo, radiation to brain
"coin lesion", pleural effusion, pancoast's tumor, horner's
168
Q

ONCOLOGY EMERGENCIES***

A

A. SPINAL CORD COMPRESSION
B. TUMOR LYSIS SYNDROME
C. HYPERCALCEMIA
D. SUPERIOR VENA CAVA (OBSTRUCTION) SYNDROME

169
Q

superior vena cava syndrome

A

Runs close to apex and median of right upper lobe; tumor here causes –> Blood return here is being cut off and squeeze off slowly; bright red face, swollen arms/head, big blue veins on chest
SX: SOB, chest pain, cough, dysphagia

170
Q

prostate ca Tx

A

Options: Surgery, radiation therapy (external or brachytherapy), or watch and await/ or supervised watchful wait

Oncology (2 decks)

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