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4D - Oncology and Palliative Care > Oncology - Lung and Prostate Cancer > Flashcards

Oncology - Lung and Prostate Cancer Flashcards

1
Q

what is the lifetime risk of cancer

A

1 in 2

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2
Q

What are the 4 types of cancer treatment

A
  1. surgery
  2. chemotherapy
  3. radiotherapy
  4. immunotherapy
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3
Q

3 types of curative cancer treatment

A
  1. neoadjuvant
  2. radical
  3. adjuvant
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4
Q

radical treatment

A

curative on its own or as part of a curative regime

a definitive treatment

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5
Q

neoadjuvant treatment

A

using chemo/radio/immuno to shrink and then surgery to remove

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6
Q

most common side effect of lung cancer

A

hypercalcaemia

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7
Q

general trend of lung cancer in males and females

A

reducing in men
rising in women

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8
Q

average 1 year survival rate for lung cancer

A

31%

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9
Q

average 5 year survival rate for lung cancer

A

9%
very low

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10
Q

2 types of lung cancer

A

non-small cell
small cell

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11
Q

types of non-small cell lung cancer and %

A

non small cell - 81%

adenocarcinoma 38%
squamous call carcinoma 20%
large cell 5%
other 18%

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12
Q

prevalence of small cell lung cancer

A

13%

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13
Q

EGFR mutation cancers most common in

A

females
never-smokers

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14
Q

ALK mutation cancers prevalence and drug treatment

A

5% of lung cancers
alectinib

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15
Q

target for immunotherapy for lung cancer

A

PDL-1

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16
Q

local symptoms of lung cancer

A

Cough
Breathing Problems, SOB, stridor
Change in phlegm
Lung infection
haemoptysis
Hoarseness, Hiccups
Wt loss
Chest Pain and tightness

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17
Q

metastatic symptoms of lung cancer

A

BONE PAIN - persistent pain needs to be investigated
Headaches,
Neurologic findings
Abdominal pain,
Enlarged liver
Anorexia
Cachexia
jaundice
Weight loss

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18
Q

Investigations for lung cancer

A

Biopsy (cannot treat with chemo without biopsy)
- bronchoscopy/EBUS
- maybe CT guided

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19
Q

lung cancer staging

A

TNM

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20
Q

treatment or stage 1-2 NSCLC

A

SURGERY if possible
+/- adjuvant chemotherapy (to improve the results of RT and also surgery) +/- radiotherapy if still localised but cannot be resected)
If unfit: stereotactic radiotherapy

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21
Q

treatment for stage 3 NSCLC

A

Radical chemoradiotherapy
Radical radiotherapy alone

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22
Q

treatment for stage IV NSCLC

A

palliative intent chemo only

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23
Q

what are the 3 surgical options for lung cancer

A

lobectomy
pneumonectomy
wedge removal

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24
Q

can you offer surgery for SCLC

A

NO

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25
Q

what is this

A

pneumonectomy
trachea deviated and stoma bubble
surgical clips

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26
Q

what is this

A

pneumothorax
and then pleural effusion due to a mass

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27
Q

67yr female
Known metastatic breast cancer. Bone, lymph nodes, liver
Only on hormone treatment
Presenting to A&E – unwell, fatigue, constipation.
Family – Pt more forgetful and confused than usual
what is your first possible diagnosis and main concerns

A

hypercalcaemia

also ensure you MUST check for urine and/or chest infection

CT head - for brain mets

28
Q

what is the hypercalcaemia symptoms

A

Bones, stones, groans, moans
bone pain, renal stones, body pain and confusion

29
Q

managment of hypercalcaemia

A
  1. CHECK heart and blood pressure
  2. fluids - 1litre over 2hrs
  3. bisphosphonates - 60-90mg pamidronate IV over 2 hrs
30
Q

what are the signs and symptoms of superior vena cava obstruction

A

SOB
Facial swelling, arm swelling, upper venous engorgement

31
Q

treatment of superior vena cava obstruction

A

Steroids:
frequently prescribed but no evidence to support their use dexamethasone 8mg B.D.

Chemotherapy:
used for SCLC with good response rate

Radiotherapy:
High response rates for Squamous
cell Lung cancer~60%.
Stent:
95% response rate. Rapid relief of symptoms
but doesn’t treat the cause.
If there is a clot anticoagulation treatment

32
Q

what is the most common cancer in men

A

prostate

33
Q

what is the overall most common cancer in both men and women

A

lung

34
Q

at what age is prostate cancer most common

A

70-75

35
Q

where is prostate cancer most common

A

europe, north america, australia

36
Q

what are the 2 tissue types which make up the prostate

A

70% glandular tissue
30% fibromuscular stroma

37
Q

how many lobes are there in the prostate

A

5

38
Q

which lobe is the only one which can be palpated

A

posterior (with a DRE)

39
Q

how many pathological zones are on the prostate

A

4

40
Q

which pathological zone is most common for prostate cancer

A

70% in peripheral zone

41
Q

what are the 2 germline mutations common in prostate cancer

A

BRCA1 and BRCA2

42
Q

what is the lifetime risk of prostate cancer in men

A

1 in 8

43
Q

what are some of the risk factors of prostate cancer

A

age (over 50)
FHx
black
diet
BRCA1 and BRCA2 mutations

44
Q

what is the most common pathology of prostate cancer

A

90% adenocarcinoma

45
Q

where does prostate cancer metastasis to

A

bone, liver, lung

46
Q

what lymph nodes does prostate cancer first spread to

A

pelvic -
or para-aortic

47
Q

what are local signs and symptoms of prostate cancer

A

LUTS
Haematuria
perineal pain

48
Q

what are signs and symptoms of metastatic prostate cancer

A

Lymph nodes:
Lower body oedema

Bone:
Pain
Nerve / cord compression
Anaemia
Hypercalcaemia

Liver:
Jaundice
Ascites

49
Q

what initial investigations should be undertaken for suspected prostate cancer

A

PSA and DRE
CT scan if PSA over 40

50
Q

what is the scoring system for prostate cancer

A

gleason

51
Q

what are the 5 levels of gleason scoring
(a score of microscopic appearance of biopsy spec)

A

1=Well-differentiated
2-3=Moderately differentiated
4=Poorly differentiated
5=Undifferentiated

52
Q

how is gleason score calculated

A

first by grade of most dominant cell type
then add the grade of the highest grade of cells seen

3.g. of 4 biopsies most common cell type is stage 3
highest grade seen is stage 4
therefore 3+4 stage

53
Q

what is this

A

Left peripheral zone tumour
T2 / ?early T3a

54
Q

what is this

A

Locally advanced invading pelvic sidewall
T4

55
Q

what are the 5 stages of the WHO general health and function status

A

0=Fit and active

1=Well, but no strenuous activity

2=Self-caring, >50% of the day

3=Self-caring, <50% of the day

4=bedbound

5=Dead

56
Q

what are the 2 approaches for prostate biopsy

A

trans-perineal - most common
TRUS biopsy

57
Q

what are the options for early prostate cancer

A
  1. watch and wait
  2. surgery
  3. radiotherapy
  4. neoadjuvant or hormone therapy
58
Q

what are the 2 radiotherapy options for prostate cancer

A
  1. prostate brachytherapy (insert small radioactive pellets)
  2. external radiotherapy beam
59
Q

what hormone therapy can be offered to prostate cancer patients

A

androgen deprivation therapy

60
Q

what are the 2 main types of hormone therapy offered for prostate cancer

A

LHRH analogues and Androgen receptor antagonists

61
Q

give and example of an LHRH analogue and the most important side effect of the drug

A

Goserelin (Zoladex)
causes an initial tumour flare

62
Q

2 examples of Androgen receptor antagonists

A

Bicalutamide (Casodex)
Enzalutamide (Xtandi)

63
Q

what are common side effects of androgen deprevation therapy

A

Hot flushes

Reduced libido
Erectile dysfunction
Gynaecomastia (growth of breast tissue)

Osteopaenia (loss of bone density)
Sarcopaenia (loss of muscle mass)

Insulin resistance
Weight gain

Mood swings
Fatigue

64
Q

what is the management of spinal cord compression

A

Dexamethasone 16mg per day
PPI (for gastroprotection)

Urgent MRI of while spine to determine exact location

65
Q

what anti epileptic drug is used for seizures due to brain metastasis

A

Levetiracetam (keppra)

66
Q

What antiemetic should be absolutely avoided in a patient with bowel obstruction and bowel cancer

A

metoclopramide

4D - Oncology and Palliative Care (14 decks)

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