Principles of Surgical Oncology

Question 1

What characteristic links all cancers?

Answer 1

Uncontrolled cell growth and proliferation

Question 2

True or False:

Cancer is considered a genetic disease.

Answer 2

TRUE

Question 3

What are other factors that could cause cancer?

Answer 3

Chemical: environment, tobacco, pesticides

Physical: sunlight, trauma, chronic inflammation, implants, magnets

Hormonal: estrogen/progesterone, testosterone

Viral: papillomavirus, retrovirus, FELV/FIV

Question 4

What do you call the length of time from date of diagnosis or start of treatment that 1/2 of the patients with the disease are still alive?

Answer 4

Median survival time

Question 5

What do you call the period from diagnosis until the 1st recurrance?

Answer 5

Disease free interval

Question 6

What do you call obtaining tumor tissue for microscopic analysis?

Answer 6

Biopsy

Question 7

What do you call the process of determining the extent of a tumor and the presence of regional and distant metastasis?

Answer 7

Staging

Question 8

What 3 tests does staging ALWAYS include?

Answer 8

CBC/Chem/UA

Thoracic radiographs

Regional lymph node aspirates/biopsies

Question 9

In the World Health Organization TNM Classification system, what do T, N, and M stand for?

Answer 9

T = tumor

N = node

M = metastasis

Question 10

True or False:

Metastasis can be present despite a lack of lymph node enlargement.

Answer 10

TRUE

Question 11

In evaluating the lymph nodes, what needs to be done at minimum?

Answer 11

Fine needle spirate

Question 12

What is the ultimate diagnostic tool in oncology?

Answer 12

Histopathology

Question 13

What 2 pieces of information can histopathology tell you?

Answer 13

Tumor type

Tumor grade

Question 14

What is the guideline for formalin fixation?

Answer 14

1 part tissue to 10 parts formalin

Question 15

Always change ____ and instruments when performing biopsy on multiple tumors.

Answer 15

Gloves

Question 16

For which types of lesions can a punch biopsy be used?

Answer 16

Superficial lesions - skin, oral, perianal tumors, liver

Question 17

Which biopsy technique is best for ulcerated and necrotic lesions?

Answer 17

Wedge biopsy

Question 18

When can you use an excisional biopsy?

Answer 18

Small cutaneous mass reexcision with 2-3 cm margin in all directions

Cytology clearly indicates a benign lesion

Tumor type does not change treatment plan

Risk of biopsy equal or higher to surgical risk

Surgical emergencies

Question 19

True or False:

Fine needle aspirate of lytic bone does not require anestesia.

Answer 19

TRUE

Question 20

Answer 20

Trephine

Question 21

Answer 21

Jamshidi

Question 22

When should a regional lymph node be excised?

Answer 22

When known to contain tumor cells

When grossly abnormal

When in surgical margins

Question 23

What are the 4 types of resection?

Answer 23

Intracapsular

Marginal

Wide

Radical

Question 24

With which resection is macrscopic disease left behind?

Which which resection is microscopic disease potentially left behind?

Answer 24

Intracapsular resection

Marginal resection

Question 25

Which type of resection is typically the most appropriate form of treatment?

Answer 25

Wide resection

Question 26

What are the margins of a wide resection?

Answer 26

2-5 cm

Question 27

What are the margins of a radical resection?

Answer 27

Margins extend beyond anatomical compartment (Limb amputation, chain mastectomy)

Question 28

What type of tumors might intracapsular excision be used for?

Answer 28

Thyroid Parathryoid

Question 29

Which excision is "just out the pseudocapsule"?

Answer 29

Marginal excision

Question 30

What is an example of a tumor where marginal excision can be used?

Answer 30

Lipoma

Question 31

What 4 things does a wide excision remove?

Answer 31

1. En bloc removal of the mass 2. Pseudocapsule 3. Reactive zone 4. Normal margin or tissue

Question 32

What is a broad example of tumor where wide excision might be used?

Answer 32

Low grade, minimally invasive malignant tumor

Question 33

What are your skin margins for a sarcoma?

Answer 33

3-5 cm on skin 1-2 fascial planes deep

Question 34

What are your skin margins for a mast cell tumor?

Answer 34

1-3 cm on skin 1 fascial plane deep - ALWAYS

Question 35

What is you minimal margin for an oral tumor?

Answer 35

1 cm minimum

Question 36

Which tumor type might require a radical excision?

Answer 36

Highly invasive, poorly localized malignant tumor

Question 37

True or False: It is necessary to change ALL instruments and glove for wound closure.

Question 38

True or False: Primary closure is not always preferred in tumor removal.

Answer 38

FALSE Close with primary repair whenever possible!

Question 39

In closure of the wound after tumor removal, what are the 3 things that should be avoided?

Answer 39

Tension Dead space Drains

Question 40

Samples should be allowed to dry. About how long should you wait before placing that sample in formalin?

Answer 40

About 20 minutes

Question 41

Histopathology is NOT an \_\_\_\_.

Question 42

Histopathology not only allows for a definitive diagnosis, it will also assist in the evaluation of what?

Answer 42

Margins

Question 43

Adjuvant therapy is generally good in helping fight microscopic disease but is less effective for _____ disease.

Answer 43

Macroscopic

Question 44

Where should vaccines be given in cats? Where should vaccines NOT be given in cats?

Answer 44

Give as distal on limbs as possible AVOID INERSCAPULAR AREA!!!