Questions for Cancer examples

Question 1

A 29 year-old male patient presents at the clinic with symptoms of weight loss and rectal bleeding. He is later diagnosed with colon cancer, and the pathology report notes local inflammation and immunologic reaction around the tumour site.

a) List THREE other presenting symptoms (or signs) of colon cancer patients.
b) The patient’s doctor attempts to stage the patient’s cancer using the Dukes’ staging system. The patient’s cancer has metastasized to the lymph nodes, but the apical lymph node is negative. What Dukes’ stage is this?
c) List TWO clinical features and TWO pathology features this patient has and their effect on his prognosis.

Answer 1

a) ● Altered bowel habit ● Unexplained iron deficiency anaemia ● Discharge of mucus PR ● Bloating ● Intermittent ‘colicky’ abdominal pain ● Intermittent obstruction leading to bloating/swelling of the abdomen ● Tiredness and malaise (linked to iron deficiency anaemia)
b) C1
c) Male – diminished; age <30 – diminished; rectal bleeding as the presenting symptom – improved; lymph invasion to nodes – diminished; local inflammation and imm reaction – improved

Question 2

Describe how leukaemia can lead to:

a. Leucocytosis
b. Splenomegaly
c. Anaemia
d. Thrombocytopaenia
e. Neutropenia
f. Sepsis
g. Lymphadenopathy
h. Renal failure

Answer 2

a. Leucocytosis – Increased production of white cells as a result of all leukaemias
b. Splenomegaly – Due to increased white cell pooling in the spleen
c. Anaemia – Due to bone marrow crowding out of normal cells by infiltrating cancerous cells.
d. Thrombocytopaenia – Due to bone marrow crowding out of normal cells by infiltrating cancerous cells.
e. Neutropenia - Due to bone marrow crowding out of normal cells by infiltrating cancerous cells.
f. Sepsis - Increased white cell production, but the white cells cannot perform normal immune functions, so the patient is susceptible to infections.
g. Lymphadenopathy – Increased lymphocyte numbers pool in lymph nodes > lymphadenopathy
h. Renal failure – Hyperuricaemia is one of the consequences of rapid cell proliferation, which can cause renal failure

Question 3

Which one of the following is NOT a risk factor for breast cancer?

a) Age
b) Early menopause
c) Early menarche
d) Obesity
e) OCP

Answer 3

B – Early Menopause

Remember with Breast cancer there is increased risk with prolonged exposure to oestrogen

Question 4

A.State 4 symptoms of non-metastatic prostate cancer.

B.State 4 symptoms of metastatic prostate cancer

Answer 4

A

–Hesitancy

–Poor stream

–Terminal dribbling

–Nocturia

–pain when urinating

B)

–Bone pain

–Cord compression

–Systemic symptoms: malaise, anorexia, weight loss

–Paraneoplastic syndromes (e.g. hypercalcaemia)