S1: Cancer Therapy

Question 1

What is the time limit that patients with suspected tumours should be seen in?

Answer 1

2 weeks

Potential cancer patients are prioritised to improve the outcome of treatment

Question 2

What are the factors that affect the choice of therapy?

Answer 2

· Site
	· Spread
	· Stage
	· Histology
	· Patients general condition
	· Sensitivity of tumour
	· Patient preference 
	· Resources

Question 3

Explain how undiffrentiated/anaplastic tissue is different from the cells of origin

Answer 3

The cells appear primitive and lack specialisation along with any particular cell line

They respond worse to treatment compared the differentiated tissues

They can be so different that the site of origin cannot be found

Question 4

What does radioresistent tumours mean?

Answer 4

Tumours that do not shrink during radiation

Question 5

List some treatment approaches to cancer

Answer 5

• Radical- Radical aims to get rid of cancer completely
• Palliative is used to slow the growth of cancer and relieve the symptoms
• Sole treatment modality
• Part of a combined therapy
• Adjuvant therapy: Given in addition to priamary treatment afterwards
• Neo-adjuvant: Given before primary treatment
• Prophylactic therapy: Preventative

Question 6

Give an example of neo-adjuvant therapy

Answer 6

If breast tumour is to large then chemotherapy is used to reduce the size and then the tumour is surgically removed

Question 7

In what ways can surgery be used to treat cancer?

Answer 7

• For the management of the primary tumour
• For the management of regional lymph nodes
• The use palliative surgery

Question 8

Explain how surgery of primarily tumour can be used in several ways for management

Answer 8

▪ To do a tissue biopsy to establish a diagnosis
▪ To remove a malignant disease that has a clear margin with normal tissue
▪ Repair, reconstruction and restoration of normal function.

Question 9

Why is surgical excision of regional lymph nodes often carried out?

Answer 9

Surgical excision of regional lymph nodes (lymph nodes around the area where the cancer is), is commonly done in order to see if the cancer has spread.

• If an individual has breast cancer, the axillary nodes will be looked at
• If head/neck cancer then a radical neck dissection will be done - If cancer of vulva, anal and or penile tissue then an inguinal node dissection will be done.

Question 10

Why is palliative surgery used?

Answer 10

To control the disorder

e.g. relief of obstructive symptoms

Question 11

What is radiotherapy?

Answer 11

Radiotherapy is the treatment of malignant disease with high energy x-rays or gamma rays.

Question 12

What are the types of radiotherapy?

Answer 12

An external beam can be used, such as particle therapy, or internal radiotherapy (also known as brachytherapy), where a radioactive source is placed inside the patient and very high doses given over a short period of time.

Question 13

What are the side effects of radiotherapy?

Answer 13

Side effects of radiotherapy are site dependent, dose dependent and depend on whether the tissue is early or late responding. Side effects include:

Skin reactions, hair loss, GI disturbances, Tissue fibrosis

Question 14

When is chemotherapy used?

Answer 14

As adjuvant therapy

There is high sensitivity, modest sensitivity and low sensitivity.

Question 15

Give an example of hormone therapy

Answer 15

e.g. zoladex for prostate cancer