Surgical Oncology

Question 1

What are the steps of Getting treated for Ca?

Answer 1

Diagnosis and staging: obtain tissue, stage, monitor for response to therapy
Fine needle aspiration: done in office, takes cells and needs to be read by cytopathologist.
Core Needle biopsy: needle takes a core of tissue out, can look at architecture, more infvasive, more tissue info
Incisional/Excisional biopsy: when previous ones dont work, take out part or the whole mass. may make sx more challenging
Remove needle track in sx

Question 2

What are the diff ways to do sx?

Answer 2

Primary tumor resection: Take out tumor and normal tissue around the tumor. margin.

Resection of regional lymph nodes: most prevelent for solid tumors, important in prognosis, prevents recurrence, imp for predicting who does well and not

Resection of Metastatic Dz: survival is good if we go after the metastatic implant. based on disease process and health of the pnt.

Tumor debulking; removing as much as is feasible. and ppl do better.

Question 3

How do you use surgery to prevent cancer?

Answer 3

Angelina Jolie.
BRCA 1/2
Undescended testicle has higher risk for ca - pull it down
Genetic problems linked with cancers can be treated with sx (colectomy, thyroidectomy, mastectomy, etc.)

Question 4

What is the palliative role of Sx in cancer?

Answer 4

Improvement of QOL
remember that sx is a trauma and last thing we want is to kill them.
common: pain, obstruction, vascular access, feeding tube, pain, bleeding, wounds

Question 5

patients have an ASA class

Answer 5

rated based on health, comorbidities, etc. the bigger the number, the worse off the patient is and will likely do worse with sx

Question 6

Patient selection

Answer 6

ECOG - classification system
Karnofsky - classification system
0 on ecog is 100% on K. fully active, no complaints.
5 on ecog is 0% on K , bad

Question 7

DO all ca need to be treated with sx?

Answer 7

NO. some are better with chemo/radiation

Question 8

What are the major challenges associated with this?

Answer 8

Accurate identification of pnts who can be cured
Selection of local treatments that provide balance between local cure and impact of adjuvant treatements on survival and QOL

Question 9

want to find it early.

Answer 9

get screened. mutations accumulate.

Question 10

what are the risk factors of Colon cancer?

Answer 10

Age, hi fat diet, polyps, hx, famhx, IBD,

Symptoms: change in bowel habits, bleeding,