W07_07 Principles of medical oncology

Question 1

what does breast cancer present with?

Answer 1

abnormal mammogram + breast lump

Question 2

what does prostate cancer present with?

Answer 2

high psa, obstructive urinary problems

Question 3

what does colon cancer present with?

Answer 3

GI bleeding, change in bowel habits, positive colon CA screening

Question 4

what does lung cancer present with?

Answer 4

cough, shortness of breath, chest pain (advanced cancer)

Question 5

what does pancreatic cancer present with?

Answer 5

abdominal pain, obstructive jaundice

Question 6

what are the 3 types of biopsies that can be performed?

Answer 6

fine needle aspirate;
core biopsy;
excisional biopsy

Question 7

what scale is used for performance status in oncology?

Answer 7

ECOG (eastern cooperative oncology group)

Question 8

briefly outline the ECOG scale

Answer 8

0 - no restrictions;
5 - dead;
4 - bedridden;
2/3 - bedridden for 50% of time

Question 9

what are the goals of chemotherapy?

Answer 9

cure (e.g. acute leukemias);
cure along with radiotherapy (ENT cancers);
(neo)adjunctive

Question 10

note: chemotherapy can be palliative to ease symptoms AND increase survival

Answer 10

ok

Question 11

what’s the goldie coldman hypothesis?

Answer 11

there’s a spontaneous rate of resistance that emerges in a tumour, so the larger the tumour, the more cells, the higher chance of resistance

Question 12

what are the major side effect sites of chemotherapy?

Answer 12

bone marrow (anemia, neutropenia, thrombocytopenia),
GI (mucositis, nausea/vomiting, diarrhea),
hair loss, fatigue, thinning etc.

Question 13

what are 3 long-term potential side effects of chemotherapy?

Answer 13

cardiomyopathy,
secondary malignancy;
peripheral neuropathy

Question 14

drugs that end in -nib are which kind of drug?

Answer 14

tyrosine kinase inhibitors (e.g. imatinib)

Question 15

drugs that end in -mab are which kind of drug?

Answer 15

monoclonal antibody (e.g. trastuzumab)

Question 16

how to take an oncologic history?

Answer 16

• symptoms that led to investigations + important risk factors (e.g. smoking);
• diagnosis from pathology
• staging from pathology/radiology
• treatment received so far
• performance status
• symptoms
• patient’s understanding of illness

Question 17

how is a diagnosis of malignancy made?

Answer 17

biopsy

Question 18

note: staging is done through both pathology and imaging

Answer 18

ok