Oncology

Question 1

2 types of radiotherapy

Answer 1

External beam, brachytherapy

Question 2

SE of radiotherapy

Answer 2

Fatigue, localised soreness, fibrosis, normal tissue damage

Question 3

Cure rate of radiotherapy for localised disease?

Answer 3

20-50%

Question 4

Name 5 chemosensitive tumours

Answer 4

Choriocarcinoma, testicular cancer, leukaemia, Hodgkin’s lymphoma, some sarcomas

Question 5

Ablation is used in what cancer?

Answer 5

Localised liver, skin, kidney and lung cancer

Question 6

What is classified as neutropenic sepsis? Treatment?

Answer 6

Neutrophils38º
Start broad spectrum antibiotics immediately
Can be dead within 6 hours

Question 7

Name 6 biomarkers used for personalised therapy

Answer 7

ER, PR receptors,
EGFR, ALK, BRAF mutations
Her-2 cell surface antigen

Question 8

SE of chemotherapy

Answer 8

Fatigue
Reversible alopecia
Nausea and vomiting and diarrhoea
risk of infection
Oral mucositis
Premature menopause

Question 9

Women’s lifetime risk of breast cancer

Answer 9

1/8

Question 10

12 risk factors for breast cancer

Answer 10

Age, FH
High breast density
Alcohol, overweight, not exercising
Not having children before 30
Not breast feeding
HRT/pill/early periods/late menopause
Radiation exposure
Previous breast cancer
Ethnic group
Being taller

Question 11

Give some symptoms of breast cancer

Answer 11

Lump, pain, nipple discharge
Nipple retraction, breast distortion
Swelling, scaling nipple
Metastatic symptoms

Question 12

In TMN staging, what classifies T3?

Answer 12

> 5cm

Question 13

How do you diagnose breast cancer?

Answer 13

Triple assessment:
History & examination
Mammogram/ultrasound/MRI
Biopsy

Question 14

Name some classes of systemic treatments for breast cancer

Answer 14

Hormone therapies, chemotherapy, biological therapy, bisphosphonates/denosumab

Question 15

When does screening happen for breast cancer?

Answer 15

All women over the age of 50 get screened every 3years on a rolling basis until 70

Question 16

Sensitivity and specificity of breast screening?

Answer 16

Sens: 83-95%
Spec: >80%

Question 17

What % of cancer is detected by screening versus 2 week wait clinic after presentation to GP or self referral?

Answer 17

30% screening

50% 2 week wait clinic

Question 18

A well circumscribed breast lesion could be:

Answer 18

Benign cyst
Benign fibroadenoma
Breast cancer
Breast lymphoma
Metastasis

Question 19

A stellate lesion on the breast could be:

Answer 19

Breast cancer
Traumatic fat necrosis
Radial scar
Hyalinised fibroadenoma

Question 20

What are the options for post mastectomy breast reconstruction?

Answer 20

Single sided padded bra/ breast prosthesis
Prosthetic reconstruction w/slwoly enlarging artificial implants
Latissimus dorsi reconstruction
Abdominal flap reconstruciton
Nipple reconstruction & tattoo

Question 21

What proportion of breast cancer is hereditary? and what % are BRCA-1 or 2?

Answer 21

5-10%, almost all of these are thought to be BRCA-1 or 2

Question 22

What is the risk of breast cancer if it is hereditary in your family (1º relatives before age of 50, man has had breast cancer, women w/cancer in both breasts)

Answer 22

Up to 80%

Question 23

What are women with hereditary breast cancer in their family also at risk of?

Answer 23

Ovarian, colonic, pancreatic cancer

Melanoma

Question 24

What are the common sites for breast cancer metastasis?

Answer 24

Lymph nodes (contralateral/axillary)
Bone, brain
Liver, lung

Question 25

How many characteristics for cancer cells have been described by Hanahan and Weinberg?

Answer 25

10

Question 26

2 types of apoptosis

Answer 26

Intrinsic and extrinsic
Intrinsic cell stress and DNA damage, growth factor removal, cell detatchment
Extrinsic cytotoxic T cells & NK cells -> initiator capsases

Question 27

BCl-2?

Answer 27

50% human cancers overexpress Bcl-2
Resistance to chemo and radiation
Pro survival

Question 28

What is ABT-737 and ABT-199?

Answer 28

BCL-2 inhibitor and BH-3 mimetic, inhibits pro survival molecules