Cancer Conditions

Question 1

Which organisms can cause cancer?

Answer 1

• HPV (HPV16)
• EBV
• Hep B
• Retrovirus - HTLV-1 can cause T-cell lymphomas
• H. Pylori

Question 2

What is CEA?

Answer 2

Carcinoembryonic antigen

Question 3

In which cancers is CEA elevated?

Answer 3

• Colorectal
• Pancreatic
• Gastric
• Breast
• Lung

Question 4

In which benign conditions is CA125 elevated?

Answer 4

• Endometriosis
• Menstruation
• Pregnancy

Question 5

In which benign conditions is CEA elevated?

Answer 5

• Smoking
• IBD
• Hepatitis
• Pancreatitis
• Gastritis

Question 6

Which cancer is CA125 commonly used to detect?

Answer 6

Ovarian carcinoma

Question 7

Which cancer is alpha-FP used to detect?

Answer 7

• Hepatocellular carcinoma

- Teratomas

Question 8

Which cancers have elevated BHCG?

Answer 8

Non-seminomatous testicular cancers, some seminoma

Question 9

Which tumour marker is raised in pancreatic cancer?

Answer 9

CA-19-9

Question 10

What is an adenocarcinoma?

Answer 10

Malignant tumour formed from glandular structures in epithelial tissues

Question 11

What is Squamous carcinoma?

Answer 11

Carcinoma of squamous cells in outer epidermis

Question 12

What is the difference between carcinoma and sarcoma?

Answer 12

Carcinoma is a malignant neoplasm of epithelial origin whereas sarcomas originate in supportive and connective tissues

Question 13

Where does a leiomyosaroma originate?

Answer 13

Smooth muscle

Question 14

Where does a mesothelioma originate?

Answer 14

Membranous lining of body cavities

Question 15

Where does a myeloma originate?

Answer 15

Plasma cells of bone marrow

Question 16

Which cancers is MRI the gold standard for?

Answer 16

Neurospinal
Rectal
Prostate
MSK
Staging for head/neck cancers

Question 17

Which questionnaire can be used to assess pain?

Answer 17

McGill Pain Questionnaire (MPQ)

Question 18

Which cancers have screening programs in the UK and when/how often?

Answer 18

Cervical

• 25-64yr olds
• 25-49yrs = every 3 years, 5 years after 50

Breast
- 50-70yrs every 3yrs

Colorectal

• Foecal occult blood (home test kit)
• Offered after 55
• Every 2 years from 60-74

Question 19

What is the most common form of breast cancer?

Answer 19

Invasive/infiltrating ductal carcinoma - 70-80%

Question 20

Where does breast cancer commonly metastasise to?

Answer 20

Bone, lung, liver

Question 21

What 3 investigations are key for diagnosing breast cancer?

Answer 21

• Clinical - history and exam
• Imaging - mammography
• Histology - fine needle aspiration cytology

Question 22

What is a poor receptor prognosis in breast cancer?

Answer 22

HER-2 +ve and ER -ve

Question 23

When is tamoxifen indicated in breast cancer?

Answer 23

ER +ve primary tumours

Question 24

What are complications of tamoxifen?

Answer 24

• Increased thrombotic complications

- Increased risk of endometrial cancer

Question 25

What is Anastrazole/Letrozole?

Answer 25

- Aromatase inhibitors used in breast cancer, more effective in post-menopausal women - Block extra-ovarian oestrogen production

Question 26

When is Trastuzumab indicated?

Answer 26

Overexpression of HER-2 in breast cancer

Question 27

What is a major side-effect of Trastuzumab?

Answer 27

Cardiotoxic

Question 28

Which 3 Chemotherapy agents are common in breast cancer in women >50yrs?

Answer 28

Docetaxel + epirubicin + cyclophosphamide

Question 29

What is the 10yr survival in women with breast cancer?

Answer 29

80%

Question 30

What is the 5yr survival rate for colorectal cancer?

Answer 30

60%

Question 31

What are the 2 types of colorectal cancer?

Answer 31

- Hereditary non-polyposis colon cancer - DNA mismatch repair genes - Familial adenomatous polyposis (FAP)

Question 32

What causes FAP?

Answer 32

Mutation in APC gene

Question 33

What classification tool is used in prognosis for colorectal cancer?

Answer 33

Duke's

Question 34

What is the 5yr overall survival in lung cancer?

Answer 34

20%

Question 35

Which form of lung cancer is the most common?

Answer 35

NSCLC = 82%

Question 36

Although not routinely used, which tumour markers can be used to detect lung cancer?

Answer 36

- NSE = neurone specific enolase | - LDH = lactate dehydrogenase

Question 37

Which form of immunotherapy is rapidly increasing life expectancy in NSCLC?

Answer 37

Anti-PD-1

Question 38

Which grading system is used for Prostate cancer?

Answer 38

Gleason Grading

Question 39

Which mutations increase the risk of prostate cancer?

Answer 39

pTEN | BRCA 2

Question 40

On examination, what is indicative of prostate cancer?

Answer 40

Enlarged, hard, craggy gland with obliteration of the median sulcus

Question 41

What kind of endocrine therapy can be used in the treatment of prostate cancer?

Answer 41

Goserelin and buserelin = LHRH agonists that interfere with normal release of gonadotropins from pituitary and reduces levels of circulating testosterone

Question 42

Which chemotherapeutic agents are commonly used in the treatment of prostate cancer?

Answer 42

Docetael and Cabazitazel

Question 43

Which cancers commonly metastasize to the liver?

Answer 43

- Colon - Lung - Breast

Question 44

Which cancers commonly metastasise to the lung?

Answer 44

- Breast - Kidney - Colorectal

Question 45

Which cancers commonly metastasise to the brain?

Answer 45

- Lung - Breast - Melanoma

Question 46

Which cancers commonly metastasise to the bone? - 5B's

Answer 46

- Breast - Bronchus - Byroid - Bidney - Brostate

Question 47

Which cancers are commonly adenocarcinomas?

Answer 47

- GI tract - Breast - Ovary - Lung

Question 48

Which tumour markers are indicative for testicular cancer?

Answer 48

- bHCG | - aFP

Question 49

What staging system is used in testicular cancer?

Answer 49

Royal Marsden Staging System