CCC- cancer intro

Question 1

Which cancer has highest incidence

Answer 1

Lung

Question 2

Top 4 cancer women

Answer 2

Breast Lung Bowel Uterus

Question 3

Top 4 cancer men

Answer 3

Prostate Lung Bowel Bladder

Question 4

Name of the interval between symptom onset and presentation

Answer 4

patient interval

Question 5

name of the interval between presentation and referral

Answer 5

primary care interval

Question 6

name of interval between referral and secondary care

Answer 6

referral interval

Question 7

What are the five types of systemic anti-cancer treatment?

Answer 7

Cytotoxic Hormone Biologic/targeted Immunotherapy Radioisotopes

Question 8

Two types of biologic/targeted therapy?

Answer 8

monoclonal antibodies tyrosine kinase inhibs

Question 9

What is radical chemo?

Answer 9

Curative intent

Question 10

What is primary chemo?

Answer 10

The main treatment

Question 11

What is neo-adjuvant chemo?

Answer 11

Before surgery or radio

Question 12

What is adjuvant chemo?

Answer 12

After surgery

Question 13

What is chemoradiation

Answer 13

chemo with radio

Question 14

What is palliative chemo

Answer 14

incurative advanced disease

Question 15

when is high dose chemo given?

Answer 15

With bone marrow or stem cell transplant

Question 16

A repeating pattern of treatment and rest days is called

Answer 16

a cycle

Question 17

The complete pattern of cycles is the

Answer 17

course

Question 18

What is the ‘line’ in cancer treatment?

Answer 18

Order of treatments

Question 19

Three haem side effects of chemo

Answer 19

anaemia thrombocytopenia neutropenia

Question 20

What is the name of the nail change seen in chemo? what are they?

Answer 20

Bow lines- lines of weakness as they stop growing for a bit- they may correspond to timing of chemo delivery

Question 21

What is hand-foot syndrome? What might it indicate?

Answer 21

side effect of chemo- redness, pain and peeling of hands, soles of feet and sometiems scrotum. Can be a warning that sensitive to the drug

Question 22

Could hand-foot syndrome happen with all chemo?

Answer 22

No only certain drugs

Question 23

Which organs with a low rate of renewal might chemo effect?

Answer 23

heart, peripheral nerves, hearing

Question 24

True or false, chemo is a risk factor for VTE but cancer itself is not

Answer 24

False- both are. And it is also made worse by being immobile, old etc.

Question 25

Which chemos are especially bad for VTE risk

Answer 25

Platinum based

Question 26

What two things determine how a patient tolerates chemo?

Answer 26

Patient fitness (co-morbs, WHO performance status, frailty index) Dose

Question 27

What is the WHO performance status

Answer 27

0=fit 5=dead if can hoover, \>/=1

Question 28

Immunotherapy side effects can mimic \_\_\_\_. How do you manage them, broadly?

Answer 28

Infection Steroids

Question 29

True or false immunotherapy side effects only occur during the course of treatment

Answer 29

False, can occur after

Question 30

Radiotherapy can be delivered by which two types of particle?

Answer 30

Photons (deeper, produce secondary electrons in tissue) or electrons (superficial)

Question 31

Radiotherapy is delivered by what machine?

Answer 31

Linear accelerator

Question 32

How does RT work?

Answer 32

Damaging DNA- cancer cells can't repair damage like normal cells can. Mitotic or apoptotic cell death

Question 33

What unit is RT dose in?

Answer 33

Gray (Gy)

Question 34

What is each dose of RT called?

Answer 34

A fraction

Question 35

Does radical or palliative RT have a longer course, more RT and more fractions?

Answer 35

Radical

Question 36

7 stages of RT

Answer 36

1. consent 2. immobilisation 3. ct simulation 4. tattoos 5. volume definition 6. RT 7. follow up

Question 37

Name each area

Answer 37

Top to bottom: Gross tumour volume Clinical target volume Planning target volume Treated volume Irradiated volume

Question 38

What is tungsten used for in RT?

Answer 38

Constantly shapes the beam to the shape of the tumour as it is delivered

Question 40

Why does RT toxicity occur?

Answer 40

Transient damage to normal cells

Question 41

Short term reactions to RT are often '-\_ _ \_ _ '

Answer 41

-itis

Question 42

Long term reactions to RT are often '-\_ _ \_ \_'

Answer 42

-osis

Question 43

Examples of RT side effect to head and neck and some possible supportive treatments

Answer 43

Raditaion dermatitis (skin care) Mucositis (mouth care) Thick oral secretions (pain swallowing and salivary gland damage- may be permament fibrosis) (nutritional support, analgesia, mouth care) Loss of taste Fatigue Dry mouth (analgesia, admission)

Question 44

What could you give to help prostatitis caused by prostate ca RT

Answer 44

Alpha blocker to increase flow

Question 45

What is the benefit of giving RT as well as CT?

Answer 45

Makes radio more effective

Question 46

What is 'verification' in RT?

Answer 46

Pt in same position each time

Question 47

Which four cancers are the source of 80% bone mets?

Answer 47

Lung Breast Renal Prostate

Question 48

How are mets normally spread to bones?

Answer 48

Haematogenous

Question 49

Likely sites of bone mets?

Answer 49

Skull Prox humerus Vertebrae Pelvis Prox femur

Question 50

3 types bone mets

Answer 50

Lytic Sclerotic Mixed

Question 51

Bone mets can be bone ____ or bone \_\_\_\_\_

Answer 51

Loss or formation

Question 52

Which imaging modalities are good to see bone mets?

Answer 52

X-ray: difficult to see if \<30-50% density loss CT good MRI sens to bone marrow changes