Oncology Pt. 3 (Exam 4)

Question 1

What is the leading cause of cancer related death

Answer 1

Lung cancer

Question 2

70% of lung cancer patient present with

Answer 2

advanced or metastatic cancer

Question 3

What is the key to Lung Cancer Treatment?

Answer 3

Early diagnosis

Question 4

Who is most affected by lung cancer

Answer 4

> 65 years

African Americans

Question 5

Lung Cancer Etiology

Answer 5

Cigarette smoking = 85% are current of former

The risk increase with the total number of cigarettes smoked “pack year”

Question 6

Pack Year Calculations

Answer 6

60 year old who smokes 2 pack per day since the age of 20

40x2 = 80 pack year smoking history

Question 7

Lung Cancer Pathophysiology

Answer 7

Overload of carcinogens from smoking plus some sort of genetic pre-deposition from parents

Smoke paralyze cilia and cilia typically sweep away carcinogens.

Lesions develop and genetic structure changes occur

Question 8

Other Risk Factors for Lung Cancer

Answer 8

Passive smoke

COPD (Chronic Inflammation)

Asbestos (Construction)

Radon (common in ky)

Arsenic

Genetics

Question 9

Types of Lung Cancer

Answer 9

Non Small Cell Lung Cancer (NSCLC): Makes up 85% - Slow growing

Small Cell Lung Cancer (SCLC): Rapidly growing tumor that tends to metastasize quickly

Question 10

Signs and Symptoms of Lung Cancer

Answer 10

Cough
Hemoptysis
Wheeze or stridor
Chest pain
Dyspnea
Weight loss
Fatigue
Weakness
Hoarseness

Question 11

Obstruction in the lungs can

Answer 11

cause accumulation of secretions in the bronchioles which can appear as pneumonia

Question 12

How is lung cancer usually found

Answer 12

Via CXR. Lung cancer is typically asymptomatic

Question 13

Paraneoplastic ACTH in Lung Cancer

Answer 13

A common paraneoplastic syndrome involves lung tumor secretion of ACTH

Lung tumors can inappropriately secrete ACTH, which chemically resembles MSH

Melanocytes are stimulated giving the patient with lung cancer a tanned appearance

Question 14

Second most common cancer in the US

Answer 14

Breast Cancer

One in Eight women

Question 15

Most breast cancer develops in

Answer 15

The lining in the ducts from overexpressed

Estrogen Receptors (ER-pos)
or overexpressed
Human Epidermal Growth Factor Receptor (HER2)

Question 16

Breast cancer receptors

Answer 16

Estrogen receptors

Human epidermal growth factor receptor

Question 17

Breast Cancer RF

Answer 17

Age greater than 50

Prolonged reproductive life

Hormone replacement therapy

Obesity (estrogen storage)

Late childbirth

Nulliparous (no pregnancies)

Family history of breast or ovarian cancer

Ashkenazi Jewish Women

BRCA1 and BRCA2 mutation

Question 18

BRCA Genes

Answer 18

Genetic testing for BRCA 1 and BRCA 2 mutations can be preformed in high risk patients with strong Fx of breast or ovarian carcinoma

Genetic counseling should be available for patients undergoing this test

Many women with these gene mutation opt for preventative mastectomy and oophorectomy

Question 19

Individuals with the BRCA 1 and BRCA 2 gene mutations have an increased risk of which cancers?

Answer 19

Breast

Ovarian

Colon

Pancreatic

Prostate

Question 20

Breast Cancer Signs and Symptoms

Answer 20

Nontender

Firm

Irregular borders

Adherence to skin or chest wall

Upper, outer quadrant of breast

Nipple discharge

Swelling in one breast

Nipple or Skin retraction

Peau d’orange

Paget’s disease

Question 21

Peau d’orange

Answer 21

A thickening of skin that resembles an orange peel

Question 22

Paget’s disease

Answer 22

Disease of breast which involves redness, crusting, pruritus, and tenderness of the nipple

Question 23

3rd most common cancer in the US

Answer 23

Cervical Cancer

Question 24

Cervical Cancer: RF’s

Answer 24

Smoking

History of STD’s

HPV infection

Two or more lifetime sexual partners

Immunosuppression

Genetics

Question 25

Types of HPV

Answer 25

The high risk type of HPV causes persistent infection that progresses to cervical cancer The low risk type of HPV causes condylomata (genital warts) but does not cause cervical cancer Almost 100% of cervical cancer test + for HPV

Question 26

Patients should have Pap

Answer 26

Every 3 years

Question 27

Colorectal Cancer

Answer 27

The second leading cause of death because of cancer Beginning at age 50 all adults should have colonoscopy every 10 years

Question 28

Polyps

Answer 28

A tumorous mass that projects into the intestinal lumen. This is what colon cancer usually starts as

Question 29

Familial adenomatous polyposis and Hereditary Non-Polyposis coli

Answer 29

FAP: A well defined hereditary disorder that predisposes an individual to intestinal polyps. (100% of time turn into colon cancer) HNPCC (not likely to develop into colon cancer)

Question 30

Colorectal Cancer RF's

Answer 30

Obesity Tobacco use Physical inactivity Insulin resistance Low fiber in the diet High amount of animal fat in the diet Diets low in Vit A-C-E Ulcerative colitis Heavy alcohol use

Question 31

Symptoms of Colorectal Cancer

Answer 31

Fatigue Weakness Weight loss Iron deficiency anemia Changes in bowel habits Melena (blood in stool) Diarrhea Constipation Hematochezia (rectal bleeding)