Principles of Oncology 1

Question 1

What are the four defining features of cancer?

Answer 1

1. Unregulated cell division
2. Avoidance of cell division
3. Tissue invasion
4. The ability to metastasize

Question 2

How many deaths are caused by cancer in the US?

Answer 2

1 in 4

Question 3

How many people will be diagnosed with cancer in their lifetime?

Answer 3

40%

Question 4

What is the most significant risk factor for cancer?

Answer 4

Age

Question 5

What group are cancers most deadly in?

Answer 5

African Americans

Question 6

What are the top 3 cancers in the US?

Answer 6

1. Breast
2. Prostate
3. Lung

Question 7

What are the top 3 causes of cancer deaths in the US?

Answer 7

1. Lung
2. Breast
3. Prostate

Question 8

What determines if an environmental exposure will cause cancer?

Answer 8

How long and how often the person is exposed

Question 9

What percentage of cancers are directly linked to tobacco?

Answer 9

30%. 80% of lung cancers are smoker related

Question 10

Are light cigarettes more safe?

Answer 10

No because people smoke them more often and deeper

Question 11

What kinds of cancer does physical activity reduce the risk of?

Answer 11

Colon and breast cancer

Question 12

Diets high in what have an increased risk of cancer?

Answer 12

Fat

Question 13

What cancers does EBV cause?

Answer 13

Burkitt’s lymphoma, nasal T cell lympoma

Question 14

What cancers do estrogens cause?

Answer 14

Endometrial, liver, and breast

Question 15

What cancers do alcohol cause?

Answer 15

Liver, esophagus, head and neck

Question 16

What cancers does H pylori cause?

Answer 16

Gastric cancer and gastric MALT lymphoma

Question 17

What cancers do hepatitis B and C cause?

Answer 17

Hepatitis

Question 18

What cancers do UV light cause?

Answer 18

Skin cancer

Question 19

What cancers do tobacco cause?

Answer 19

Upper aerodigestive tract, bladder

Question 20

What age are mammograms recommended?

Answer 20

40 or 10 years before age of family onset

Question 21

What age are colorectal screenings recommended?

Answer 21

45

Question 22

What age is cervical cancer screening recommended?

Answer 22

21-65 (can reduce from 3 years to 5 years at 30)

Question 23

What is CAUTION?

Answer 23

Change in bowel or bladder
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in the breasts, testicles, etc
Indigestion or difficulty swallowing
Obvious change in size, color, shape, or thickness of a wart, mole, or mouth sore
Nagging cough or hoarseness

Question 24

What do you need to make a cancer diagnosis?

Answer 24

Tissue biopsy

Question 25

How should you communicate bad news to a patient?

Answer 25

1. Assess your patient's understanding 2. Give a warning shot 3. Use words that your patient can understand 4. Be quiet and listen 5. Provide additional information 6. Develop a plan for follow-up care

Question 26

What is the incidence of depression in cancer patients?

Answer 26

25%

Question 27

What is clinical staging based on?

Answer 27

Physical exam and imaging

Question 28

What is pathologic staging based on?

Answer 28

Surgical inspection and biopsy

Question 29

What is the TNM staging?

Answer 29

T = tumor size N = node involvement M = metastasis

Question 30

What are the determinants of treatment outcome?

Answer 30

1. stage of disease 2. physiologic reserves

Question 31

What is the Karnofsky score and ECOG interpretations?

Answer 31

Older patients and those with a Karnosfsky performance status <70 or ECOG performance status >/= 3 have a poor prognosis unless the poor performance is a reversible consequence

Question 32

What is the definition of cure?

Answer 32

Treatment has successfully eradicated all traces of a person's cancer, and the cancer will never recur

Question 33

What is the definition of remission?

Answer 33

Signs and symptoms of a person's cancer are reduced. Remissions can be partial or complete. In complete remission all signs and symptoms of cancer have disappeared

Question 34

What is the definition of relapse?

Answer 34

Return of signs and symptoms of a person's cancer - treatment of a relapse is known as salvage therapy

Question 35

What is palliative care?

Answer 35

Goal is to improve quality of life by improving symptoms and side effects, the goal is not to cure

Question 36

Can you diagnose with tumor markers?

Answer 36

No

Question 37

What is the best use of a tumor marker?

Answer 37

Assess the response to a treatment

Question 38

What causes HCG elevation?

Answer 38

Pregnancy, gestational trophoblastic disease, gonadal germ cell tumor

Question 39

What causes calcitonin elevation?

Answer 39

Medullary cancer of the thyroid

Question 40

What causes a Fetoprotein elevated?

Answer 40

Hepatocellular carcinoma, gonadal germ cell tumor, cirrhosis, hepatitis

Question 41

What causes a carcinoembryonic antigen (CEA) elevation?

Answer 41

Adenocarcinoma of the colon, pancreas, lung, breast, and ovary. Pancreatitis, hepatitis, IBD, smoking

Question 42

What causes a lactate dehydrogenase elevation?

Answer 42

Lymphoma, Ewing's sarcoma, hepatitis, hemolytic anemia, many others

Question 43

What causes an elevated prostate-specific antigen?

Answer 43

Prostate cancer, prostatitis, prostatic hypertrophy

Question 44

What causes an elevated CA-125?

Answer 44

Ovarian cancer, lymphomas, menstruation, peritonitis, pregnancy

Question 45

What causes an elevated CA 19-9?

Answer 45

Colon, pancreatic, breast cancers. Pancreatitis, ulcerative colitis