Principles of Oncology- Exam 2

Question 1

How does cancer develop?

Answer 1

when the body’s normal control mechanism stops working, abnormal mutations accelerate cell division rates or inhibit normal controls on the system

aka unregulated cell division, avoidance of cell death, tissue invasion, ability to metastsize

Question 2

Describe a cancer cell when compared to a normal cell

Answer 2

normal: small uniformly shaped nuclei with relatively large cytoplasmic volume, conformity in cell size and shape, lower levels of dividing cells, cell tissue clearly demarcated

Cancer: large, variable shaped nuclei, small cytoplasmic volume, lots of variation in cell size and shape, disorganized, loss of normal specialized features, elevated expression of certain cell markers, large number of dividing cells, poorly defined tumor boundaries

Question 3

_____ of deaths in the US is caused by cancer

Answer 3

1 in 4

Question 4

Cancer is the ____ leading cause of death in the United States

Answer 4

second

Question 5

_____ is the most significant risk factor for cancer

Answer 5

age

Question 6

**What are the top 4 types of cancer among all races and genders? (in order)

Answer 6

1. female breast
2. prostate
3. lung
4. colon and rectum

Question 7

**What are the top 4 cancer DEATHS

Answer 7

1. Lung
2. Female breast
3. Prostate
4. Colon and rectum

Question 8

_____ is the most common type of cancer in men. ____ in female

Answer 8

prostate

breast

Question 9

The individual chance that someone will develop cancer in response to a particular, single environmental exposure depends on ________ and _____ that person was exposed.

Answer 9

how long

how often

Question 10

Name some additional things that can influences your chances for cancer.

Answer 10

Exposure to certain environmental factors (including diet, hormones)
Genetic makeup
Age and gender

Question 11

Healthy lifestyle is what kind of prevention?

Answer 11

primary prevention

Question 12

Mammograms are an example of _____ prevention

Answer 12

secondary prevention

Question 13

Treating prostate cancer is an example of ______ prevention

Answer 13

tertiary prevention

Question 14

What is the primary focus of primary prevention?

Answer 14

is to prevent a cancer from ever developing or to delay the development of a malignancy

Question 15

primary prevention may include the use of _____ or ______ to prevent or significantly reduce the risk of developing a malignancy.

Answer 15

chemopreventive agents

prophylactic surgery

Question 16

_____ is the most common preventable cause of cancer death;

Answer 16

Tobacco

Question 17

Smokeless tobacco also represents a substantial health risk. Linked to ????

Answer 17

dental caries, gingivitis, oral leukoplakia, and oral cancer

Question 18

_____ is linked to carcinogens in tobacco dissolved in saliva and swallowed

Answer 18

Esophageal cancer

Question 19

_____ is associated with reduced risk of colon and breast cancers

Answer 19

physical activity

Question 20

In observational studies, _____ is associated with a reduced risk of colonic polyps and invasive cancer of the colon

Answer 20

dietary fiber

Question 21

**Heavy drinkers have an increased risk of cancers of the ???

Answer 21

*head, *liver, *neck *esophagus

Question 22

**Epstein-Barr virus is linked to ____

Answer 22

Burkitt’s lymphoma, nasal T cell lymphoma

Question 23

**H. pylori is associated with ____

Answer 23

Gastric cancer, gastric MALT lymphoma

Question 24

**Hepatitis B or C is associated with ____

Answer 24

Liver cancer

Question 25

**HIV is associated with ____

Answer 25

non-Hodgkin's lymphoma, Kaposi's sarcoma, squamous cell carcinomas (especially of the urogenital tract)

Question 26

**HPV is associated with _____

Answer 26

Cervix cancer, head and neck cancer

Question 27

**Sunlight is associated with ____

Answer 27

skin cancer

Question 28

**Tobacco including smokeless tobacco is associated with _____

Answer 28

Cancer of the upper aerodigestive tract, bladder

Question 29

Secondary prevention refers to the ??? of subclinical, asymptomatic, or early disease in individuals without obvious signs or symptoms of cancer

Answer 29

early detection and treatment

Question 30

Secondary cancer prevention includes ???? for developing malignancy and implementing ????? based on the risk assessment

Answer 30

identifying people who are at risk appropriate screening recommendations

Question 31

____ proportion of persons with the disease who test positive in the screen

Answer 31

sensitivity

Question 32

____ proportion of persons who do not have the disease that test negative in the screening test

Answer 32

specificity

Question 33

_____ proportion of persons who test positive that actually have the disease

Answer 33

positive predictive value

Question 34

_____ proportion testing negative that do not have the disease

Answer 34

negative predictive value

Question 35

Ages ____ have the option to start screening with a mammogram every year. Women ____ should get mammograms every year

Answer 35

40-44 45 to 54

Question 36

Women _____ can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least _____

Answer 36

55 and older 10 more years.

Question 37

Women who are at high risk for breast cancer based on certain factors should get a ????? typically starting at age 30.

Answer 37

breast MRI and a mammogram every year,

Question 38

Define what ACS considers women at high risk for breast cancer

Answer 38

Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on family history. Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing) Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves Had radiation therapy to the chest before they were 30 years old Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes

Question 39

What is the age recommendations for colorectal cancer screenings

Answer 39

Beginning at age 45 (through age 75) Colonoscopy every 10 years

Question 40

What is the cervical screening recommendations?

Answer 40

age 21 to 29 get a pap smear every three years as long as they are normal

Question 41

What are the detection signs of cancer?

Answer 41

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

Question 42

What are some classic signs of cancer?

Answer 42

Classic symptoms: Nightsweats, Unexplained weight loss or loss of appetite, Persistent low-grade fever Chronic pain, especially in the bones Persistent fatigue

Question 43

**The diagnosis of cancer relies most heavily on ??? and should never be made without obtaining ____

Answer 43

invasive tissue biopsy tissue

Question 44

Staging determines the ???; helps determine ____ and best _____

Answer 44

extent of disease prognosis treatment plan

Question 45

The first priority in patient management is to ???? of disease.

Answer 45

determine the extent

Question 46

_____ is the first major determinant of treatment outcome/prognosis

Answer 46

Tumor burden

Question 47

For most cancers, the extent of disease is evaluated by a variety of noninvasive and invasive diagnostic tests and procedures, called ____

Answer 47

staging

Question 48

What kind of staging is based on physical examination, radiographs, isotopic scans, CT scans, and other imaging procedures?

Answer 48

Clinical staging

Question 49

_____ takes into account information obtained during a surgical procedure, which might include intraoperative palpation, resection of regional lymph nodes and/or tissue adjacent to the tumor, and inspection and biopsy of organs commonly involved in disease spread.

Answer 49

Pathologic staging

Question 50

What is the most widely used system of staging?

Answer 50

TNM (tumor, node, metastasis) system codified by the International Union Against Cancer and the American Joint Committee on Cancer

Question 51

Which type of cancer cannot be grouped on the basis of anatomic considerations?

Answer 51

leukemia, myeloma, and lymphoma

Question 52

_____ is a determinant of how a patient is likely to cope with the physiologic stresses imposed by the cancer and its treatment

Answer 52

Physiologic reserve

Question 53

**What does a high Karnofsky performance index indicate? What number is considered high?

Answer 53

100-High: able to do normal ADLs by themselves 0-Low: death, very sick

Question 54

**What is the ECOG performance scale?

Answer 54

0= full active and functional 5= dead

Question 55

Treatment recommendations depend upon _____, _____, and _____

Answer 55

extent of disease prognosis patient wishes

Question 56

**_______ treatment has successfully eradicated all traces of a person’s cancer, and the cancer will never recur

Answer 56

Cure

Question 57

**______ signs and symptoms of a person’s cancer are reduced. Remissions can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared.

Answer 57

remission

Question 58

**_____ return of signs and symptoms of a person’s cancer - treatment of a relapse is known as “salvage” therapy

Answer 58

relapse

Question 59

**_____ provided to improve a patient’s quality of life; to prevent or treat the symptoms and side effects of the disease and its treatment, in addition to the related psychological, social, and spiritual problems. The goal is not to cure.

Answer 59

Palliative care

Question 60

Tumor markers (are/are not) specific enough to permit a diagnosis of malignancy to be made.

Answer 60

are not The marker is best used to assess response to treatment.

Question 61

____ is the MC of cancer overall

Answer 61

lung cancer

Question 62

**Human chorionic gonadotropin (HCG) is associated with ____

Answer 62

Gestational trophoblastic disease, gonadal germ cell tumor pregnancy

Question 63

**Calcitonin is associated with ____

Answer 63

Medullary cancer of the thyroid

Question 64

**α Fetoprotein is associated with ____

Answer 64

Hepatocellular carcinoma, gonadal germ cell tumor Cirrhosis, hepatitis

Question 65

**Carcinoembryonic antigen (CEA) is associated with ____

Answer 65

Adenocarcinomas of the colon, pancreas, lung, breast, ovary Pancreatitis, hepatitis, inflammatory bowel disease, smoking

Question 66

**Lactate dehydrogenase is associated with ____

Answer 66

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

Question 67

**Prostate-specific antigen is associated with ____

Answer 67

prostate cancer Prostatitis, prostatic hypertrophy

Question 68

**CA-125 is associated with ____

Answer 68

Ovarian cancer, some lymphomas Menstruation, peritonitis, pregnancy

Question 69

**CA 19-9 is associated with ____

Answer 69

Colon, pancreatic, breast cancer Pancreatitis, ulcerative colitis