The Basics

Question 1

List at least the top 4 (out of 10) most common cancers in men (from England 2012 new patients National Statistics)

Answer 1

1. Prostate
2. Lung
3. Colorectal
4. Bladder
5. Non-Hodgkins lymphoma
6. Melanoma of the skin
7. Oesophageal
8. Renal
9. Lip, oral cavity and pharyngeal
10. Leukaemia

Question 2

List the at least the top 4 (out of 10) most common cancers in women (from England 2012 new patients National Statistics)

Answer 2

1. Breast
2. Lung
3. Colorectal
4. Uterine
5. Ovarian
6. Melanoma
7. Non-Hodgkins lymphoma
8. Pancreatic
9. Leukaemia
10. Renal

Question 3

Define ‘Adjuvant’

Answer 3

A treatment given after a definitive treatment with an aim to increase the chance of cure.

Question 4

What is the name for treatment when 2 or more therapies are given simultaneously?

Answer 4

Concurrent therapy

Question 5

What is ‘Patient Performance Status’?

Answer 5

A standardised way to express a patient’s fitness.

Question 6

Why is it important to consider a Patients’ Performance Status?

Answer 6

This will help to predict survival and help predict the ability to tolerate therapies. It may also guide decisions such as which therapies will be most appropriate.

Question 7

According to the ECOG scale, what does the following score get defined as; 0?

Answer 7

Fully active, able to carry out all pre-disease performance without restriction

Question 8

According to the ECOG scale, what does the following score get defined as; 1?

Answer 8

Restricted in physically strenuous activity but ambulatory and able to carry out light work

Question 9

According to the ECOG scale, what does the following score get defined as; 2?

Answer 9

Ambulatory and capable of self-care but unable to carry out any work activities. Up and about >50% of waking hours.

Question 10

According to the ECOG scale, what does the following score get defined as; 3?

Answer 10

Capable of only limited self-care. Confined to bed/chair >50% of waking hours.

Question 11

According to the ECOG scale, what does the following score get defined as; 4?

Answer 11

Completely disabled and confined to bed/chair. No self-care.

Question 12

According to the ECOG scale, what does the following score get defined as; 5?

Answer 12

Deceased

Question 13

What is cancer?

Answer 13

Uncontrolled division of unhealthy cells that can spread around the body.

Question 14

What is radiotherapy?

Answer 14

In plain terms, it is targeted X-Ray treatment

Question 15

What happens to cancer cells when they are blasted with ionising radiation?

Answer 15

Ionising radiation causes damage to double stranded DNA which causes cell lysis and death

Question 16

Why is radiotherapy split in its delivery?

Answer 16

This allows the normal cells that are hit with the radiation to recover as they recover more fully than the cancer cells

Question 17

What is 1 session of radiotherapy called?

Answer 17

A fraction

Question 18

What is the range of fractions of radiotherapy that can be given to patients with cancer?

Answer 18

Between 1 and 33 fractions

Question 19

How often is radiotherapy given?

Answer 19

Once every day, except weekends usually

Question 20

How long does each fraction of radiotherapy take?

Answer 20

15-30 minutes

Question 21

When a patient is receiving radiotherapy as a palliative treatment, how many fractions are usually given?

Answer 21

1-10

Question 22

When a patient is receiving radical radio treatment, how many fractions are commonly given?

Answer 22

10-33

Question 23

What is of vital importance in patients receiving radiotherapy?

Answer 23

Positioning of the patient is crucial

Question 24

What methods do we have for mobilisation of the patient to ensure accurate positioning?

Answer 24

1. Immobilisation shells
2. Breast/lung boards
3. Radiotherapy tattoos
4. Lasers

Question 25

What are the early side effects of radiotherapy due to?

Answer 25

Localised inflammation of the tissues targeted by the radiotherapy

Question 26

What are the late side effects of radiotherapy due to?

Answer 26

Tissue healing and scarring

Question 27

What are the early side effects of radiotherapy?

Answer 27

1. Fatigue 2. Pain 3. Inflammation (-itis) 4. Skin reaction 5. Nausea 6. Raised intracranial pressure 7. Hair loss 8. Diarrhoea

Question 28

What are the late side effects of radiotherapy?

Answer 28

1. Fibrosis 2. Strictures 3. Osteonecrosis 4. Rib fractures 5. A secondary malignancy

Question 29

Which cancers commonly have a radical radiotherapy approach?

Answer 29

1. Lung 2. Cervix 3. Prostate 4. Larynx

Question 30

What is important to consider about tumour position in a live human?

Answer 30

The position of the tumour will constantly change due to; - breathing - eating - sneezing - coughing Essentially, anything that can cause organ movement will alter the position of the tumour.

Question 31

How long can it take to just plan radiotherapy with radical intnent?

Answer 31

2 weeks

Question 32

What is brachytherapy?

Answer 32

Internal radiotherapy whereby 'seeds' are internally inserted into the tumour that slowly release the radiotherapy from inside to out. This means it is quite localised to the tumour.

Question 33

Which 2 cancers commonly use brachytherapy?

Answer 33

1. Prostate | 2. Cervix

Question 34

When is proton treatment useful?

Answer 34

1. In paediatric patients | 2. In patients who's tumour is located in a sensitive structure

Question 35

What are the benefits of proton treatment?

Answer 35

Protons are a form of radiotherapy | They have a much smaller exit dose to other tissues, therefore the spread of tissue affected is much less