Term
| What are the MC CA in men? |
|
Definition
Prostate
Lung/bronchus
colon/rectum |
|
|
Term
| What are the MC CA in men? |
|
Definition
Breast
Lung/bronchus
colon/rectum |
|
|
Term
| What are the risk factors for Breast CA? |
|
Definition
prev Hx breast disease
age > 60y/o
Menarche <12y/o
Menopause > 55y/o
Age at first birth >30y/o or nulliparous
Obesity
Decreased physical activity
Alcohol > 2-3 drinks qd
Maternal use of DES
HRT (estrogen) |
|
|
Term
| What are the risk factors for Breast CA? |
|
Definition
prev Hx breast disease
age > 60y/o
Menarche <12y/o
Menopause > 55y/o
Age at first birth >30y/o or nulliparous
Obesity
Decreased physical activity
Alcohol > 2-3 drinks qd
Maternal use of DES
HRT (estrogen) |
|
|
Term
| What are the odds that a women will develop breast cancer? |
|
Definition
|
|
Term
| What can happen after successful treatment of Breast CA? |
|
Definition
| Relapse and MM more common |
|
|
Term
| On which chromosome is BRCA- 1 located? On which chromosome is BRCA-2 located? |
|
Definition
BRCA-1 on chromosome 17q21
BRCA-2 on chromosome 11 |
|
|
Term
| What percentage breast CA arise from the HER-2/neu overexpression? |
|
Definition
|
|
Term
| What % of Breast CA are caused by p53 mutations? |
|
Definition
|
|
Term
| What % of breast Ca is caused by the BRCA-2 gene? |
|
Definition
|
|
Term
| What BRCA gene causes an increased risk of ovarian and prostate CA? |
|
Definition
|
|
Term
| What BRCA gene causes an increased risk of ovarian and prostate CA? |
|
Definition
|
|
Term
| Which marker is more common to result in CA that are more aggressive and reoccurring? |
|
Definition
|
|
Term
| What factor improves the dx of breast CA? |
|
Definition
| Expression of estrogen receptor (ER) |
|
|
Term
| When should women receive their baseline mammograms? How often should mammograms be conducted after that? |
|
Definition
| @ 40 y/o; yearly or biannually after that till age 50, then yearly after that |
|
|
Term
| What is the appropriate f/u for a mass in a premenopausal women that persists throughout her cycle? |
|
Definition
|
|
Term
| What is the appropriate f/u for any mass in a post-menopausal women? |
|
Definition
|
|
Term
| What is the appropriate f/u for a cyst with non-bloody fluid that resolves with aspiration? |
|
Definition
|
|
Term
| What is the appropriate f/u of a cyst with bloody fluid or a residual mass? |
|
Definition
| Repeat mammography & excisional biopsy |
|
|
Term
| What is the appropriate fu for a solid mass? |
|
Definition
| Mammography & excisional biopsy |
|
|
Term
| Which type of Breast CA appears on mammograms as abnormal calcifications? |
|
Definition
|
|
Term
| Which type of Breast CA is described as a noninvasive tumor in the breast, without stromal invasion that can progress to invasive CA? |
|
Definition
|
|
Term
| Which type of Breast CA is classified as operable, locally advanced or metastatic? |
|
Definition
|
|
Term
| Which ER has been identified as a target for the treatment of breast malignancy? |
|
Definition
|
|
Term
| How is the ipsilateral axilla often staged? |
|
Definition
| staged using a lumpectomy |
|
|
Term
| If HER-2 neu is present with breast malignancy, what is used as a treatment? |
|
Definition
| Herceptin - to block production of estrogen |
|
|
Term
| What is a symptom complaint for men who have undiagnosed prostate CA? |
|
Definition
| Obstructive Voiding issues |
|
|
Term
| At what age should prostate CA screening begin in pts with low risk? At what age should prostate screening be done if the pt has a high risk? |
|
Definition
50y/o with low risk
45y/o with high risk |
|
|
Term
| What are the risk factors for Prostate CA? |
|
Definition
African American Ethnicity
FHx (1st degree relative) of Prostate CA in male < 65y/o |
|
|
Term
| At what level of PSA is Prostate CA diagnosed? |
|
Definition
|
|
Term
| What are the treatment options for prostate CA? |
|
Definition
- Watchful Waiting
- Androgen Deprivation
- Prostatectomy (TURP)
- External Beam RT
- Brachytherapy (Internal radioactive seed implants)
- Cryotherapy
- Robotic Prostatectomy
- Hormone Therapy |
|
|
Term
| With prostate CA, when is RX necessary? |
|
Definition
| With Urethral and outflow obstruction, renal failure, recurrent UTI, hematuria, bladder stones |
|
|
Term
| What are the types of NSCLC? Which type is most common? |
|
Definition
Adenocarcinoma (Most Common - 40%)
Squamous Cell (30%)
Large Cell |
|
|
Term
| What is the leading cause of CA death in men and women? What is the greatest risk factor for developing this type of CA? |
|
Definition
| Lung CA; Smoking is the biggest risk factor |
|
|
Term
| With what lung condition is lung CA 4x more likely to develop? |
|
Definition
|
|
Term
| What are some symptoms of lung CA? |
|
Definition
cough
hemoptysis
dyspnea
pleural or chest wall pain
lymphadenopathy
anorexia, wt loss
fatigue
anemia |
|
|
Term
| Which test is more sensitive for staging PET or CT scan? |
|
Definition
|
|
Term
| Which test IDs areas of increased glucose metabolism? |
|
Definition
|
|
Term
| What type of exposure is mesothelioma generally associated with? How quickly after this exposure does mesothelioma develop? |
|
Definition
| Asbestos exposure; develops 30 - 35 y after exposure |
|
|
Term
| What are the signs and symptoms of mesothelioma? |
|
Definition
SOB
Chest wall discomfort |
|
|
Term
| Is metastasis common with Mesothelioma? What is the prognosis for these pts? |
|
Definition
| NO... tumor spreads locally but rarely mets. Prognosis is poor, Median survival rate is between 9 - 12 y |
|
|
Term
| What is the 2nd leading cause of cancer-related deaths? |
|
Definition
|
|
Term
| What are the three MC types of colorectal CA? |
|
Definition
Adenomas (polyps)
adenocarcinomas
anal carcinomas |
|
|
Term
| What GI condition causes an increased risk of CA? |
|
Definition
|
|
Term
| What are the S & S of Colorectal CA? |
|
Definition
Rectal Bleeding
Changes in Stool Size
+ hemoccult
Obstruction (rare) |
|
|
Term
| What is the best way to diagnose Colorectal CA? |
|
Definition
|
|
Term
| How does colorectal CA show up on Barium radiography? |
|
Definition
|
|
Term
| What is the best tx for a pt who presents with rectal bleeding? |
|
Definition
| Referral to GI for colonoscopy |
|
|
Term
| At what age should screening for colorectal CA begin in pts? |
|
Definition
| 50 y/o with low risk; sooner for pts with higher risks |
|
|
Term
| What is the Hallmark for FAP? |
|
Definition
| development of hundreds to thousands of adenomatous polyps in the large bowel at a relatively young age |
|
|
Term
What is the progression of FAP?
2nd Decade?
3rd or 4th Decade? |
|
Definition
In the 2nd Decade Adenomas appear
In the 3rd and 4th decade GI symptoms appear and by age 40 Colorectal CA will develop if left untreated |
|
|
Term
| What gene is the cause of FAP? |
|
Definition
| Autosomal Dominant APC gene |
|
|
Term
| What is the treatment for FAP? |
|
Definition
| Proctocolectomy with ileostomy or ileoanal pouch |
|
|
Term
| How should FAP be monitored? |
|
Definition
| Flex Proctosigmoidoscopy annually from age 12, even in those who test neg for APC gene |
|
|
Term
| What are some common conditions associated with FAP? |
|
Definition
Increased tendency for duodenal adenomas, osteomas of the skull, mandible and long bones
Epidermoid cysts, fibromas, lipomas, mesenteric fibromatosis & desmoid tumors
Congenital hypertrophy of the retina occurs in > 90% of pts with extracolonic manifestations |
|
|
Term
| What are the criteria for diagnosing Hereditary Nonpolypoidal Colorectal CA? |
|
Definition
3 or more relatives with colon CA (one must be first degree relative)
Colorectal CA involving at least 2 generations
1 or more family members dx with colorectal CA when younger than 50 |
|
|
Term
| Where are polyps with HNPCC often found? |
|
Definition
|
|
Term
| Which type of CA are female pts with HNPCC more prone to developing? |
|
Definition
| CA of the female genital tract (ovary and endometrium) |
|
|
Term
| When should screening for pts with family hx of HNPCC begin? |
|
Definition
| 10 yrs earlier than the earliest onset of colon CA in afamily member |
|
|
Term
| What is the prognosis of pancreatic CA? |
|
Definition
| Usually fatal within 2 yrs |
|
|
Term
| What is the MC type of pancreatic CA? |
|
Definition
|
|
Term
| What increases the risk for pancreatic CA? |
|
Definition
1st or 2nd degree relative w/Pancreatic CA
Increased Age
HNP
Peutz-Jehgers Syndrome (multiple dark macules on lips)
Smoking
Hx of chronic pancreatitis
Alcohol
Cholelithiasis
DM
Increased fat in diet |
|
|
Term
| What are the signs and symptoms of pancreatic CA? |
|
Definition
VAgue, dull mid-epigastric pain radiating to the back
Wt loss
Anorexia
Dysgeusia (distortion of taste)
Vomiting
Jaudice
Courvoisier's Sign (non-tender palpable Gallbladder distension from an obstruction of the common bile duct) |
|
|
Term
| If labs show anemia, ↑ ESR, ↑ alk phos, ↑ bilirubin, ↑ transaminases and ↑ Ca19-9 (tumor marker) what condition should you suspect? |
|
Definition
|
|
Term
| If CBD (Common Bile Duct) obstruction is present, where is the CA located? |
|
Definition
|
|
Term
| What is the gold standard for visualizing pancreatic duct and biliary system? |
|
Definition
|
|
Term
| How can pancreatic CA be diagnosed? |
|
Definition
Transabdominal U/S
CT of the abdomen
ERCP |
|
|
Term
| What is the treatment for pancreatic CA? |
|
Definition
Surgical Resection
Whipple Procedure (with lesions of the head of the pancreas)
Pain Meds
Chemotherapy
RT |
|
|
Term
| What are the S & S of Ovarian CA? |
|
Definition
Lack of energy
Increased Abdominal Girth/Fullness/Swelling
Wt Loss/ ↓ appetite/ feeling full quickly
Abdominal or pelvic discomfort
Dysuria or urinary frequency
dyspareunia
persistent indigestion/ Gas /Nausea
Constipation
Low Back Pain |
|
|
Term
| What are the risk factors for Ovarian CA? |
|
Definition
Women with FHx of Ovarian or Breast CA
BRCA-1 or BRCA-2 Gene mutation |
|
|
Term
| How can ovarian CA be prevented? Who is this preventative measure recommended for? |
|
Definition
| Prophylactic Oophorectomy or salpingo-oophorectomy; Recommended for high risk women |
|
|
Term
| How is Ovarian CA diagnosed? |
|
Definition
Abdominal/Pelvic U/S
Abdominal/Pelvic CT Scan
Ca 125 II level |
|
|
Term
| What factors seem to reduce the risk of developing ovarian CA? |
|
Definition
Child Bearing
OC (Containing both estrogen and progesterone x 5y)
Breast Feeding x 1 y |
|
|
Term
| Which chemo treatments are used for Ovarian CA? |
|
Definition
| Tamoxifen, Femara, Aromasin |
|
|
Term
| Which marker is best to determine if Herceptin will be an effective treatment for Breast CA? |
|
Definition
|
|
Term
| Which markers are tested after newly diagnosed breast CA? |
|
Definition
|
|
Term
| What is the biomarker for Colorectal CA? |
|
Definition
| CEA (Carcinoembryonic antigen) > 10ng/mL |
|
|
Term
| What is the biomarker for Hepatocellular Ca? |
|
Definition
|
|
Term
| Which marker is used to estimate prognosis, monitor for recurrent disease and assess response to Rx with metastasis disease for Colorectal Ca? |
|
Definition
| CEA (Carcinoembryonic antigen) |
|
|
Term
| What is the marker that is produced during pregnancy and used with U/S in high risk pts with cirrohsis, chronic Hep B & C, to monitor response to chemo and to detect recurrences after liver transplant or surgical resection? |
|
Definition
|
|
Term
| What is the biomarker for Ovarian CA? |
|
Definition
|
|
Term
| Which biomarker helps distinguish benign lesions in the ovaries from malignant ones? |
|
Definition
|
|
Term
| Which biomarker is used for early detective and dx of prostate ca? |
|
Definition
| PSA (Prostate Specific Antigen) |
|
|
Term
| Which biologic is used for brain, lung, breast and colon CA? |
|
Definition
|
|
Term
| Which biologics are used as protein inhibitors for treating lymphoma and breast CA? |
|
Definition
|
|
Term
| Which biologics alter the function of the immune system and are used to treat Rheumatoid arthritis and psoriasis? |
|
Definition
|
|
Term
| Which biologics alter the function of the immune system and are used to treat MS and Chron's disease? |
|
Definition
|
|
Term
| What are the possible SE of biologics? |
|
Definition
Infections
MI
Lymphoma
CNS Disorders
Immune System Disorders
Some have Black Box Warnings |
|
|
