Cancer Biology and Risk Factors
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Which of the following is considered a primary lifestyle-related risk factor for the development of cancer?

  • Radon exposure
  • Genetic predisposition
  • Exposure to viruses
  • Poor diet and physical inactivity (correct)

The pathophysiology of cancer is primarily driven by alterations in which of the following?

  • DNA structure and function (correct)
  • Protein synthesis
  • Cellular respiration
  • Lipid metabolism

A patient newly diagnosed with cancer expresses a desire to understand their prognosis better. Which of the following approaches is most appropriate for the healthcare provider?

  • Sharing personal anecdotes about other patients with similar diagnoses to foster hope.
  • Providing a broad overview of cancer statistics without focusing on specific details.
  • Avoiding direct discussion of prognosis to prevent causing undue anxiety.
  • Offering a detailed explanation of the expected course of the illness, including potential outcomes, based on available data. (correct)

A patient presents with a tumor that is 3 cm in diameter, and no lymph node involvement or distant metastasis are identified. According to the TNM staging system, this tumor would most likely be classified as which stage?

<p>Stage I (D)</p> Signup and view all the answers

In the context of cancer statistics, which types of cancer are typically excluded from incidence and mortality calculations?

<p>Basal cell and squamous cell skin cancers. (A)</p> Signup and view all the answers

Mutations leading to the activation of oncogenes and inactivation of tumor suppressor genes are critical events in cancer development. Which of the following best describes the typical function of tumor suppressor genes?

<p>Inhibiting uncontrolled cell proliferation (D)</p> Signup and view all the answers

Which of the following statements best reflects the impact of facing one's own mortality, as expressed by Paul Kalanithi?

<p>It paradoxically changes nothing and everything, bringing acute awareness to the fact of death while highlighting the importance of living. (D)</p> Signup and view all the answers

Unexplained weight loss, fatigue, and fever are best described as which type of cancer symptoms?

<p>Systemic symptoms (A)</p> Signup and view all the answers

A patient presents with persistent hoarseness. This symptom is most concerning for which of the following types of cancer?

<p>Laryngeal or Thyroid cancer (A)</p> Signup and view all the answers

A researcher aims to analyze trends in cancer incidence over the next decade. Which source would provide the most relevant data for this analysis?

<p>Current cancer facts and figures publications from organizations like the American Cancer Society. (B)</p> Signup and view all the answers

According to the TNM staging system, Stage II-III cancers are characterized by:

<p>Any combination of tumor and nodal involvement without metastasis (A)</p> Signup and view all the answers

A 50-year-old male with no significant past medical history is diagnosed with prostate cancer. He is distraught and insists on aggressive treatment despite the oncologist's recommendation for active surveillance due to the cancer's low-risk characteristics. Which ethical principle is most directly challenged by the patient's insistence on treatment?

<p>Non-maleficence. (A)</p> Signup and view all the answers

The definitive diagnosis of cancer is primarily established through which of the following methods?

<p>Pathological examination of tissue (A)</p> Signup and view all the answers

According to the projected cancer statistics for 2025, what types of cancer are typically excluded from incidence and mortality calculations?

<p>Basal cell and squamous cell skin cancers (A)</p> Signup and view all the answers

In Paul Kalanithi's reflection on facing mortality, which aspect remained unchanged despite his cancer diagnosis?

<p>His knowledge of eventual death (C)</p> Signup and view all the answers

If a healthcare provider is seeking the most up-to-date data on estimated cancer deaths in the United States for 2025, which source would be most appropriate?

<p>The Cancer Facts &amp; Figures 2025 by the American Cancer Society (D)</p> Signup and view all the answers

Paul Kalanithi's quote, 'The problem wasn’t really a scientific one,' suggests what about the experience of facing death?

<p>The challenges are more existential than medical. (D)</p> Signup and view all the answers

Which statement, reflecting Kalanithi's perspective, captures the paradoxical impact of confronting one's own mortality?

<p>It profoundly alters one's perception while simultaneously affirming fundamental truths. (B)</p> Signup and view all the answers

A patient presents with melena. Which type of cancer should be initially suspected?

<p>Colon cancer (D)</p> Signup and view all the answers

Which of the following factors is least likely to be a direct cause of somatic DNA alterations leading to cancer?

<p>Poor posture (C)</p> Signup and view all the answers

A patient is diagnosed with a tumor that is staged as Tis, N0, M0. According to the TNM staging system, what does 'Tis' indicate?

<p>Carcinoma in situ (C)</p> Signup and view all the answers

Which of the following diagnostic methods provides the most definitive confirmation of a suspected cancerous lesion?

<p>Tissue biopsy (D)</p> Signup and view all the answers

Which of the following is the most appropriate initial imaging modality for staging a newly diagnosed case of locally advanced cervical cancer?

<p>MRI (B)</p> Signup and view all the answers

A researcher is conducting a study on the genetic mutations associated with pancreatic cancer. Which of the following genes is most likely to be found mutated in a significant majority of pancreatic cancer cases?

<p>KRAS (C)</p> Signup and view all the answers

A patient presents with persistent dysphagia and unintentional weight loss. Further examination reveals a mass in the esophagus. Which of the following factors would most strongly suggest that the patient's condition is cancerous rather than benign?

<p>Rapid progression of symptoms (C)</p> Signup and view all the answers

A 68-year-old male with a history of smoking presents with hemoptysis and persistent cough. Chest imaging reveals a 4 cm mass in the lung with ipsilateral hilar lymph node involvement, but no evidence of distant metastasis. Which of the following TNM classifications most accurately represents this scenario?

<p>T2N1M0 (D)</p> Signup and view all the answers

Which genetic alteration is present in more than 95% of pancreatic cancers?

<p>KRAS mutation (A)</p> Signup and view all the answers

A 45-year-old male presents with hematochezia and unintentional weight loss. Which tumor marker is most appropriate to evaluate for a potential diagnosis of colon cancer?

<p>CEA (A)</p> Signup and view all the answers

Which of the following is NOT a common sign of cancer?

<p>Unexplained weight gain (D)</p> Signup and view all the answers

A biopsy confirms breast cancer with lymph node involvement and a tumor size of 3 cm. According to staging guidelines, what is the correct classification?

<p>Stage IIA (B)</p> Signup and view all the answers

All of the following are complications of cancer EXCEPT:

<p>Hypoglycemia (D)</p> Signup and view all the answers

Which chemotherapy agent is associated with pulmonary fibrosis as its primary toxicity?

<p>Bleomycin (B)</p> Signup and view all the answers

Why do mutations in tumor suppressor genes contribute to cancer progression?

<p>They impair DNA repair processes (D)</p> Signup and view all the answers

Which cancer screening test should be performed annually for patients aged 50-80 with a 20 pack-year smoking history?

<p>Low-dose CT scan (C)</p> Signup and view all the answers

Which tumor marker is most commonly used to screen patients with suspected hepatocellular carcinoma?

<p>AFP (B)</p> Signup and view all the answers

A 60-year-old woman presents with breast cancer and is considering adjuvant therapy. Which statement best describes adjuvant therapy?

<p>Treatment given after surgery to eliminate residual cancer cells (A)</p> Signup and view all the answers

Which chemotherapy side effect is correctly matched with its drug?

<p>Nephrotoxicity - Cisplatin (A)</p> Signup and view all the answers

A transgender woman with 6 years of estrogen therapy should follow breast cancer screening guidelines starting at what age?

<p>50 years (C)</p> Signup and view all the answers

Which of the following cancers is associated with tumor marker CA 19-9?

<p>Pancreatic cancer (C)</p> Signup and view all the answers

A 52-year-old male with jaundice, weight loss, and an elevated AFP level is suspected to have which type of cancer?

<p>Hepatocellular carcinoma (B)</p> Signup and view all the answers

Which cancer staging category indicates the presence of distant metastases?

<p>Stage IV (A)</p> Signup and view all the answers

Which somatic DNA alteration results in unrestrained proliferation and is present in more than 40% of colon cancers?

<p>KRAS mutation (A)</p> Signup and view all the answers

A 60-year-old man presents with persistent cough and hemoptysis. Which diagnostic imaging is most appropriate to evaluate for lung cancer?

<p>PET scan (D)</p> Signup and view all the answers

Which of the following is NOT a typical complication of cancer?

<p>Leukoplakia (D)</p> Signup and view all the answers

A patient diagnosed with breast cancer has a tumor measuring 4 cm and positive lymph nodes. Which stage is this classified as?

<p>Stage IIB (B)</p> Signup and view all the answers

Which cancer treatment is used before surgery to shrink the tumor?

<p>Neoadjuvant chemotherapy (B)</p> Signup and view all the answers

A mutation in which type of gene leads to a loss of regulation in cell division due to impaired DNA repair?

<p>Tumor suppressor gene (D)</p> Signup and view all the answers

Which tumor marker is used for monitoring ovarian cancer?

<p>CA 125 (D)</p> Signup and view all the answers

Which chemotherapy agent can cause dilated cardiomyopathy as a side effect?

<p>Doxorubicin (D)</p> Signup and view all the answers

A 65-year-old male with a history of smoking presents for lung cancer screening. Which criterion would disqualify him from annual low-dose CT scans?

<p>15-pack-year smoking history (D)</p> Signup and view all the answers

Which screening recommendation is INCORRECT?

<p>Annual Pap test for women between ages 21 and 29 (A)</p> Signup and view all the answers

Which combination of laboratory findings is characteristic of tumor lysis syndrome?

<p>Hyperkalemia, hyperphosphatemia, hypocalcemia (C)</p> Signup and view all the answers

Which of the following is a key diagnostic test for confirming hepatocellular carcinoma in high-risk patients?

<p>Alpha-fetoprotein (AFP) and RUQ ultrasound (B)</p> Signup and view all the answers

A 50-year-old man presents with changes in bowel habits and melena. What is the most appropriate initial screening test for colon cancer?

<p>Colonoscopy every 10 years (D)</p> Signup and view all the answers

Which treatment approach is used after surgery to eliminate residual cancer cells?

<p>Adjuvant chemotherapy (C)</p> Signup and view all the answers

Which tumor marker is associated with testicular non-seminomas?

<p>Beta HCG &amp; AFP (A)</p> Signup and view all the answers

A 65-year-old woman with a history of breast cancer presents with shortness of breath and distant metastases confirmed on PET scan. Which stage is this classified as?

<p>Stage IV (D)</p> Signup and view all the answers

Which of the following is NOT a typical cause of cancer?

<p>Overactivation of tumor-suppressor genes (A)</p> Signup and view all the answers

A patient presents with persistent dysphagia. Which type of cancer should be considered?

<p>Esophageal or stomach cancer (D)</p> Signup and view all the answers

All of the following are screening recommendations for colon cancer EXCEPT:

<p>Stool DNA test every 5 years (D)</p> Signup and view all the answers

Which chemotherapy agent is associated with hemorrhagic cystitis?

<p>Cyclophosphamide (A)</p> Signup and view all the answers

Which process is disrupted when an oncogene is activated?

<p>Cell cycle regulation (B)</p> Signup and view all the answers

Which symptom is specific to bladder or prostate cancer?

<p>Hematuria (B)</p> Signup and view all the answers

Which of the following is a primary diagnostic tool for solid tumor cancers?

<p>Tissue biopsy (C)</p> Signup and view all the answers

A 45-year-old male with a 20-pack-year smoking history who quit 12 years ago presents for lung cancer screening. What is the appropriate recommendation?

<p>No screening required (A)</p> Signup and view all the answers

Which of the following is NOT a typical emergency complication of cancer?

<p>Galactorrhea (B)</p> Signup and view all the answers

Which tumor marker is associated with pancreatic cancer?

<p>CA 19-9 (C)</p> Signup and view all the answers

A 52-year-old woman presents with a thickening in her breast tissue. Which diagnostic imaging is most appropriate?

<p>Mammography (A)</p> Signup and view all the answers

A 70-year-old man presents with fatigue, weight loss, and hematuria. Which tumor marker should be tested?

<p>PSA (C)</p> Signup and view all the answers

Which treatment approach directly targets specific proteins involved in cancer growth?

<p>Targeted therapy (B)</p> Signup and view all the answers

Which oncogene mutation is present in over 95% of pancreatic cancers and 40% of colon cancers?

<p>KRAS (C)</p> Signup and view all the answers

A 68-year-old man with a history of smoking presents with hemoptysis and weight loss. Imaging shows a lung mass, and biopsy confirms lung cancer. Which complication is he at greatest risk of developing?

<p>Superior vena cava syndrome (C)</p> Signup and view all the answers

A 35-year-old woman presents with a breast mass measuring 4.5 cm and positive axillary lymph nodes. Which stage does this represent?

<p>Stage IIIA (A)</p> Signup and view all the answers

Which of the following is NOT a complication of tumor lysis syndrome?

<p>Hypouricemia (C)</p> Signup and view all the answers

Which chemotherapy agent is most likely to cause nephrotoxicity, ototoxicity, and neurotoxicity?

<p>Cisplatin (D)</p> Signup and view all the answers

A mutation in which type of gene leads to uncontrolled cell proliferation due to loss of growth regulation?

<p>Tumor suppressor gene (D)</p> Signup and view all the answers

Which tumor marker is used for detecting hepatocellular carcinoma?

<p>AFP (C)</p> Signup and view all the answers

Which screening test is recommended annually for adults aged 50 to 80 with a 20-pack-year smoking history who have quit within the last 15 years?

<p>Low-dose CT scan (D)</p> Signup and view all the answers

A 45-year-old man presents with changes in bowel habits and hematochezia. Which tumor marker should be tested to aid in diagnosis?

<p>CEA (C)</p> Signup and view all the answers

Which of the following is NOT a screening recommendation for cervical cancer?

<p>Annual Pap test for women over 65 (B)</p> Signup and view all the answers

Which of the following tumor markers is associated with pancreatic cancer?

<p>CA 19-9 (C)</p> Signup and view all the answers

Which imaging modality is used to evaluate bone metastases in cancer patients?

<p>Bone scan (A)</p> Signup and view all the answers

A 50-year-old transgender woman undergoing estrogen therapy for 6 years is due for breast cancer screening. What is the appropriate recommendation?

<p>Breast screening as per cisgender women starting at age 50 (B)</p> Signup and view all the answers

Which cancer treatment is used after surgical removal of the tumor to eliminate residual cancer cells?

<p>Adjuvant chemotherapy (D)</p> Signup and view all the answers

Flashcards

What is Cancer?

Uncontrolled growth and spread of abnormal cells.

Cancer Statistics Relevance

Estimates new cancer cases in the US, excluding some skin cancers and in situ carcinomas.

Cancer Mortality Tracking

Tracks estimated cancer deaths in the US.

Impact of Mortality

Facing mortality changes priorities and perspectives. It highlights the preciousness of time.

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Cancer Information Resources

Resources such as cancer.gov and cancer.org can provide data

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Common Cancer Causes

Tobacco use, poor diet, lack of physical activity, radiation, viruses/infections, genetic predisposition and carcinogens.

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Cancer Pathophysiology

Somatic DNA alterations lead to unrestrained proliferation due to replication errors, carcinogen exposure, and faulty DNA repair.

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General Cancer Signs/Symptoms

Weight loss, fever, fatigue, pain, and skin changes (hyperpigmentation, jaundice, erythema, pruritus, excessive hair growth).

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Cancer-Specific Symptoms

Changes in bowel habits (colon cancer). Unusual bleeding (hemoptysis, melena, hematochezia, vaginal, hematuria, nipple discharge). Sores that don't heal (skin/oral). Persistent cough (lung cancer)

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Cancer Diagnosis

Pathology via tissue biopsy is required for definitive cancer determination.

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TNM Cancer Staging

T (tumor size/extent), N (lymph node involvement), M (distant metastasis).

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Key Cancer Stages

Stage 0: Carcinoma in situ (Tis, N0, M0); Stage I: Localized tumor (Tumor, N0, M0); Stage IV: Metastatic disease.

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Cancer Stage II and III

Stage II is any combination of Tumor and Nodes. Stage III is any tumor greater than 5 cm, with node involvement.

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Cancer's Impact

Uncontrolled growth that can impact nothing or everything.

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Cancer Incidence

Estimated new cases in the US, excluding some skin cancers.

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Cancer Mortality

Tracks projected deaths in the US.

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Mortality Awareness

Facing one's mortality changes priorities.

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Cancer Information

Resources that provide cancer data.

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Stage 0 Cancer

Cancer stage with carcinoma in situ, no lymph node involvement, and no metastasis.

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Stage I Cancer Characteristics

Stage I: Tumor ≤2 cm, node negative, no metastasis.

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Stage IIA Details

Tumor 2-5 cm OR tumor 5 cm, node negative OR tumor 2-5 cm, node positive.

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Cancer Tissue Diagnosis

Tissue sample examination to diagnose cancer.

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Unusual Bleeding Types & Cancer

Hemoptysis (lung), melena/hematochezia (colon), vaginal bleeding (cervical/endometrial), hematuria (bladder), nipple discharge (breast).

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Palpable Mass Cancer Signs

Thickening or lump in breast or testicles.

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Methods of Cancer Staging

Examining the extent of cancer spread using surgery, CT, PET, bone scan, MRI.

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Oncogene Activation

Mutations activating genes promoting cell growth.

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KRAS Mutation

Somatic DNA alteration resulting in unrestrained proliferation

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PET Scan

Imaging to evaluate for lung cancer after initial findings

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Leukoplakia

A symptom of oral cancer, not a result of cancer

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Stage IIB Cancer

Tumor is 4-5 cm, positive lymph nodes.

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Vincristine Side Effect

Vincristine causes neuropathy, not kidney damage.

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Neoadjuvant Chemo

Treatment before surgery, to shrink tumor

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Tumor Suppressor Mutation

Impairs cell cycle regulation by disrupting DNA repair

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CA 125

Monitoring tumor progression in ovarian cancer

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Doxorubicin Cardiotoxicity

Side effect causing heart muscle damage

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Lung Cancer Qualifier

Smoking history does not allow for CT scan

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Pap Test Frequency

Testing frequency for cervical cancer

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Tumor Lysis Findings

Metabolic imbalances that happen from cancer

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HCC Diagnostic tests

Uses ultrasound and a lab level

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Colon Cancer Screening

Procedure to initial test

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Adj Chemo

Procedure helps eliminates left over cells

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Beta HCG & AFP

Tumor marker for non-seminomas

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Stage IV metastatic

Due to metastasis

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Tumor Supressor Genes

Uncontrolled cell division = bad

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Esophageal Cancer

Swallowing issues = consider what

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FIT test

Not due to frequency

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Cyclophosphamide causes

Drug toxicity concerns

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Cell cycle

Process if disruption occurs

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Hematuria and cancer

Blood in urine causes concern

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PET scans aren't dx

Biopsy of tumors

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Previous smoking

Test for 15 years

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What is Galactorrhea

Condition with cancer

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Pan Cancer

Tumor level eval

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Brest Tissue

Tissue for imaging

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Hematuria in man

Lab levels related to cancer

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Targeted Therapy

Type of cancer that spreads throughout

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Study Notes

Cancer Statistics 2025

  • The top 3 cancers to know for male and female estimated new cancer cases and deaths.

Review of Cancer Treatment Options

  • Neoadjuvant (before CA is removed) targets tumors before surgery
  • Adjuvant (after CA is removed) targets tumors after surgery
  • Oncolytic virus therapy (for bladder CA)

Selected Chemotherapy Specific Toxicities

  • Memorize the Chemo-Tox Man

Colon Cancer Screening

  • Tests find polyps and cancer with colonoscopy
  • Tests primarily find cancer with FIT (fecal immunochemical test)

Prostate Cancer Screening

  • Screening conversation is recommended for high-risk men starting age 45

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Description

Explore cancer biology, risk factors, and treatment approaches. Understand the TNM staging system, oncogenes, and tumor suppressor genes. Review the statistics of cancer.

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