Podcast
Questions and Answers
Which tumor suppressor gene is considered the most important regulator of apoptosis?
Which tumor suppressor gene is considered the most important regulator of apoptosis?
In which stage of the cell cycle do normal cells typically enter a quiescent phase, where they are not actively dividing?
In which stage of the cell cycle do normal cells typically enter a quiescent phase, where they are not actively dividing?
Which of the following receptors, when overexpressed, is most strongly associated with breast cancer?
Which of the following receptors, when overexpressed, is most strongly associated with breast cancer?
What is the primary function of telomerase, an enzyme that is often overexpressed in cancer cells?
What is the primary function of telomerase, an enzyme that is often overexpressed in cancer cells?
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Loss of which protein leads to tumors becoming invasive by reducing cell-cell adhesion?
Loss of which protein leads to tumors becoming invasive by reducing cell-cell adhesion?
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Which of the following is the most common symptom of Superior Vena Cava Syndrome (SVCS)?
Which of the following is the most common symptom of Superior Vena Cava Syndrome (SVCS)?
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What is the primary method of diagnosis for SVCS?
What is the primary method of diagnosis for SVCS?
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What is the most appropriate treatment for SVCS that is resistant to chemotherapy and radiation?
What is the most appropriate treatment for SVCS that is resistant to chemotherapy and radiation?
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In a patient with cancer, what is the most common metabolic disorder associated with the disease?
In a patient with cancer, what is the most common metabolic disorder associated with the disease?
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What is the recommended initial treatment for life-threatening hypercalcemia?
What is the recommended initial treatment for life-threatening hypercalcemia?
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Which of the following is a key adverse prognostic factor in patients with neutropenic fever?
Which of the following is a key adverse prognostic factor in patients with neutropenic fever?
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What is the most common source of brain metastasis in cancer patients?
What is the most common source of brain metastasis in cancer patients?
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Which of the following is considered palliative treatment for metastatic disease?
Which of the following is considered palliative treatment for metastatic disease?
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Which of the following is most commonly associated with exposure to dye and rubber manufacturing?
Which of the following is most commonly associated with exposure to dye and rubber manufacturing?
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A patient with a history of asbestos exposure is most at risk for developing which malignancy?
A patient with a history of asbestos exposure is most at risk for developing which malignancy?
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Which of the following cancers is linked to exposure to PVC?
Which of the following cancers is linked to exposure to PVC?
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Based on the provided information, which malignancy is least likely to be associated with inhaled smoke?
Based on the provided information, which malignancy is least likely to be associated with inhaled smoke?
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A patient presents with Burkitt's lymphoma. Which of the following infectious agents is most likely implicated?
A patient presents with Burkitt's lymphoma. Which of the following infectious agents is most likely implicated?
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What gene is associated with multiple endocrine neoplasia type 2 (MEN-2)?
What gene is associated with multiple endocrine neoplasia type 2 (MEN-2)?
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According to the Eastern Cooperative Oncology Group (ECOG) performance scale, a patient who is confined to bed or a wheelchair for the majority of their waking hours, but can perform limited self-care, would be classified as which of the following?
According to the Eastern Cooperative Oncology Group (ECOG) performance scale, a patient who is confined to bed or a wheelchair for the majority of their waking hours, but can perform limited self-care, would be classified as which of the following?
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Which of the following cancers are associated with diethylstilbestrol (DES) exposure?
Which of the following cancers are associated with diethylstilbestrol (DES) exposure?
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A patient presents with a painless lump in the scrotum that does not transilluminate. Which of the following is the MOST appropriate next step in management?
A patient presents with a painless lump in the scrotum that does not transilluminate. Which of the following is the MOST appropriate next step in management?
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Which of the following is NOT a risk factor for ovarian cancer?
Which of the following is NOT a risk factor for ovarian cancer?
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A patient with breast cancer is found to have ER-positive, PR-positive, and HER2-positive tumors. Which of the following is the MOST appropriate treatment?
A patient with breast cancer is found to have ER-positive, PR-positive, and HER2-positive tumors. Which of the following is the MOST appropriate treatment?
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Which of the following is a characteristic of teletherapy?
Which of the following is a characteristic of teletherapy?
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Which of the following biological therapies targets the HER2 receptor?
Which of the following biological therapies targets the HER2 receptor?
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Which of the following is NOT a common site for distant metastases in breast cancer?
Which of the following is NOT a common site for distant metastases in breast cancer?
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A patient presents with elevated CA-125 levels and a pelvic mass. What is the MOST likely diagnosis?
A patient presents with elevated CA-125 levels and a pelvic mass. What is the MOST likely diagnosis?
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Which of the following is a risk factor for developing testicular cancer?
Which of the following is a risk factor for developing testicular cancer?
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A patient presents with signs of spinal cord compression, including symmetrical weakness and sensory loss with a clear sensory level. Reflex examination reveals hyperreflexia with extensor plantar reflexes. Which location of compression is most likely?
A patient presents with signs of spinal cord compression, including symmetrical weakness and sensory loss with a clear sensory level. Reflex examination reveals hyperreflexia with extensor plantar reflexes. Which location of compression is most likely?
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Which tumor marker is most closely associated with mucinous ovarian cancer and can also be found in pancreatic and gastric cancers?
Which tumor marker is most closely associated with mucinous ovarian cancer and can also be found in pancreatic and gastric cancers?
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A 70-year-old patient is diagnosed with a squamous cell carcinoma of the lung and presents with hyponatremia, what could this be?
A 70-year-old patient is diagnosed with a squamous cell carcinoma of the lung and presents with hyponatremia, what could this be?
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Which imaging modality is typically preferred as an initial investigation for a suspected breast lesion?
Which imaging modality is typically preferred as an initial investigation for a suspected breast lesion?
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A patient presents with suspected medullary thyroid carcinoma. Which tumor marker is most relevant for monitoring this condition?
A patient presents with suspected medullary thyroid carcinoma. Which tumor marker is most relevant for monitoring this condition?
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A young male patient has a testicular mass and elevated serum AFP. Which of the following diagnoses is most likely?
A young male patient has a testicular mass and elevated serum AFP. Which of the following diagnoses is most likely?
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A 68-year-old patient has non-small cell lung cancer and presents with signs and symptoms of hypercalcaemia. Which paraneoplastic syndrome is MOST likely associated with the hypercalcemia observed?
A 68-year-old patient has non-small cell lung cancer and presents with signs and symptoms of hypercalcaemia. Which paraneoplastic syndrome is MOST likely associated with the hypercalcemia observed?
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Which of the following is the primary indication for using MRI in the staging of a colorectal malignancy?
Which of the following is the primary indication for using MRI in the staging of a colorectal malignancy?
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What is the primary treatment for edema in cases of brain lesions?
What is the primary treatment for edema in cases of brain lesions?
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Which imaging technique is preferred first-line for diagnosing bone metastases?
Which imaging technique is preferred first-line for diagnosing bone metastases?
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What are common symptoms of liver metastases?
What are common symptoms of liver metastases?
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Which type of chemotherapy is administered before a cyto-reductive surgical procedure?
Which type of chemotherapy is administered before a cyto-reductive surgical procedure?
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Which of the following is most likely to show a false negative result in detection of bone metastases?
Which of the following is most likely to show a false negative result in detection of bone metastases?
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What percentage of malignant pleural effusions are due to malignancy?
What percentage of malignant pleural effusions are due to malignancy?
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In the context of metastatic bone disease, which treatment is administered to manage complications such as fractures?
In the context of metastatic bone disease, which treatment is administered to manage complications such as fractures?
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Which type of chemotherapy is administered primarily for symptomatic relief in cases of metastasis?
Which type of chemotherapy is administered primarily for symptomatic relief in cases of metastasis?
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Study Notes
Oncology
- Most common global tumor type is skin cancer
- P53 is a tumor suppressor gene important for apoptosis regulation
- Normal cells enter a quiescent (Go) stage when growth signals are absent
- EGFR (epidermal growth factor receptor) is overexpressed in cancers of the gastrointestinal tract
- HER2/neu receptor is linked to breast cancer
- Telomerase adds nucleotides to telomeres, allowing continued cell division, but is absent in normal cells
- Cadherin-1 (CDH1) expression is reduced in cancer, acting as an antagonist to invasion and metastasis
- Loss of CDH1 increases tumor invasiveness
- Cancer cells can avoid immune system detection
- Tobacco use is a major risk factor for numerous malignancies, including lung and breast cancers
Environmental Factors Predisposing to Cancer
- Dye & rubber manufacturing (aromatic amines) can cause bladder cancer
- Asbestos exposure (mining/construction) is linked to lung cancer and mesothelioma
- PVC exposure is associated with liver angiosarcoma
- Chemotherapy can lead to acute myeloid leukemia (AML)
- Inhaled smoke is implicated in lung and bladder cancer
- Epstein-Barr Virus (EBV) is associated with Burkitt's lymphoma and nasopharyngeal cancer
- Human papillomavirus (HPV) is linked to cervical and nasopharyngeal cancers
- Hepatitis B (Hep B) and C (Hep C) are associated with hepatocellular carcinoma (HCC) and cholangiocarcinoma, respectively
- Liver fluke (Opisthorchis sinensis) and schistosoma are associated with cholangiocarcinoma and gallbladder cancer
- Low roughage/high-fat diet and high nitrosamine intake are associated with colonic and gastric cancers, respectively
Other Factors and Treatments
- CT exposure, occupational exposure (beryllium and strontium mining), and therapeutic radiotherapy can cause lung, medullary thyroid, and sarcoma cancers
- Diethylstilbestrol (DES) and estrogen exposure have links to vaginal, endometrial, and breast cancers
- MEN-1 and MEN-2 are related to genes affecting multiple endocrine neoplasia
- Peutz-Jegher syndrome is associated with cancers of the stomach and colon
- Prostate cancer can be linked to STK11 and HPC1 genes
Investigations
- ECOG (Eastern Cooperative Oncology Group) performance status scale is used to assess overall fitness in cancer patients
- In ECOG scale, 0 = fully active, no restrictions
- In ECOG scale, 1 = fully active, but needs analgesics
- In ECOG scale, 2 = ambulatory, can take care, but unable to work
- In ECOG scale, 3 = limited self-care, bed-bound
- In ECOG scale, 4 = completely disabled, unable to perform any self-care
TNM Staging and Markers
- TNM staging (Tumor, Node, Metastasis) is used to classify cancers.
- High levels of HER2 indicate sensitivity to trastuzumab (Herceptin)
- Common tumor markers include AFP (alpha-fetoprotein), calcitonin, CA-125, CEA (carcinoembryonic antigen), HCG (human chorionic gonadotropin), PSA (prostate-specific antigen), and thyroglobulin
- PLAP (placental alkaline phosphatase)
- SCC of lung is associated with ADH, ACTH, and Lambert-Eaton Syndrome
Hypercalcemia
- Hypercalcemia is related to myeloma and breast cancer.
- Elevated serum calcium levels may indicate tumor progression
- Treatment includes IV fluids, bisphosphonates, and calcitonin.
Neutropenic Fever
- Neutropenic fever often follows chemotherapy.
- Patients present with fever (above 38°C), and low neutrophil counts.
- A significant risk of opportunistic infection.
- Important to monitor for sepsis.
Metastatic Disease
- Metastasis is a major cause of cancer morbidity and mortality.
- Brain mets often originate in the lung.
- Lung mets can come from breast and colon cancers.
Liver Mets
- Liver mets arise from colorectal cancers, melanomas, and neuroendocrine tumors.
- Symptoms often include right upper quadrant pain, jaundice, and abnormal liver function tests (LFTs).
- Common investigations include isotope bone scans
- treatment may include bisphosphonates or other appropriate therapies.
Malignant Pleural Effusion
- Malignant pleural effusion frequently involves breast and lung cancers.
- Pleural aspiration helps assess for malignant cells
- Pleurodesis or pleurectomy can be palliative procedures.
Treatment Strategies
- Adjuvant chemotherapy aims to reduce tumor bulk after surgery
- Neoadjuvant chemo is given before surgery for better tumor reduction.
- Pre-op chemo shrinks the tumor, increasing the possibility for complete removal during surgery, improving outcomes and lowering the risk of recurrence
- Chemoprevention uses pharmacological agents to prevent cancer development.
- Surgical treatment is a standard curative approach for many solid tumors
- Radiotherapy types include teletherapy and brachytherapy
- Hormone therapy is used for breast and prostate cancers.
- Biological therapies such as targeted therapies, for instance, inhibit epidermal growth factor (EGF) and other molecules critical for cancer growth and survival
Additional Topics
- Superior vena cava obstruction (SVCO) is a serious condition, due to tumors, often involving the chest and upper body
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Description
Test your knowledge on cancer biology, tumor suppressor genes, and treatment options for various conditions associated with cancer. This quiz covers key concepts such as apoptosis regulation, cell cycle stages, and management of complications like Superior Vena Cava Syndrome. Take this quiz to deepen your understanding of cancer mechanisms and therapies.
