Oncology Quiz: Tumor Markers and Carcinomas

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Questions and Answers

What is an indicator of poor differentiation in a colorectal carcinoma histological section?

Packed ill-formed glands (correct)

Regular cell arrangement

Well-formed glands

Presence of inflammatory cells

Which of the following is a tumor marker that can be monitored in colorectal cancers?

CA-125

Human chorionic gonadotropin (hCG)

Alpha-fetoprotein (AFP)

Carcinoembryonic antigen (CEA) (correct)

What symptom might commonly indicate advanced prostatic carcinoma?

Back pain (correct)

Nausea and vomiting

Increased urination frequency

Increased libido

In assessing a prostate biopsy, what histological characteristic would indicate malignancy?

High nuclear-to-cytoplasmic ratio Signup and view all the answers

What is the significance of an elevated serum Prostate Specific Antigen (PSA) level?

It can suggest the presence of prostate cancer. Signup and view all the answers

What is the highest grade in the Gleason Scale for prostate cancer?

Grade 5 Signup and view all the answers

What type of cancer is least sensitive to radiotherapy?

Sarcoma Signup and view all the answers

Which chemotherapy drug acts on cells in mitosis and the G1 and S phases?

Cyclophosphamide Signup and view all the answers

Which factor is NOT considered when determining radiotherapy treatment?

Patient's age Signup and view all the answers

What is a key marker for the diagnosis and treatment prediction in hormone therapy?

HER-2 Signup and view all the answers

Which tumor marker is specifically associated with hepatocellular carcinoma?

Alpha fetoprotein Signup and view all the answers

What is NOT an aim of cancer screening?

Identify all cancer types Signup and view all the answers

Which type of cancer is characterized by fairly high sensitivity to radiotherapy?

Squamous carcinoma Signup and view all the answers

What does the 'T' in the TNM staging system represent?

Tumor size Signup and view all the answers

Which of the following corresponds to Stage II Hodgkin’s disease?

Two separate groups on the same side of the diaphragm Signup and view all the answers

What is the significance of tumor grade?

It shows how well differentiated the tumor cells are Signup and view all the answers

Which cancer treatment is classified as a newer agent?

Herceptin Signup and view all the answers

What does a well-differentiated tumor indicate?

It is similar to the normal tissue of origin Signup and view all the answers

What type of information does the 'N' in the TNM system provide?

Lymph node involvement Signup and view all the answers

Which tumor marker is associated with monitoring testicular cancer?

Human chorionic gonadotrophin Signup and view all the answers

What factor does NOT influence the grading of breast cancer?

Size of the tumor Signup and view all the answers

What is the purpose of cervical screening?

To identify early changes such as dysplasia Signup and view all the answers

What is a crucial factor for breast cancer screening?

Frequency of mammography screenings Signup and view all the answers

Which type of tumor is most likely found in an 18-year-old male with a testicular swelling?

Testicular Teratoma Signup and view all the answers

What is a common characteristic feature found in histology of Hodgkin's disease?

Reed-Sternberg cells Signup and view all the answers

Which factor is NOT relevant in improving prognosis in cancer patients?

Patient's dietary habits Signup and view all the answers

What is the primary method used in breast cancer screening?

Mammography Signup and view all the answers

What is a next step after surgery for a patient with testicular tumors?

Using tumor markers to guide further treatment Signup and view all the answers

What can affect the staging of a breast cancer patient?

Presence of retraction of the nipple Signup and view all the answers

Study Notes

Session 12: Neoplasia IV - Incidence, Prognosis & Treatment

The session covered neoplasia IV, focusing on incidence, prognosis, and treatment.
Objectives included understanding malignant tumor staging (rectum, breast, prostate, bladder, Hodgkin's disease), malignant tumor grading (squamous cell carcinoma, breast cancer, colon cancer), and the biological basis for cancer treatments (radiotherapy, chemotherapy, hormone therapy, newer agents like Herceptin).
Tumor markers (carcinoembryonic antigen, human chorionic gonadotropin, alpha fetoprotein) and screening (cervix, breast) were also discussed.
Cancer incidence and mortality data (2008 estimates) by site and sex were presented.
The presentation of the commonest ten cancers by primary site (2009) was shown graphically.
The incidence rate of commonest ten cancer deaths by site (2009) in Iraq was displayed in a separate graph showing data per 100,000 population.
Tumor behavior prediction relies on staging (TNM) and grading.

Staging (TNM)

Staging (TNM) evaluates tumor size, lymph node status (N), and metastasis (M).
It is based on objective pathology and clinical criteria.
TNM is a crucial prognostic tool.
T classifications (tumor sizes): T1 (less than 2 cm), T2 (2-5 cm), T3 (involvement of skin or chest wall).
N classifications (lymph node status): N0 (no involvement), N1 (mobile nodes involved).
M classifications (metastasis): M0 (no metastasis), M1 (demonstrable metastasis).
Specific staging systems exist for different cancers, such as Dukes staging for rectal neoplasms, and Ann Arbor staging for Hodgkin's disease.
Ann Arbor staging categorizes Hodgkin's disease based on the involved lymph node groups (I to IV) and presence of B symptoms (fever, sweats, weight loss) in addition to the location of nodes involved.

Grading

Grading assesses tumor differentiation.
Well-differentiated tumors closely resemble the original cell type, while poorly differentiated tumors show significant structural differences.
Immunohistochemical stains are used to confirm differentiation.
Specific grading systems exist for different cancers (e.g., Glasgow system for breast cancer, Gleason scoring for prostate cancer).
Grading provides information about the tumor's aggressiveness and potential response to treatment. Grading factors include tubule formation, nuclear variation, and number of mitoses. Examples include well differentiated adenocarcinoma and moderately differentiated adenocarcinoma for breast cancer and Gleason scale for prostate cancer.

Treatment and Response Prediction

Primary treatment depends on the tumor type and stage.
Adjuvant treatment is given after primary treatment to reduce the risk of recurrence or metastasis.
Radiotherapy factors include radiation type, cumulative dose, rate of delivery, and target tissue susceptibility.
Chemotherapy targets specific stages of the cell cycle impacting rapidly-dividing cells such as bone marrow. Examples of chemotherapy drugs include Cyclophosphamide, Vincristine and Methotrexate acting on different cell division phases.
Hormone therapy is commonly used for cancers sensitive to hormones (e.g., breast, prostate).
Response prediction involves detecting hormone receptors (estrogen receptor) and other markers (like HER-2 amplification/overexpression) for effective treatment strategies.

Tumor Markers

Tumor markers are substances released from tumors into the bloodstream.
These substances aid in diagnosing cancer and assessing treatment response.
Examples of tumor markers include alpha-fetoprotein, human chorionic gonadotropin, acid phosphatase, and prostate-specific antigen.
Tumor markers may aid in establishing diagnosis and monitoring treatment outcomes, hence helping in follow ups.

Screening

Screening aims to detect pre-malignant, non-invasive, and early-invasive cancers to improve prognosis and survival.
Common screening targets are cervix, breast, large intestine, and prostate.
Specific screening methods (e.g., Pap smear for cervix, mammography for breast) and factors including age, population at risk, cytological examination are critical.

Small Group Questions

Various cases and accompanying questions (e.g., case scenarios of testicular teratoma, Hodgkin's disease, breast carcinoma, and colorectal carcinoma) were presented along with relevant graphics, histology and additional information to assist decision making.

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Description

Test your knowledge on various tumor markers and histological characteristics in different types of cancers, specifically focusing on colorectal and prostate cancers. This quiz covers cancer diagnosis, treatment predictions, and the significance of specific markers in oncology.