Introduction to Oncology

Question 1

What is cancer?

Answer 1

Diseases in which abnormal cells divide without control and are able to invade other tissues

Question 2

What are the cardinal features of a cancer?

Answer 2

Loss of regulation of cell division and cell death

Ability to invade surrounding structures/metastasize to other parts of the body

Question 3

What is a carcinoma?

Answer 3

Cancer that begins in epithelial tissues

Question 4

Give examples of carcinomas

Answer 4

Adenocarcinoma
Squamous cell carcinoma
Transitional cell carcinoma
Small cell carcinomas

Question 5

What is an adenocarcinoma?

Answer 5

Cancer from glandular epithelium, e.g. stomach, intestine, some lung cancers

Question 6

What is squamous cell carcinoma?

Answer 6

From squamous epithelium, e.g. cervix, anus etc.

Question 7

What is a transitional cell carcinoma?

Answer 7

Cancer from urethelium, e.g. renal pelvis, bladder etc.

Question 8

What are sarcomas?

Answer 8

Cancer that begins in mesenchyme (e.g. bone, cartilage, fat, muscle, BVs or other connective tissue)

Question 9

What are leukaemias?

Answer 9

Cancers that start in the blood forming tissue, e.g. bone marrow

Question 10

What are lymphomas/myelomas?

Answer 10

Cancers beginning in cells of the immune system

Question 11

What are germ cell tumours?

Answer 11

Cancers originating from germ cells in the testes/ovaries

Question 12

What are the ways cancer can spread to other tissues?

Answer 12

Direct invasion
Lymphatic spread
Haematogenous spread
Trans-colaemic spread

Question 13

What is direct invasion?

Answer 13

Directly spreading to adjacent tissues

Question 14

What is lymphatic spread?

Answer 14

Spread of cancer to regional lymph nodes

Question 15

What is haematogenic spread?

Answer 15

Spread via the bloodstream to distant organs

Question 16

Where does prostate cancer tend to spread to?

Answer 16

Bone

Question 17

Where does bowel cancer tend to spread to?

Answer 17

Liver

Question 18

What is trans-coelomic spread?

Answer 18

Across one of the three body cavities (pleura, peritoneum or pericardium)

Question 19

Give an example of a cancer that often spreads trans-coelomic

Answer 19

Ovarian cancer typically spreads across the peritoneal cavity producing multiple seedings in the peritoneum, often causing ascites

Question 20

What is staging of cancer?

Answer 20

Defining the extent of the spread of cancer

Question 21

What is the most commonly used staging system for cancer?

Answer 21

TNM staging
T - local tumour extent (1-4)
N - regional nodal involvement (0/1)
M - metastases (0/)1

Question 22

What imaging is best for prostate cancer?

Answer 22

MRI of pelvis and bone scan to check for mets

Question 23

What are the three ways in which you can give treatment for a cancer?

Answer 23

Local - aimed at anatomical target

Regional - aimed at treating draining nodal region

Systemic

Question 24

What are the 4 ‘intents’ of cancer treatment?

Answer 24

Curative/radical - aimed at curing
Palliative - improving QoL/prolonging life if cure not possible
Adjuvant - given after definitive treatment to eradicate micrometastatic disease
Neo-adjuvant - adjuvant treatment given before definitive treatment

Question 25

What are the main types of local treatment in cancer medicine?

Answer 25

Surgical resection
Radiotherapy

Others: cryotherapy, radiofrequency ablation, photodynamic therapy, high intensity focussed US

Question 26

What are the two main regional treatments in cancer medicine?

Answer 26

Surgery/radiotherapy to draining lymph nodes

Question 27

What are the systemic therapies used in cancer medicine?

Answer 27

Chemotherapy
Biologics
Hormonal therapy
Immunotherapy