ONCOLOGY EXAM 3 UPDATED QUESTIONS AND
CORRECT ANSWERS
Question:
1. What is cancer?
Answer:
The name given to a collection of related disease. In all types of cancer, some of the body's cells
begin to divide without stopping and spread into surrounding tissues -->Cancerous tumors are
malignant, which means they can spread into, or invade, nearby tissues. In addition, as tumors grow,
cancerous cells can break off and travel to distance places in the body through the blood or lymph
system.
Question:
2. What are the 7 warning signs of cancer?
Answer:
CAUTION Change in bowel or bladder habbits A sore that does not heal Unusual bleeding or
discharge Thickening or lump in breast/other tissue Indigestion or difficulty swallowing Obvious
change in mole or wart Nagging cough or hoarseness
Question:
3. Characteristics of cancer cells
Answer:
A series of cellular and genetic changes that cause a loss of normal cell regulation Lack
differentiation Loss of contact inhibition Abnormal cell proliferation Unchecked local growth and
invasion of surrounding tissue Ability to metastasize (spread)
Question:
4. Benign tumors
Answer:
Structure and differentiation: typical of tissue origin Rate of growth: usually slow Progression: slowly
progressive (can regress or remain stationary) Mode of growth: expansion with capsule Tissue
destruction: none Recurrence: rare Prognosis: fatal only if surgically inaccessible
Question:
5. Malignant tumor
,Answer:
Structure and differentiation: atypical of tissue origin Rate of growth: slow, rapid, or very rapid
Progression: usually progressive Mode of growth: local infiltration and/or metastasis to distant sites
Tissue destruction: common, ulceration and necrosis Recurrence: common Prognosis: fatal if not
controlled
Question:
6. Routes of Metas-tasis
Answer:
Spread of tumor cells to distant sites --> Seeding: across body cavities (ex. peritoneal and pleural
cavities) -->Dissemination via the lymphatic system (most common mechanism) -->Dissemination
via blood capillaries and veins Most common sites: lung, liver, CNS, bone
Question:
7. Carcinogens
Answer:
Radiation: Ionizing radiation, UV rays Viruses: Human T-cell leukemia-1, Hep B &C, EBV, HPV
Chemicals: Alkylating agents (Cyclophosphamide) Chromates (asbestos) Aromatic hydrocarbons
(soot, benzene) Tobacco Alcohol Dietary Genetics and Familial Factors •Multiple primary tumors in
the same organ •Multiple primary tumors in different organs •Bilateral primary tumors •Younger than
usual age •Two or more first degree relatives with same or related tumor types •Two or more first
degree relatives with rare tumors.
Question:
8. Diagnosis
Answer:
Referred to an oncologist, hematologist, or surgeon Work-up: PE/History Blood work
Scans—specifics depend on presenting s/s Biopsy/resection Must have tissue diagnosis prior to
starting treatment!!!
Question:
9. Describe the ma-jor treatment modalities used in cancer
Answer:
Surgery Radiation therapy Chemotherapy Targeted agents Immunotherapy
Question:
10. Differentiate among the three phases of the development of cancer.
Answer:
Initiation: initial cell mutation occurs. It may involve one or more cellular changes that are either
spontaneous or started by exposure to a carcinogen. These changes create a potential for the affected
cell and its daughter cells to develop into a cancer cell Promotion: the transformed (or initiated) cells
are stimulated to divide. The environment within (intracellular) and outside (extracellular) the cell
influences cancer development. Malignant transformation may involve more than one step and
requires repeated exposures to promoting agents Progression: tumor cells compete with one another
to survive, leading to more mutations that make the cells more aggressive. As the tumor increases in
size, the cells undergo further mutations, leading to increased heterogeneity within the tumor
, Question:
11. Tumor Staging
Answer:
Nature of malignancy Histology of cells that comprise the tumor Disease Stage: tumor size and areas
involved Different staging systems (TNM, Dukes, Ann Arbor)
Question:
12. TNM System
Answer:
Tumor, Node, Metastasis System of categorizing tumors Once the T, N, and M are determined, they
are combined, and an overall "stage" of I, II, III, or IV is assigned.
Question:
13. TNM System: T
Answer:
Tumor The T category describes the original (primary) tumor. TX means the tumor can't be measured
or found. T0 means there is no evidence of primary tumor. Tis means the cancer is in situ (the tumor
has not started growing into the surrounding structures). The numbers T1 - T4 describe the size
and/or level of invasion into nearby structures. -->the higher the T number, the larger the size of the
tumor and the further it may have grown into nearby structures. (T1 is less than 2 cm)
Question:
14. TNM System: N
Answer:
Nodes The N category describes whether the cancer has reached nearby lymph nodes. NX means the
nearby lymph nodes can't be measured or found. N0 means nearby lymph nodes do not contain
cancer. The numbers N1 - N3 describe the size, location, and/or the number of lymph nodes involved
-->the higher the N number, the more involved the lymph nodes are.
Question:
15. TNM System: M
Answer:
Metasteses The M category tells whether there are distant metastases: MX means metastasis can't be
measured or found. M0 means there are no known distant metastases. M1 means that distant
metastases are present.
Question:
16. Goals of Therapy
Answer:
Acute management of symptoms ex: mediastinal mass impinging on airway, spinal cord compression
Curative -produce lethal damage to cancer cells, sub-lethal damage to normal cells (re-pairable)
Palliative ex: relieve symptoms by shrinking size of mass, dose will not cure/minimal side effects -->
Extremely effective pain control
Question:
17. Treatment
CORRECT ANSWERS
Question:
1. What is cancer?
Answer:
The name given to a collection of related disease. In all types of cancer, some of the body's cells
begin to divide without stopping and spread into surrounding tissues -->Cancerous tumors are
malignant, which means they can spread into, or invade, nearby tissues. In addition, as tumors grow,
cancerous cells can break off and travel to distance places in the body through the blood or lymph
system.
Question:
2. What are the 7 warning signs of cancer?
Answer:
CAUTION Change in bowel or bladder habbits A sore that does not heal Unusual bleeding or
discharge Thickening or lump in breast/other tissue Indigestion or difficulty swallowing Obvious
change in mole or wart Nagging cough or hoarseness
Question:
3. Characteristics of cancer cells
Answer:
A series of cellular and genetic changes that cause a loss of normal cell regulation Lack
differentiation Loss of contact inhibition Abnormal cell proliferation Unchecked local growth and
invasion of surrounding tissue Ability to metastasize (spread)
Question:
4. Benign tumors
Answer:
Structure and differentiation: typical of tissue origin Rate of growth: usually slow Progression: slowly
progressive (can regress or remain stationary) Mode of growth: expansion with capsule Tissue
destruction: none Recurrence: rare Prognosis: fatal only if surgically inaccessible
Question:
5. Malignant tumor
,Answer:
Structure and differentiation: atypical of tissue origin Rate of growth: slow, rapid, or very rapid
Progression: usually progressive Mode of growth: local infiltration and/or metastasis to distant sites
Tissue destruction: common, ulceration and necrosis Recurrence: common Prognosis: fatal if not
controlled
Question:
6. Routes of Metas-tasis
Answer:
Spread of tumor cells to distant sites --> Seeding: across body cavities (ex. peritoneal and pleural
cavities) -->Dissemination via the lymphatic system (most common mechanism) -->Dissemination
via blood capillaries and veins Most common sites: lung, liver, CNS, bone
Question:
7. Carcinogens
Answer:
Radiation: Ionizing radiation, UV rays Viruses: Human T-cell leukemia-1, Hep B &C, EBV, HPV
Chemicals: Alkylating agents (Cyclophosphamide) Chromates (asbestos) Aromatic hydrocarbons
(soot, benzene) Tobacco Alcohol Dietary Genetics and Familial Factors •Multiple primary tumors in
the same organ •Multiple primary tumors in different organs •Bilateral primary tumors •Younger than
usual age •Two or more first degree relatives with same or related tumor types •Two or more first
degree relatives with rare tumors.
Question:
8. Diagnosis
Answer:
Referred to an oncologist, hematologist, or surgeon Work-up: PE/History Blood work
Scans—specifics depend on presenting s/s Biopsy/resection Must have tissue diagnosis prior to
starting treatment!!!
Question:
9. Describe the ma-jor treatment modalities used in cancer
Answer:
Surgery Radiation therapy Chemotherapy Targeted agents Immunotherapy
Question:
10. Differentiate among the three phases of the development of cancer.
Answer:
Initiation: initial cell mutation occurs. It may involve one or more cellular changes that are either
spontaneous or started by exposure to a carcinogen. These changes create a potential for the affected
cell and its daughter cells to develop into a cancer cell Promotion: the transformed (or initiated) cells
are stimulated to divide. The environment within (intracellular) and outside (extracellular) the cell
influences cancer development. Malignant transformation may involve more than one step and
requires repeated exposures to promoting agents Progression: tumor cells compete with one another
to survive, leading to more mutations that make the cells more aggressive. As the tumor increases in
size, the cells undergo further mutations, leading to increased heterogeneity within the tumor
, Question:
11. Tumor Staging
Answer:
Nature of malignancy Histology of cells that comprise the tumor Disease Stage: tumor size and areas
involved Different staging systems (TNM, Dukes, Ann Arbor)
Question:
12. TNM System
Answer:
Tumor, Node, Metastasis System of categorizing tumors Once the T, N, and M are determined, they
are combined, and an overall "stage" of I, II, III, or IV is assigned.
Question:
13. TNM System: T
Answer:
Tumor The T category describes the original (primary) tumor. TX means the tumor can't be measured
or found. T0 means there is no evidence of primary tumor. Tis means the cancer is in situ (the tumor
has not started growing into the surrounding structures). The numbers T1 - T4 describe the size
and/or level of invasion into nearby structures. -->the higher the T number, the larger the size of the
tumor and the further it may have grown into nearby structures. (T1 is less than 2 cm)
Question:
14. TNM System: N
Answer:
Nodes The N category describes whether the cancer has reached nearby lymph nodes. NX means the
nearby lymph nodes can't be measured or found. N0 means nearby lymph nodes do not contain
cancer. The numbers N1 - N3 describe the size, location, and/or the number of lymph nodes involved
-->the higher the N number, the more involved the lymph nodes are.
Question:
15. TNM System: M
Answer:
Metasteses The M category tells whether there are distant metastases: MX means metastasis can't be
measured or found. M0 means there are no known distant metastases. M1 means that distant
metastases are present.
Question:
16. Goals of Therapy
Answer:
Acute management of symptoms ex: mediastinal mass impinging on airway, spinal cord compression
Curative -produce lethal damage to cancer cells, sub-lethal damage to normal cells (re-pairable)
Palliative ex: relieve symptoms by shrinking size of mass, dose will not cure/minimal side effects -->
Extremely effective pain control
Question:
17. Treatment
