ALU 301: Chapter 10: Underwriting Complex Cancer Issues Questions With Accurate Answers

Tumor staging - ANSWER-The most valuable prognostic indicator both short and long term. Tumor size - ANSWER-Correlates with the number of histologically involved nodes but also has independent prognostic significance. The time to development of metastases becomes shorter as tumor size increases. Differentiation of cells (or lack of same) - ANSWER-A key prognostic factor. The more poorly differentiated the cells and the more extensive the degree of lymphatic or vascular invasion, the worse the disease responds to therapy both long and short term. Estrogen or progesterone receptors - ANSWER-Tumors that lack either or both of these receptors are more likely to recur than tumors that have them. Prostate carcinoma - ANSWER-Seems to be almost a naturally evolving disease of male aging. Lifetime risk is about 1 in 6 and risk of death is about 1 in 30. Prostate cancer staging - ANSWER-Stage A to D OR Stage I to IV Stage A - localized and generally confined to the gland. Stage B - confined to the gland with B1 and B2 referring to either a single or multiple focus of disease. Stage C - cancer outside the capsule with C1 and C2 referring to volume of tissue involved. Stage D - metastatic cancer. Treatment options for prostate cancer? - ANSWER-1. No treatment. 2. Radical surgical prostatectomy. (most definitive and curative, but with side effects) 3. External beam radiation. 4. Brachytherapy (radioactive seeds placed in the prostate). *Type of treatment doesn't actually reflect the severity of the disease. PSA - ANSWER-Prostate Specific Antigen - can lead to a definitive diagnosis over 95% of the time. The velocity and degree of rise in PSA is as important as the value. The faster and more linear the rise, the more likely cancer is the cause.