NURS 5461 Oncology EXAM QUESTIONS
AND CORRECT ANSWERS
Cancer - ANSWER>>58% of all cases of cancer occur in people over 65 - Women
over 65 have 61-78% of lung and colon cancers Between ages 20-60 incidence of
cancers is about the same in both genders; after age 60 aaa cancer rates
increase for men-- 70% higher
In patients over 65 years - ANSWER>>Women get colon, pancreas and gastric
cancers most often - Men get prostate, colon and bladder cancer most often
Second Tumors - ANSWER>>- XRT for Hodgkin's disease may result in
subsequent lung or breast cancer in the treated field - Patients with colon
cancer may have second operable colon cancer rather than a recurrence
- Strong link between viruses and specific human cancers - ANSWER>>•
Hepatocellular cancer with Hepatitis B and Hepatitis C • Burkitt's tumor,
nasopharynx cancer with EBV • Cervical cancer with HPV 16 and 18 • Kaposi's
sarcoma with HIV
Prevention - ANSWER>>Avoid carcinogens - Radiation; tobacco - Organic dyes;
benzene - Arsenic; asbestos - Chromium Avoid sunlight - Linked to preventing
skin cancers
Screening - ANSWER>>Breast Cancer - Monthly self breast exams after menses
begins - First screening mammogram at age 35 - Second screening exam at age
40, then yearly mammograms thereafter
- Women aged 65-74/Women over age 75 - ANSWER>>• Breast exam yearly;
mammogram every 2 years/• If life expectancy and general health goodaa -
,Breast exam yearly; mammogram every 2 years • If notaaa - Monthly self breast
exam
Screening/Prostate Cancer - - ANSWER>>Men aged 50 and over • DRE • PSA •
US of prostate if indicated • Start earlier in African Americans and men with
positive family history
Screening/colon Cancer - ANSWER>>Colon Cancer - All adults over 50 need
flexible sigmoidoscopy and stools for OB • In patients with polyps --->
colonoscopy needed • After 3 normal flexible sigmoidoscopies at 3 year
intervals, can stop surveillance
Screening Bladder Cancer - ANSWER>>- Test urine of OB, more than 2-3 RBC per
field otherwise its not microscopic hematirua-unlinkey to be ca
Screening Endometrial Cancer - ANSWER>>- Evaluate abnormal uterine bleeding
in woman on Tamoxifen or HRT
Aging: Impact on Disease and Therapy - ANSWER>>Studies have shown that
seniors are not uniformly infirm and they tolerate chemo as well as people
under age under 70 Elderly [>70] are excluded from oncologic clinical trials
Studies have shown that response and toxicities of treatment are not influenced
by age
Clinical Assessment - ANSWER>>?Symptoms of weight loss, fever, night sweats,
jaundice, anorexia and pain should lead to high index of suspicion of cancer
Abnormal bleeding or discharge needs attention Headache, vision change and
change in coordination and strength should be noted
History - ANSWER>>History should include questions about occupation and
exposure to meds - Occupational exposure to metals, chemicals and asbestos -
Medication use such as HRT and maternal diethylstilbestrol [DES] Ask about
smoking and ETOH use Exposure to hepatitis
, Physical Exam - ANSWER>>Targeted PE - Look for jaundice, anemia, petechiae or
weight loss - Assess for skin nodules, ulcers and nevi larger than 5-7 mm •
Carefully assess back in men and posterior calves in women Targeted PE -
Examine mouth for ulcers, leukoplakia or lumps - Carefully palpate lymph nodes
• **Nodes more than 1 cm should be biopsied - Inspect/palpate both breasts
Diagnosis and Staging - ANSWER>>Staging requires additional tests that specify
location or locations of disease Must separate treatable cancers [lymphoma,
breast, ovarian, prostate or thyroid] from untreatable cancers [pancreas,
stomach or lung]
Treatment - ANSWER>>Surgery - Mainstay of cancer therapy Radiation - XRT
plays a major role in curative therapy and in palliation aaa • Also used to treat
prostate cancer and palliation of bone metastasis Chemotherapy and Hormonal
Therapy - Adjuvant chemo or hormone therapy are effective in a variety of
cancers - Leukopenia/anemia • More prevalent in seniors • Use of growth
factors helps to maintain marrow reserves
Breast Cancer - ANSWER>>Three common masses found in the breast -
Fibroadenoma - Fibrocystic breast changes - Cancer
Fibroadenoma - ANSWER>>Common benign lesion Occurs in women within 20
years after puberty, 15-35 year age group Peak age is 20-25 years Multiple
tumors in one or both breasts found in 10-15% of patients Tends to occur at an
earlier age in African American women than in Caucasian women
Tumor is round, rubbery, discrete, movable, nontender mass 1-5 cm. in
diameter, without associated calcium deposition
Fibroadenoma 2 - ANSWER>>Does not occur normally after menopause but
menopausal woman can occasionally develop fibroadenoma after
administration of hormones FNA confirms the diagnosis; treatment is by
excision under local anesthesia as an OP procedure
AND CORRECT ANSWERS
Cancer - ANSWER>>58% of all cases of cancer occur in people over 65 - Women
over 65 have 61-78% of lung and colon cancers Between ages 20-60 incidence of
cancers is about the same in both genders; after age 60 aaa cancer rates
increase for men-- 70% higher
In patients over 65 years - ANSWER>>Women get colon, pancreas and gastric
cancers most often - Men get prostate, colon and bladder cancer most often
Second Tumors - ANSWER>>- XRT for Hodgkin's disease may result in
subsequent lung or breast cancer in the treated field - Patients with colon
cancer may have second operable colon cancer rather than a recurrence
- Strong link between viruses and specific human cancers - ANSWER>>•
Hepatocellular cancer with Hepatitis B and Hepatitis C • Burkitt's tumor,
nasopharynx cancer with EBV • Cervical cancer with HPV 16 and 18 • Kaposi's
sarcoma with HIV
Prevention - ANSWER>>Avoid carcinogens - Radiation; tobacco - Organic dyes;
benzene - Arsenic; asbestos - Chromium Avoid sunlight - Linked to preventing
skin cancers
Screening - ANSWER>>Breast Cancer - Monthly self breast exams after menses
begins - First screening mammogram at age 35 - Second screening exam at age
40, then yearly mammograms thereafter
- Women aged 65-74/Women over age 75 - ANSWER>>• Breast exam yearly;
mammogram every 2 years/• If life expectancy and general health goodaa -
,Breast exam yearly; mammogram every 2 years • If notaaa - Monthly self breast
exam
Screening/Prostate Cancer - - ANSWER>>Men aged 50 and over • DRE • PSA •
US of prostate if indicated • Start earlier in African Americans and men with
positive family history
Screening/colon Cancer - ANSWER>>Colon Cancer - All adults over 50 need
flexible sigmoidoscopy and stools for OB • In patients with polyps --->
colonoscopy needed • After 3 normal flexible sigmoidoscopies at 3 year
intervals, can stop surveillance
Screening Bladder Cancer - ANSWER>>- Test urine of OB, more than 2-3 RBC per
field otherwise its not microscopic hematirua-unlinkey to be ca
Screening Endometrial Cancer - ANSWER>>- Evaluate abnormal uterine bleeding
in woman on Tamoxifen or HRT
Aging: Impact on Disease and Therapy - ANSWER>>Studies have shown that
seniors are not uniformly infirm and they tolerate chemo as well as people
under age under 70 Elderly [>70] are excluded from oncologic clinical trials
Studies have shown that response and toxicities of treatment are not influenced
by age
Clinical Assessment - ANSWER>>?Symptoms of weight loss, fever, night sweats,
jaundice, anorexia and pain should lead to high index of suspicion of cancer
Abnormal bleeding or discharge needs attention Headache, vision change and
change in coordination and strength should be noted
History - ANSWER>>History should include questions about occupation and
exposure to meds - Occupational exposure to metals, chemicals and asbestos -
Medication use such as HRT and maternal diethylstilbestrol [DES] Ask about
smoking and ETOH use Exposure to hepatitis
, Physical Exam - ANSWER>>Targeted PE - Look for jaundice, anemia, petechiae or
weight loss - Assess for skin nodules, ulcers and nevi larger than 5-7 mm •
Carefully assess back in men and posterior calves in women Targeted PE -
Examine mouth for ulcers, leukoplakia or lumps - Carefully palpate lymph nodes
• **Nodes more than 1 cm should be biopsied - Inspect/palpate both breasts
Diagnosis and Staging - ANSWER>>Staging requires additional tests that specify
location or locations of disease Must separate treatable cancers [lymphoma,
breast, ovarian, prostate or thyroid] from untreatable cancers [pancreas,
stomach or lung]
Treatment - ANSWER>>Surgery - Mainstay of cancer therapy Radiation - XRT
plays a major role in curative therapy and in palliation aaa • Also used to treat
prostate cancer and palliation of bone metastasis Chemotherapy and Hormonal
Therapy - Adjuvant chemo or hormone therapy are effective in a variety of
cancers - Leukopenia/anemia • More prevalent in seniors • Use of growth
factors helps to maintain marrow reserves
Breast Cancer - ANSWER>>Three common masses found in the breast -
Fibroadenoma - Fibrocystic breast changes - Cancer
Fibroadenoma - ANSWER>>Common benign lesion Occurs in women within 20
years after puberty, 15-35 year age group Peak age is 20-25 years Multiple
tumors in one or both breasts found in 10-15% of patients Tends to occur at an
earlier age in African American women than in Caucasian women
Tumor is round, rubbery, discrete, movable, nontender mass 1-5 cm. in
diameter, without associated calcium deposition
Fibroadenoma 2 - ANSWER>>Does not occur normally after menopause but
menopausal woman can occasionally develop fibroadenoma after
administration of hormones FNA confirms the diagnosis; treatment is by
excision under local anesthesia as an OP procedure
