Oncology

Front (Question) || Back (Answer)

ONCOLOGY KNOWT FLASHCARDS

What is the definition of cancer? || Uncontrolled growth and proliferation of abnormal cells.

What differentiates benign from malignant tumors? || Benign tumors can become malignant if insulted; malignant tumors invade, metastasize, and evade apoptosis.

What are hallmark signs of cancer cells? || Evasion of apoptosis, atypical energy production, and immune system evasion.

What does cancer remission mean? || Reduction or disappearance of cancer signs and symptoms; not always a cure but indicates less detectable disease.

How many new U.S. cancer diagnoses occur annually? || About 2 million, with roughly 600,000 deaths each year.

What are the top 4 most common cancers in the U.S.? || Lung, breast, prostate, colorectal.

Which cancers are most lethal? || Lung, colorectal, pancreatic, and breast cancers.

Which cancers are increasing in men and women? || Men → Prostate; Women → Liver and bile duct.

Which cancers are decreasing in men? || Lung and laryngeal cancers.

Etiology & Risk Factors

What are acquired causes of cancer? || Radiation, chemical carcinogens, viral infections (EBV, HPV).

What are inherited causes of cancer? || Lynch syndrome and other genetic mutations.

List common cancer risk factors. || Age, smoking, obesity, alcohol, sun exposure, gender, diet, occupational exposures.

How does obesity increase cancer risk? || Chronic inflammation and hyperinsulinemia promote abnormal cell growth.

Epigenetics

What is the Two-Hit Hypothesis? || 1st hit = loss of tumor suppressor gene; 2nd hit = activation of proto-oncogene → tumor formation.

How can drugs affect gene expression in cancer? || By altering methylation or histone modification without changing DNA sequence.

Staging (TNM)

What does TNM stand for? || Tumor size (T), Node involvement (N), Metastasis (M).

Describe cancer stages 0–IV. || 0: Carcinoma in situ | I: Local invasion no LN | II: LN involvement | III: Local tissue spread | IV: Metastasis/palliative care.

Detection

What tests detect or screen for cancer? || MRI, CT, targeted ultrasound, PET, CBC, hormones, liquid biopsy.

What are common screening tests by cancer type? || Mammogram (breast), Pap (cervical), PSA (prostate), colonoscopy (colon).

What is a liquid biopsy? || Blood test detecting circulating tumor cells or cfDNA/RNA for screening and monitoring.

Major Cancer Types

What cell defines Hodgkin lymphoma? || Reed–Sternberg B cells.

What virus is associated with Hodgkin lymphoma? || Epstein–Barr virus (EBV).

What are B-symptoms of lymphoma? || Fever, night sweats, weight loss, fatigue.

What is the 5-year survival for Hodgkin vs Non-Hodgkin lymphoma? || Hodgkin ≈ 89%; Non-Hodgkin ≈ 74%.

What is multiple myeloma? || Plasma-cell cancer in bone marrow; 60% 5-yr survival; long remission but no cure.

List main carcinoma types. || Adenocarcinoma (glandular), Basal cell (skin base), Squamous (lung/bladder), Transitional (urinary tract).

What are sarcomas? || Bone or soft-tissue cancers (osteosarcoma, leiomyosarcoma, liposarcoma, Kaposi).

Which skin cancer is most aggressive? || Melanoma.

What are skin-cancer risk factors? || Fair skin, light hair/eyes, sunburns, arsenic exposure, immunosuppression.

Which type of sunscreen is preferred? || Mineral (physical) sunscreen.

Treatment Modalities

What is chemotherapy? || Nonspecific cytotoxic agents that kill rapidly dividing cells (both cancer and normal).

What is radiation therapy used for? || Local control and pain management; not curative but slows progression.

What cancers use hormone therapy? || Prostate and breast cancers.

What is immunotherapy? || Treatment that stimulates the immune system to attack cancer (CAR-T, checkpoint inhibitors).

What is photodynamic therapy? || Light-activated drugs that destroy cancer cells.

Immunotherapy Highlights

What are checkpoint inhibitors? || Drugs that block T-cell suppression so T cells can attack tumor cells.

What is CAR-T therapy? || Patient T cells reengineered to target tumor antigens; risk = cytokine release syndrome.

What is cytokine therapy? || Interleukins and interferons to enhance immune response.

What do monoclonal antibodies do? || Target specific tumor antigens for immune destruction.

Cancer Metabolism

What is the Warburg effect? || Cancer cells use anaerobic glycolysis → lactate buildup → acidic immunosuppressive environment.

Which medication counteracts the Warburg effect? || Metformin.

Blood Cancers

Which chromosome defines CML? || Philadelphia chromosome (BCR-ABL).

What defines Polycythemia Vera? || Elevated H/H causing hyperviscosity and thrombosis.

Prevention

List major cancer-prevention strategies. || Exercise, healthy diet, HPV vaccine, sun protection, routine screening, smoking cessation.

Oncologic Emergencies

Why is DVT in cancer considered provoked? || Due to ↑ factor X, cytokines, platelet activation, and endothelial damage from chemo.

How is cancer-associated DVT treated? || Heparin → LMWH → DOACs (Apixaban 10 mg BID × 10 days then 5 mg BID).

When should Apixaban dose be reduced? || Age ≥ 80, weight < 60 kg, or Cr > 1.5.

Pericardial Effusion

What causes pericardial effusion in cancer? || Thoracic malignancy, radiation, or renal impairment.

What is a complication of untreated pericardial effusion? || Cardiac tamponade → needs drainage or pericardial window.

Febrile Neutropenia

When does febrile neutropenia typically occur post-chemo? || 1–2 weeks after chemotherapy.

What is first-line management? || Immediate broad-spectrum antibiotics (Zosyn + Vancomycin).

Thrombocytopenia

What are the causes of thrombocytopenia? || Consumption (trauma/surgery), destruction (HIT), production failure (bone marrow suppression).

Tumor Lysis Syndrome

What are hallmark lab findings in TLS? || ↑K, ↑Phosphate, ↑Uric acid, ↓Calcium.

When is TLS most likely to occur? || 12–72 hours after starting chemo or radiation.

How is TLS managed? || IV hydration, Rasburicase or Allopurinol, phosphate binders, calcium gluconate, dialysis if severe.

Graft vs Host Disease

What is GVHD? || Immune attack on host tissues after bone-marrow transplant.

What are symptoms of GVHD? || Rash, liver inflammation, diarrhea, GI bleeding.

How is GVHD treated? || Immunosuppression (Tacrolimus, Rituximab).

Superior Vena Cava Syndrome

What causes SVC syndrome in cancer? || Compression by lung cancer, lymphoma, or thrombosis.

What are key symptoms of SVC syndrome? || Facial/upper-body edema, JVD, stridor, seizures.

What is the treatment for SVC syndrome? || Stent placement or radiation therapy.

Paraneoplastic Syndromes

What are paraneoplastic syndromes? || Autoimmune-like effects where immune system attacks normal cells due to tumor antigens.

Give examples of paraneoplastic symptoms. || Cushing’s syndrome, rashes, neuropathies.

Nephrotic Syndrome

What characterizes nephrotic syndrome? || Proteinuria > 3.5 g/day, hypoalbuminemia, edema, lipiduria.

How does cancer cause nephrotic syndrome? || Tumor cells clog glomeruli → protein and lipid leakage.

Cushing’s Syndrome

What causes Cushing’s in cancer? || Ectopic ACTH secretion (lung or thyroid cancer).

How is Cushing’s diagnosed? || 24-hour urine cortisol and dexamethasone suppression test.

What is the treatment for Cushing’s? || Adrenalectomy or tumor resection.

Hypercalcemia of Malignancy

What serum level defines hypercalcemia of malignancy? || Calcium > 10.5 mg/dL.

What causes hypercalcemia of malignancy? || Tumor secretion of PTH-related peptide (PTHrP) → bone resorption and Ca release.

What are symptoms of hypercalcemia of malignancy? || Weakness, confusion, dehydration, sluggish reflexes, constipation.

How is hypercalcemia treated? || IV fluids, bisphosphonates, calcitonin, glucocorticoids, loop diuretics, rehydration.