1) Why is the prognosis of patients with Hodgkin lymphoma usually better than
that of patients with non-Hodgkin lymphoma?
Hodgkin's is very treatable and can often be treated. It is fairly predictable in
the way it spreads in that it is usually restricted
Surgery removes the bulk of the tumor. It is aimed at cure if the entire tumor can
be resected. If it is not resectable due to size or location, surgery can still reduce the
tumor burden and prolong life. Radiation prevents local recurrenc
Module 5: The difference in
age of peak incidence in HCC
is due to the different
etiologic agents. See
Module 6: The most common
testicular malignancy is
seminoma, which is easy to
treat with radiation. See
The best way to prevent cancer is to ban all known carcinogens.
It is hard to definitively state that the best way to prevent cancer is by
banning all known carcinogens. This is because most cancers are
products of genetic predisposition AND exposure to e
Why does the definitive diagnosis of cancer require pathologic confirmation
based on tissue rather than the results of history, physical
examination, blood tests, and X-rays?
Only a biopsy and a pathologists report can give you a definitive
diagnosis of c
1) Explain how the early detection of breast cancer in a 55-year-old woman is a
cooperative effort among the patient herself, her primary care physician, and the
The first step is usually a physical exam by a doctor or nurse practitioner. The
1) What recommendations would you make to a 25-year-old patient to reduce the
risk of developing colon cancer? What else would you recommend in terms of
early detection if the patient were 50 years old?
For a 25 year old, you can lower your risk of develo
1) A 35-year-old woman has a routine Pap smear. It is reported as showing cells
consistent with carcinoma-in-situ. A Pap smear done a year ago was reported as
normal. What are some of the possible causes of the negative report a year ago?
One possible exp
1) A 59-year-old woman consults her physician for weakness and fatigue
she's had over the last six months. She states that her stools have
appeared normal. Physical examination is normal except for mild anorexia.
Her CBC shows a hemoglobin of 7 gm% (norma
1) Discuss some possible causes of the worldwide increase in the incidence of
As ozone levels are depleted, the atmosphere loses more of its protective
function so more UV radiation hits the Earth's surface. Some studies have
shown that a 10% de
1) How do surgery, radiation, and chemotherapy work in a complementary
manner in treating a patient with cancer?
Cancer can be treated by surgery, chemotherapy, and radiation
amongst other methods such as immunotherapy and monoclonal
antibody therapy. Sur
(8/10) Hodgkin lymphoma has a longer survival because it is often early stage at
presentation and spreads predictably. There are fewer abnormal cells in HL. Patients are
often young and otherwise healthy. In contrast, patients with non-Hod
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What we will not give a shit about:
What are the molecular mechanisms leading to neoplasia?
What role do gene abnormalities play in cancer?
What is the mechanism of action of each of the families of chemotherapeutic
How do growth an
There is an old saying in radiation oncology: " No meat, no treat." Tissue
confirmation is essential in the diagnosis of cancer. Although cancer may be suspected
based on H + P, blood tests, and X-rays, tissue confirmation is still require
Many carcinogens cannot easily be banned. The fundamental question here is
marginal cost versus marginal benefit. If all known carcinogens were banned, the cost
may exceed the benefit. Sunlight is a carcinogen. It would be ridiculous to ba
The patient should report any masses that she notices in her breasts to her primary
care doctor for evaluation. The American Cancer Society previously recommended
monthly breast self-examination (BSE). Recent data does not show any benefit
The 25-year old should aim at preventing the development of colon cancer.
Colon cancer in this age group is very uncommon. Prevention basically means a highbulk diet rich in fruits and vegetables. The goal is to decrease intestinal transit
There was probably sampling error or laboratory error in the Pap 1 year ago. 75%
of false negative cases are due to sampling error and 25% are due to laboratory error.
About half of laboratory errors are due to failure to detect the abnorm
The positive FOBT and microcytic anemia indicate GI bleeding. No source was
found in the colon, so the upper GI tract must be examined. The most likely source is the
stomach. Bleeding is uncommon in the esophagus except for varices associa
Increased sun exposure without sunscreen and the deterioration of the ozone layer
will lead to an increased incidence of melanoma. Melanoma is caused by radiation from
the sun. Tanning booths increase exposure to UV light. Dark-skinned rac
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