Clinical Oncology – Previous Examination Papers
Clinical Oncology Past Examination Papers
1999 – 2009
Time allowed: 3 hours
There are a total of six (6) questions per paper
JULY 2009
Question 1
You have decided to prepare a meta-analysis on a specific patient intervention for your research project. How,
why, and what would you do to achieve this?
Question 2
A 38 year old woman had breast conserving surgery for a node positive, Grade 3, 30mm medullary carcinoma
of her left breast. The tumour was ER negative, PR negative and HER2 negative. Her mother had died of
ovarian cancer aged 54. She requested an opinion regarding genetics testing.
a)
What is the process, benefits and disadvantages of a genetics opinion?
b)
How might a genetics opinion influence her ongoing management?
c)
She has a 15 year old daughter. How would you advise her regarding future screening for her daughter?
Question 3
a)
Describe the types and incidence of treatment related second primary malignancies in patients
undergoing radiotherapy and/or chemotherapy for Hodgkin lymphoma. What factors influence the risk of
developing these second cancers?
b)
A 40 year old woman, previously treated with mantle radiotherapy and chemotherapy for Hodgkin
lymphoma at the age of 16, presented with a 10 mm, screen-detected, grade 2 infiltrating duct carcinoma
at the 6 o’clock position in her left breast.
How would her previous treatment affect your recommendations for loco-regional and systemic
management?
Question 4
What are the indications for bisphosphonates in the treatment of the following primary cancers and what is the
evidence that would support your recommendations?
a) Breast.
b) Prostate.
Question 5
You are planning to develop a new randomised phase III clinical trial comparing surgery with chemo-
radiotherapy for resectable carcinoma of the oesophagus.
a)
What factors would you need to consider before embarking on this project?
b)
What fundamental components do you need to include when writing the trial protocol? In your answer, list
the key statistical issues.
c)
What other factors would you need to consider before activating the trial?
Question 6
A 45 year old male presented with a 3 month history of slowly enlarging lumps in his left axilla and left
supraclavicular fossa. Apart from mild discomfort in his axilla, he was asymptomatic and had not experienced
any weight loss (ECOG 1). He had no co-morbidities and had no past history of cancer. Physical examination
revealed a 30 mm hard, fixed mass in his left supraclavicular fossa and a 40 mm hard, mobile mass in his left
axilla. The remainder of the physical examination was normal. An incisional biopsy of the supraclavicular fossa
mass showed metastatic poorly differentiated carcinoma. He had not undergone any further investigations and