Clinical Oncology – Previous Examination Papers
was 5cm from the anal margin and it extended 4 cm superiorly. A rectal ultrasound demonstrated extension
through the rectal wall into perirectal fat and pararectal nodal enlargement was also noted. CT and PET staging
did not demonstrate any extra pelvic disease.
Following her case discussion at a multidisciplinary meeting it was recommended that she receive neoadjuvant
pelvic radiotherapy with concurrent 5-fluorouracil.
a.
What are the acute and late toxicities of neoadjuvant chemoradiotherapy in this setting?
b.
What are the objectives of treatment and what is the evidence for neoadjuvant chemo-radiotherapy in the
management of operable rectal cancer?
Question 3
a.
What are the potential causes of delirium in patients with advanced cancer?
b.
Describe your management plan for a 50 yr old man with metastatic lung cancer who presents with a 3
day history of agitation and confusion.
Question 4
Regarding the supportive care of patients receiving radiation therapy for head and neck cancer:
a.
describe your nutritional management plan for a 60 yr old woman receiving concurrent chemo-
radiotherapy for a loco-regionally advanced squamous cell carcinoma of the oropharynx.
b.
outline your indications for feeding tube insertion.
c.
what information would you provide to this patient if you were to recommend a prophylactic percutaneous
endoscopic gastrostomy tube?
Question 5
a.
How can oncology electronic information systems improve quality and efficiency in radiation oncology
practice?
b.
List the limitations associated with electronic oncology information systems.
Question 6
Anxiety and depression are commonly associated with the diagnosis and management of cancer.
a.
Describe how clinicians treating cancer patients can identify those with higher than average risk of
psychological morbidity.
b.
What treatment options are available for cancer patients diagnosed with anxiety and/or depression?
AUGUST 2007
Question 1
Regarding the management of cancer pain:
a) Describe the use of systemic analgesic drugs and other pharmaceutical agents (adjuvants).
b) What are the commonly observed side effects of opioid therapy and how would you manage them?
Question 2
Describe the acute side effects and the late complications of the following systemic therapies:
a)
Androgen deprivation therapy for prostate cancer.
b)
BEP (Bleomycin, Etoposide and Cisplatin) chemotherapy for testicular cancers.
c)
Herceptin (Trastuzumab) for breast cancer.
Question 3
Regarding colorectal cancer screening programmes:
a)
Describe the criteria for choosing a suitable screening test.
b)
Describe the advantages and disadvantages of potential screening tests including a summary of the
evidence for each test.
c)
Describe the factors to be considered in assessing the costs and benefits.
Question 4
Describe the rationale, type of drugs used, expected benefits and potential risks associated with the use of
cytotoxic chemotherapy given concurrently with radiation treatment for cancers of the following sites:
a)
Head and neck
b) Rectum
c) Oesophagus
Question 5