CTR SEER 3

What is the name of the procedure that replenishes the supply of normal stem cells that are destroyed by high-dose chemotherapy and/or radiation therapy as part of a patient's cancer treatment? Response : A. Hematopoietic stem cell transplant B. Bone marrow transplant C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: HEMATOPOIETIC STEM CELL TRANSPLANT is a procedure that REPLENISHES the SUPPLY of NORMAL STEM CELLS that are DESTROYED by HIGH-DOSE CHEMO and/or RT as part of cancer treatment. It is also referred to as a stem cell transplantation (SCT) or bone marrow transplantation (BMT) that uses stem cells COLLECTED from the PT or DONOR BM.

autologous bone marrow transplant

A PT'S OWN BM or STEM CELLS are given to them AFTER they have received HIGH-dose CHEMO

What is the name of the procedure involving an infusion of bone marrow or stem cells from a donor that are given to the patient after they have received high-dose chemotherapy? Response : A. Allogeneic bone marrow transplant B. Autologous bone marrow transplant C. Autologous stem cell transplantation D. None of the above

A. Allogeneic bone marrow transplant Rationale: An ALLOGENEIC BM TRANSPLANT involves an INFUSION of BM or STEM CELLS from a DONOR that are given to the patient AFTER they have received HIGH-DOSE CHEMO During an autologous stem cell transplantation, blood-forming stem cells are removed, stored, and later given back to the same person.

What count does an in situ hybridization test determine? Response : A. Genes B. Cancer cells C. Both (a) and (b) D. Neither (a) nor (b)

A. Genes Rationale: An IN SITU HYBRIDIZATION test COUNTS the # of COPIES of a GENE. A GENE REPS the coded instructions in a cell that controls the behavior of a cell and duplication of new cells. It involves the use of a DNA or RNA probe (a labeled bit of DNA and RNA) to detect complimentary genetic material in cells or tissues. In situ hybridization involves the forming of a double stranded nucleic acid using a labeled nucleic acid (DNA or RNA) to suitably prepare cells or tissues on microscope slides to allow visualization in the normal location.

What is a major disadvantage(s) of using cryosurgery? Response : A. There is uncertainty regarding its long-term effect. B. Surgeons need specialized training before they can do cryosurgery. C. Both (a) and (b) D. Neither (a) nor (b)

A. There is uncertainty regarding its long-term effect. Rationale: The two major disadvantages of cryosurgery include: Uncertainty surrounding its long-term effectiveness because, while cryosurgery may be effective in treating tumors that can be seen using imaging tests, it can miss microscopic cancer spread. Because the effectiveness of the technique is still being assessed, insurance coverage issues may arise.

What term(s) refers to a substance isolated from tumor cells that may stimulate the body's immune system to find and kill cancer cells? Response : A. Tumor antigen vaccine B. PEI C. Both (a) and (b) D. Neither (a) nor (b)

A. Tumor antigen vaccine Rationale: TUMOR ANTIGEN VACCINES are made of CA CELLS, PARTS of CA CELLS, orPURE TUMOR ANTIGEN that MAY STIMULATE the body's IMMUNE SYSTEM to FIND and KILL CA CELLS.

What statement(s) is true regarding the blood-brain barrier disruption? Response : A. With a concentrated sugar solution or drugs, the tightly knit cells that line the brain's blood vessels can be shrunk, which allows chemotherapy to pass into the brain and reach the tumor. B. Because this barrier exists, chemotherapy must be given a certain way to treat brain tumors effectively (e.g., via an injection of the femoral vein). C. Both (a) and (b) D. Neither (a) nor (b)

A. With a concentrated sugar solution or drugs, the tightly knit cells that line the brain's blood vessels can be shrunk, which allows chemotherapy to pass into the brain and reach the tumor. Rationale: The blood-brain barrier is a protective network of blood vessels and tissue that protects the brain from harmful substances, but can also prevent anticancer drugs from reaching the brain. Blood-brain barrier disruption refers to the use of drugs or specific solutions to create openings between tightly knit cells that form the blood-brain barrier. Because this barrier exists, CHEMO MUST BE GIVEN a CERTAIN WAY to TX BRAIN TUMORS effectively. For example, with a CONCENTRATED SUGAR SOLUTION the tightly knit cells that line the BRAINS BLOOD VESSEL can be SHRUNK, ALLOWING CHEMO to be INFUSED (e.g. femoral) that goes to the BRAIN and can REACH the TUMOR. Compared to standard chemotherapy, this type of blood-brain barrier disruption procedure DELIVERS 10 to 100 times more MED TO THR TUMOR and its surrounding area.

Which statement(s) regarding x-rays is true? Response : A. X-rays are a type of radiation called electromagnetic waves B. Bones appear gray on x-rays while fat and other soft tissues appear white. C. Both (a) and (b) D. Neither (a) nor (b)

A. X-rays are a type of radiation called electromagnetic waves Rationale: An x-ray is a type of IMAGING used in the DX and TX of CA and other DZ. X-rays are a type of RADIATION called ELECTOMAGNETIC WAVES. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. The images show the parts of your body in different shades of black, white and gray. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less, and look gray. Air absorbs the least, so lungs look black. When you have an x-ray, you may wear a lead apron to protect certain parts of your body.

What term(s) refers to the selective destruction of tissue by use of chemicals? Response : A. Chemotaxis B. Chemosurgery C. Both (a) and (b) D. Neither (a) nor (b)

B. Chemosurgery Rationale: Chemosurgery involves the SELECTIVE DESTRUCTION of TISSUE by use of CHEMICALS.

What is the implication(s) of a negative sentinel lymph node biopsy? Response : A. It confirms cancer has not spread to nearby lymph nodes. B. It decreases the number of lymph node dissections performed unnecessarily. C. Both (a) and (b) D. Neither (a) nor (b)

B. It decreases the number of lymph node dissections performed unnecessarily. Rationale: A negative sentinel lymph node biopsy (SLNB) result suggests that cancer has not developed the ability to spread to nearby lymph nodes or other organs. However, there is a POTENTIAL it is actually a FALSE NEG RESULTS cancer cells are not seen in the SLNB although they are present and may have already spread to other regional lymph nodes or other parts of the body. There may, in fact, still be cancerous cells in the lymph node basin. There are advantages to the sentinel node procedure, including: Decreases lymph node dissections where unnecessary SLNB has a REDUCED RISK OF LYMPHEDEMA COMPARED to a LYMPH NODE DISSECTION Increased attention on the node(s) identified to MOST LIKELY contain METS is also more likely to detect MICROMETS that could impact stage and treatment decisions.

What statement(s) is true regarding most tumor markers? Response : A. Most markers have enough sensitivity or specificity to be useful in screening programs. B. Markers are most useful in detecting early relapse of a malignancy and monitoring the response to therapy. C. Both (a) and (b) D. Neither (a) nor (b)

B. Markers are most useful in detecting early relapse of a malignancy and monitoring the response to therapy. Rationale: While most tumors release detectable markers into the circulation, no tumor marker has all the characteristics mentioned below to provide enough sensitivity or specificity to be useful in screening programs. The following are characteristics of an ideal tumor marker: It is released from only tumor tissue. It is specific for a given tumor type. It is detectable at low levels of tumor burden. There is a direct relationship between the marker's presence and the existence of the tumor. It must be present in all patients with a particular form of cancer. Serum tumor markers may offer corroborating evidence in patients with findings suggestive of a specific cancer. However, markers are most useful in detecting early relapse of a malignancy and monitoring the response to therapy.

Which phase of a clinical trial compares a new drug to the standard treatment currently offered to cancer patients? Response : A. Phase IV trials B. Phase III trials C. Phase II trials D. Phase I trials

B. Phase III trials Rationale: The goals of the four phases of clinical trials are: Phase I - IDENTIFY the OPTIMUM DOSAGE of the NEW DRUG that RESULTS in the FEWEST SIDE EFFECTS Phase II - EVALUATE whether the NEW DRUG works for a specific type of MALIG Phase III - COMPARE the new drug to the STANDARD TX currently OFFERED BY CA PTS. Phase IV - TEST the FDA (Food and Drug Administration) approved NEW DRUGS in many more patients DX W/ different types of MALIG

What is the magnifying power of an electron microscope compared to a light microscope? Response : A. The electron microscope's magnifying power is about 10,000 times greater than that of an ordinary light microscope. B. The electron microscope's magnifying power is about 1,000 times greater than that of an ordinary light microscope. C. The electron microscope's magnifying power is about 100 times greater than that of an ordinary light microscope. D. None of the above

B. The electron microscope's magnifying power is about 1,000 times greater than that of an ordinary light microscope. Rationale: The ELECTRON MICROSCOPES MAGNIFYING POWER is about 1,000 x GREATER than that of an ordinary light microscope. This degree of magnification is rarely needed to confirm whether a cell is cancer. However, sometimes it helps find very tiny details of a cancer cell's structure that provide clues to the exact type of cancer.

Permanent section

Biopsy MOUNTED specially PREPARED and MOUNTED on SLIDES so that it CAN BE EXAMINED UNDER MICROSCOPE by a pathologist.

Question : What blood test(s) is used to check for a possible metastasis of cancer? Response : A. CBC B. Blood enzyme tests C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: A complete blood count (CBC) and a check on the carcinoembryonic antigen (CEA) level are examples of blood tests that can be used to help assess whether cancer has spread. For example, if blood counts are low, the cancer may have spread to the bone or is causing bleeding. A high CEA level suggests that cancer has spread in a male or in a female who is not pregnant. Blood tests can also be done to check for the following enzymes that may indicate distant metastasis: Alkaline phosphatase - elevated levels might indicate skeletal metastases Alpha-fetoprotein - elevated levels might indicate liver metastasis

In what way(s) is an endoscopy inserted for the purpose of an endoscopic biopsy? Response : A. Through the mouth B. Through a tiny surgical incision C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: An ENDOSCOPIC BX involves the use of an endoscope, which is a thin, lighted, flexible tube with a camera used to view the inside of the body, including the bladder, abdomen, joints, or gastrointestinal tract. An endoscope can be inserted through any orifice (e.g., mouth, anus, urethra) or through a tiny surgical incision. Using an endoscope, the doctor can see any abnormal areas and pinch off tiny samples of the tissue using forceps that are part of the endoscope.

Which form(s) of radiation therapy involves an injection of a radioactive substance into the body? Response : A. BNCT B. Radioembolization C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: BNCT, RADIOEMBOLIZATION, as well as RADIOIMMUNOTHERAPY are all forms of RT that involve the INJECTION of a RADIOACTIVE SUBSTANCE into the body. As part of Boron Neutron Capture Therapy (BNCT), a substance that contains boron is injected into a blood vessel. The boron collects in the tumor cells. The patient then receives radiation therapy with atomic particles called neutrons. The neutrons react with the boron to kill the tumor cells without harming normal cells. Radioembolization involves the use of TINY BEADS that hold the radioisotope YTTRIUM 90 (Y 90) which are INJECTED into an ARTERY. The BEADS COLLECT in the TUMOR and the YTTRIUM 90 (Y 90) GIVES OFF RADIATION . This DESTROYS the BLOOD VESSELS that the TUMOR needs to GROW and KILLS the CA cells. During radioimmunotherapy, the RADIOACTIVE SUBSTANCE is linked to an ANTIBODY that LOCATES and kills TUMOR cells when INJECTED into the body. Radioimmunotherapy involves the use of a monoclonal antibody which has a radioactive particle attached to it. This has the benefit of killing the cancer cell that the antibody is attached to, and also killing many more cells that are in the radiation path. This means that even cells that do not have the antibody attached to them will still be killed. Because the antibody only attaches to cells that express the target antigen, nearly all normal tissue is spared any radiation.

Which type(s) of radiation therapy is considered a form of brachytherapy? Response : A. Implant radiation therapy B. Radioembolization C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: Brachytherapy is RT INSIDE the BODY. It uses RADIOACTIVE MATERIALS (sealed in needles, SEEDS, WIRES, or CATHETERS) PLACED CLOSE to the TUMOR to kill cancer cells while minimizing damage to normal tissues. It is also referred to as implant radiation therapy, internal radiation therapy, and radiation brachytherapy. Radioembolization is a type of radiation therapy in which tiny beads that hold the radioisotope yttrium 90 (Y 90) are injected into an artery. The beads collect in the tumor and the yttrium 90 (Y 90) gives off radiation. This destroys the blood vessels that the tumor needs to grow and kills the cancer cells. Radioembolization is a type of selective internal radiation therapy (SIRT). It is also called intra-arterial brachytherapy.

What term(s) refers to the use of a chemical agent to prevent the development of cancer? Response : A. Chemoprophylaxis B. Chemoprevention C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: Chemoprophylaxis and chemoprevention both involve the use of a chemical agent to prevent the development of cancer.

What type(s) of biopsy involves the use of image technology? Response : A. Percutaneous biopsy B. Stereotactic core biopsy C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: During a PERCUTANEOUS BX the RADIOLOGIST uses an US MACHINE or the CT scanner to DECIDE on the most SUITABLE POINT for INSERTING the biopsy NEEDLE to obtain tissue. The procedure involves a PUNCTURE of a TUMOR, the tissue within the lumen of the needle being DETACHED BY ROTATION, and the NEEDLE WITHDRAWN. Stereotactic core biopsy is a procedure in which tissue is removed with the help of a computer and imaging performed in at least two planes to localize a target lesion in three-dimensional space and guide the removal of tissue for examination by a pathologist under a microscope.

Question : What statement(s) is true regarding the presence of MSI? Response : A. The DNA mismatch repair process is not working correctly. B. The MSI level is used to evaluate whether chemotherapy might be effective for selected cancer primaries. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: Microsatellite instability (MSI) is a type of DNA mutation that occurs in some tumor cells. In this type of mutation, the number of repeating, short sequences of DNA is different from the number of repeating, short sequences in the DNA when it was originally inherited. MSI is phenotypic proof that DNA mismatch repair is not functioning normally. The DNA mismatch repair process should correct errors (e.g., single base mismatches or short insertions and deletions) that spontaneously occur during DNA replication. If the process is working correctly, the proteins involved in the mismatch repair form a complex that binds to the mismatch, identifies the correct strand of DNA, then subsequently removes the error and repairs the mismatch. If the mismatch repair is not working properly, cells tend to accumulate rather than correct those errors. As a result, gene sequences are not preserved accurately through DNA replication and new microsatellite fragments are created. The clinical implication of the presence of MSI impacts treatment recommendations and whether or not chemotherapy would prove effective for a specific cancer type and stage of disease at presentation.

Who is unaware of those on the experimental or control arm of the study in a randomized blind trial? Response : A. Study participants on the control arm B. Study participants on the experimental arm C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: Participants are UNAWARE of whether THEY ARE ON the DEVELOPMENT or CONTROL ARM of a randomized "blind" clinical trial. These trials are also known as "MASKED" trials.

Which statement(s) is true regarding a patient in remission? Response : A. Remission is the state following treatment during which a physician cannot find any cancer cells over a six month period. B. Remission does not mean the cancer has disappeared completely; it means only that no cancer cells have been found after testing. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: Remission refers to the state that exists after the cancer has been treated and no cancer cells are found when tests are subsequently conducted. If the physician cannot find any cancer cells over the course of six months, the patient is considered to be in remission. This does not mean the cancer has disappeared completely. It means only that no cells have been found after testing.

What type(s) of laser is used to treat cancer? Response : A. CO2 B. Argon C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: The following are the three types of lasers used to treat cancer patients: CO2 and ARGON LASERS can CUT SKIN SURFACE W/O GOING INTO DEEP LAYERS. They can be used to remove SUPERFICIAL CA, such as SKIN CA. Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is more commonly applied through an endoscope to treat internal organs, such as the colon, esophagus, and uterus. Nd:YAG laser light can also travel through optical fibers into specific areas of the body during laser-induced interstitial thermotherapy (LITT).

What is removed from the pleural space during a pleural tap? Response : A. Pus B. Blood C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Rationale: Thoracocentesis or PLEURAL TAP is an INVASIVE PROCEDURE to REMOVE an ABN COLLECTION OF FLUID (pus, blood, or too much pleural fluid) or AIR from the PLEURAL SPACE (the area that SEPARATES the LUNG from the CHEST WALL) for diagnostic or therapeutic purposes. A cannula, or hollow needle, is introduced into the thorax, generally after administration of local anesthesia.

Chemotaxis

Chemotaxis refers to the MOVEMENT of a CELL ALONG a CHEMICAL CONCENTRATION GRADIENT either TOWARD or AWAY from the CHEMICAL STIMULUS.

Which of the following is not a common laboratory test used to evaluate how well the kidneys are functioning? Response : A. Alkaline Phosphatase marker B. Blood urea nitrogen (BUN) chemistry C. Creatinine blood test D. None of the above

Correct Answer : A. Alkaline Phosphatase marker Rationale: ALK PHOSPHATASE is a TUMOR MARKER that may be included in blood chemistry screening panel. The alkaline phosphatase test (ALP) is used to HELP DETECT LIVER DZ or BONE DISORDERS. Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Two such tests include: BUN (blood urea nitrogen) is a chemistry study of blood serum to MEASURE the LEVEL OF UREA in the BLOOD, a SIGN OF IMPAIRED KIDNEY FUNCTION or URINARY OBSTRUCTION. This test is performed to check how the kidneys are functioning before starting to take certain drug therapies. Creatinine blood test evaluates the creatinine level in the blood. CREATININE is REMOVED from the BIDY ENTIRELY by the KIDNEYS. If KIDNEY FUNCTION is not NORMAL, CREATININE LEVEL INCR in the BLOOD because less creatinine is released through the urine.

What term refers to the removal of a sample of fluid and cells through a needle? Response : A. Aspiration B. Biopsy C. Core needle biopsy D. None of the above

Correct Answer : A. Aspiration Rationale: ASPIRATION refers to the REMOVAL of a SAMPLE OF FLUID and CELLS through a NEEDLE. A FNA refers to the use of a slender NEEDLE to REMOVE FLUID from a CYST or CLUSTERS of CELLS from a SOLID LUMP. Biopsy refers to the removal of a sample of tissue for purposes of diagnosis.

Question : What test measures changes in the number and/or structure of chromosomes in a patient's white blood cells or bone marrow cells? Response : A. Immunophenotyping B. Cytogenetic analysis C. Cancer gene mutation test D. None of the above

Correct Answer : B. Cytogenetic analysis Rationale: Cytogenetic analysis measures changes in the number and/or structure of chromosomes in a patient's white blood cells or bone marrow cells. It is useful in diagnosing various cancers and in deciding on appropriate treatment. Cancer gene mutation test measures the presence or absence of specific inherited mutations in genes that are known to play a role in cancer development. It is used to assess cancer risk.

Which procedure provides a quick preliminary diagnostic reference but is not 100 percent reliable? Response : A. Fine needle aspiration B. Frozen section C. Permanent section D. None of the above

Correct Answer : B. Frozen section Rationale: Frozen section: A sliver of frozen biopsy tissue. A frozen section provides a QUICK preliminary DX, but it is not 100% RELIABLE.

When may neoadjuvant chemotherapy be given? Response : A. Before surgery B. Before radiation therapy C. Both (a) and (b) D. Neither (a) nor (b)

Correct Answer : C. Both (a) and (b) Rationale: Neoadjuvant chemotherapy may be given before surgery or radiation to shrink a large cancerous tumor, making it easier to remove with surgery or allow it to be treated more easily with radiation. Neoadjuvant chemotherapy also can kill small deposits of cancer cells that cannot be seen on scans or x-rays. Chemotherapy is also considered neoadjuvant if it is given in combination with radiation therapy prior to planned surgical resection.

Who might be unaware of what medication a participant is taking in a single-blind study? Response : A. The participant may be unaware of the medication he/she is receiving but the investigator knows. B. The investigator may be unaware of the medication he/she is giving to the participant but the participant knows the medication being given. C. Both (a) and (b) D. Neither (a) nor (b)

Correct Answer : C. Both (a) and (b) Unfortunately, there ISNT ONLY ONE interpretation of the meaning of a single-blind study. For example, according to Medscape, in a single-blind study either the INVESTIGATOR or the PARTICIPANT is UNAWARE of what MEDICATION the PARTICIPANT is taking. However, according to the National Cancer Institute (NCI) Dictionary of Cancer Terms, only the investigator knows whether a patient is taking the standard treatment or the new treatment being tested. As a result of these different definitions, the best answer for this question is to assume that in a single-blind study either the investigator or the participant may be unaware of what medication the participant is taking.

What type of diagnostic imaging involves the use of a transducer? Response : A. CT scan B. MRI C. X-ray D. None of the above

Correct Answer : D. None of the above Rationale: The use of a DEVICE called a TRANSDUCER occurs during an ULTRASOUND. The patient lies on a table during an ultrasound test while the physician or ultrasound technician moves a transducer over the area of the body under investigation. The transducer sends out sound waves, which bounce off the tissues inside the body, and it also captures the waves that bounce back. The ultrasound machine creates images from those sound waves. An ultrasound is a procedure that uses HIGH-ENERGY WAVES to look at tissues and organs inside the body. The sound waves make echoes that form pictures (sonogram) of the tissues and organs on a computer screen. An ultrasound may be used to help diagnose diseases such as cancer. Health care professionals use it to view the blood vessels, heart, liver, kidneys, and other organs. During pregnancy, doctors use ultrasound to view the fetus. Unlike x-rays, ultrasound does not expose the body to radiation. The following diagnostic imaging methods do not involve the use of a transducer: A CT scan is a procedure that uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create 3-dimensional (3-D) views of tissues and organs - cross-sectional pictures. A dye may be injected into a vein or swallowed to help the tissues and organs show up more clearly. An MRI is a procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures that differentiate between normal and diseased areas inside the body. An MRI makes better images of organs and soft tissue than other scanning techniques, such as a CT scan or x-ray. X-rays are a type of radiation called electromagnetic waves. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. The images show the parts of the body in different shades of black, white, and gray. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less, so they look gray. Air absorbs the least, so lungs look black.

Which of the following environmental factors is not linked to an increased risk of developing cancer? Response : A. Viruses B. Bacteria C. Radiation D. None of the above

Correct Answer : D. None of the above Rationale: There are several environmental factors linked to an increased risk of developing various cancers including: Viral infections (e.g., Epstein-Barr, Hepatitis B or C, HPV, human herpes virus 8) Bacterial infections (e.g., H-pylori) Radiation (e.g., ultraviolet, ionizing, radon gas) Drugs and chemicals (e.g., estrogens, progestin, DES) Dietary substances (e.g., diets high in fat, consumption of large amounts of alcohol, diets high in smoked or pickled foods)

What organ(s) is examined using a colposcope? Response : A. Uterus B. Ovaries C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: A COLPOSCOPE is used to EXAMINE the CERVIX and the VAGINA for ABNORMALITIES. Through the colposcope, the clinician can see certain CHANGES in CERVICAL and VAGINAL tissues, such as abnormal blood vessels, tissue structure, color, and patterns. A speculum is inserted into the vagina. The colposcope is placed at the opening of the vagina but does not enter. A laparoscope inserted through a small, surgical opening in the abdomen can be used to view the female reproductive organs, including the uterus, ovaries and fallopian tubes.

What statement(s) regarding a double-blind study is true? Response : A. Double-blind studies produce subjective results because the expectations of the doctor and the participant about the experimental drug do not affect the outcome. B. Double-blind studies require that one group of patients be given an experimental drug or treatment while the control group is given a standard treatment for the illness. C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: A DOUBLE-BLIND STUDY is a clinical trial design in which NEITHER the PARTICIPANT individuals NOR THE STUDY STAFF WHICH PARTICIPANTS are RECEIVING EXPERIMENTAL DRUGS and WHICH ARE RECEIVING either a PLACEBO or the STANDARD TX for the illness. Double-blind trials are thought to PRODUCE OBJECTIVE RESULTS because the EXPECTATIONS of the MD and the PARTICIPANT about the EXPERIMENTAL DRUGS DO NOT AFFECT THE OUTCOME.

What type(s) of scope(s) is used to view the pleura covering the lungs? Response : A. Bronchoscope B. Mediastinoscope C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: A thoracoscope is used to view the PLEURA COVERING LUNGS and structures COVERING THE HEART. It is inserted through a small surgical OPENING IN CHEST. A bronchoscope is used to view the TRACHEA and BRONCHI OF THE LUNGS. It is inserted THROUGH THE MOUTH A mediastinoscope is used to view the LNS BETWEEN THE LUNGS. It is inserted through a SMALL CUT made in the FRONT OF NECK ABOVE THE STERNUM.

What type(s) of biopsy involves obtaining tissue by puncturing the tumor, the tissue within the lumen of the needle being detached by rotation, and the needle withdrawn? Response : A. Cone biopsy B. Excisional biopsy C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: PERCUTEOUS BX is a procedure in which tissue is obtained by PUNCTURE of a tumor, the TISSUE WITHIN within the LUMEN of the NEEDLE being DETACHED by ROTATION, and the needle withdrawn. This procedure is also called a NEEDLE BX

Who is aware of those on the experimental or control arm of the study in a randomized blind trial? Response : A. Study participants on the control arm B. Study participants on the experimental arm C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: Participants are UNAWARE of whether they are on the EXPERIMENTAL or CONTROL ARM of a RANDOMIZED "BLIND" CLINICAL TRIALS. These trials are also known as "MASKED" TRIALS.

Which treatment modality(ies) is considered a form of systemic therapy used to treat malignancies? Response : A. Surgery B. EBRT C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: Systemic therapy refers to treatment that uses SUBSTANCES (e.g., chemotherapy, hormonal drug therapy, immuno drug therapy, radiopharmaceuticals) that TRAVEL THROUGH BLOODSTREAM to reach and affect cells throughout the body. Local treatment options are those that destroy, remove, or control malignant cells in a particular area. Surgery and external beam radiation therapy (EBRT) are examples of localized therapy.

What surgical procedure(s) results in a specimen being sent to the pathology department? Response : A. Fulguration B. PDT C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: The following surgical procedures result in no specimen being sent to the pathology department unless they are done in combination with a local tumor excision (e.g., excisional biopsy): CRYOSURGERY Electrocautery; FULGERATION LASER PHOTODYNAMIC THERAPY (PDT)

What term(s) describes a method of providing experimental therapy options prior to final FDA approval for use in humans? Response : A. Palliative therapy B. Maintenance therapy C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Rationale: The term COMPASSIONATE USE describes a METHOD of providing EXPERIMENTAL THERAPY OPTIONS PRIOR to FINAL FDA APPROVAL for use in HUMANS. This procedure is used with VERY SICK INDIVIDUALS who have NO other TX OPTIONS. Often, case-by-case APPROVAL MUST be OBTAINED from the FDA for "compassionate use" of a DRUG OR THERAPY. Palliative therapy refers to treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments from the time of diagnosis through treatment, survivorship, recurrent or advanced disease, and at the end of life.

Radiation works by making small breaks in the

DNA inside cells

FNA

Fine needle aspiration: The use of a SLENDER NEEDLE to REMOVE FLUID from a cyst or clusters of cells from a solid LUMP

Percutaneous ethanol injection (PEI)

INJECTION of ALCOHOL THROUGH the SKIN DIRECTLY into a TUMOR to KILL CA CELLS. US or a CT scan is USED to guide the NEEDLE INTO the TUMOR. It is also called alcohol ablation, ethanol ablation and percutaneous ethanol injection.

laparoscope

INSERTED through a SMALL, SURG OPENING in the ABD can be used to view the female reproductive ORGANS, including the UTERUS, OVARIES and FALLOPIAN TUBES

Immunophenotyping

Immunophenotyping identifies cells based on the types of antigens present on the cell surface. It is used to diagnose, stage, and monitor cancers of the blood system and other hematologic disorders. It is most often done on blood or bone marrow samples, but it may also be done on other bodily fluids or biopsy tissue samples.

autologous stem cell transplantation

PT'S OWN BLOOD-FORMING STEM CELLS are REMOVED, STORED, and later GIVEN BACK to the SAME PERSON

Core needle biopsy

REFERS to the use of a SMALL CUTTING NEEDLE to REMOVE a core of tissue for microscopic examination.

Maintenance therapy

Refers to TX GIVEN TO HELP KEEP CA from COMING BACK AFTER it HAS DISAPPEARED following the INITIAL THERAPY.

What term refers to measuring a specific stage of cell division to assess how aggressive the tumor is? Response : A. Ploidy status B. S-phase C. Flow cytometric results D. None of the above

S-phase

What type of chemotherapy drug stops mitosis or inhibits enzymes from making proteins needed for cell reproduction? Response : A. Alkylating agents B. Anthracyclines C. Topoisomerase inhibitors D. None of the above

Some forms of chemotherapy and their actions include: Microtubule inhibitors or mitotic inhibitors (Paclitaxel (Taxol) and Docetaxel (Taxotere)) can stop mitosis or inhibit enzymes from making proteins needed for cell reproduction. Alkylating agents (Chlorambucil, Cyclophosphamide (Cytoxan), Ifosfamide, and Melphalan) damage DNA by adding a chemical to it. Anthracyclines (Daunorubicin, Doxorubicin (Adriamycin)) interfere with and damage the formation of DNA. Antimetabolites (5-fluorouracil (5-FU), Capecitabine (Xeloda), Cytarabine (Ara-C), Gemcitabine (Gemzar), Hydroxyurea, Methotrexate) inhibit the building blocks of DNA to be used. Topoisomerase inhibitors (Etoposide (VP-16), Irinotecan (CPT-11), Topotecan) interfere with the enzymes (i.e., topoisomerases) that help separate DNA strands so they can be copied during the S-phase, which is the part of the cell cycle in which DNA is replicated. .

Cone biopsy

is a PROCEDURE in which an inverted FUNNEL SHAPED area of TISSUE is EXCISED, as from the UTERINE CERVIX.

Open-label trial

is a clinical trial in which DOCTORS and PARTICIPANTS KNOW which DRUG OR VACCINE is being ADMINISTERED.

Ultrasound energy

is a form of THERAPY that involves INTENSIFIED US ENERGY that is DIRECTED AT CA CELLS to HEAT and KILL THEM.

Excisional biopsy

is a surgical procedure which results in a NARROW SURG MARGIN while REMOVING the ENTIRE TUMOR.

Cancer gene mutation test

measures the presence or absence of specific inherited mutations in genes that are known to play a role in cancer development. It is used to assess cancer risk.

Off-label use

refers to a DRUGS PERSCRIBED for CONDITIONS OTHER THAN those APPROVED by the FDA.

Orphan drugs

refers to an FDA CATEGORY OF MEDS USED TO TX DZ and CONDITIONS that OCCUR RARELY. There is LITTLE FINANCIAL INCENTIVE for the PHARMACEUTICAL INDUSTRY to DEVELOP MEDS for these DZ OR CONDITIONS. Orphan drug status, however, GIVES THE MANUFACTURER financial INCENTIVE to DEVELOP AND PROVIDE such MEDS.

Flow cytometry

refers to the measurement of CELLS IN A FLOW SYSTEM, which DELIVERS the CELLS SINGLY PAST A POINT of measurement that a COMPUTER ANALYSIS. Flow cytometry is USED TO MEASURE the S-phase FRACTION, which is the PERCENTAGE of CELLS in a SAMPLE that are in a CERTAIN STAGE DIVISION called the synthesis or S-phase. The more cells that are in the S-phase, the faster the tissue is growing and the more aggressive the cancer is likely to be.