Devita, Hellman, and Rosenberg's Cancer

LWBK1006-23 LWW-Govindan-Review December 12, 2011 19:10

316 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 23.2.9. She asks about prevention and treatment of HPV infections, and you

advise her:

A. The viral infections are rare, and promiscuity has caused her cancer.

B. Treatments for HPV infections with antiviral therapy are effective if

taken within 4 days of exposure.

C. An HPV vaccine has recently been approved by the Food and Drug

Administration (FDA) to help prevent infection from the most com-

mon HPV types.

D. An HPV vaccine has recently been FDA approved, and she should

receive the vaccine now to help treat her cancer.

Question 23.2.10.You counsel her about HPV and human immunodeficiency virus (HIV).

After extensive discussion, you decide to proceed with testing for HIV

with all of the following justifications, EXCEPT:

A. HIV immunosuppression is correlated with an increased risk of cer-

vical HPV infections.

B. Patients with HIV appear to have a faster rate of progression to high-

grade dysplasia (cervical intraepithelial neoplasia [CIN]).

C. Antiretroviral therapy to manage HIV has demonstrated direct activ-

ity against HPV.

D. Cervical cancers in HIV-positive women may be more aggressive than

in HIV-negative women.

Question 23.2.11.She has done extensive reading about cervical cancer and asks you about

factors that are associated with metastatic disease. You advise her the

following are associated with extracervical disease, EXCEPT:

A. Tumor size

B. Presence of microinvasion

C. Depth of invasion

D. Presence of lymph-vascular space invasion

Question 23.2.12.If her initial biopsy returned with invasive squamous cell carcinoma with

2 mm of invasion and no lymphovascular space involvement (LVSI), you

recommend that:

A. She be referred back to her gynecologist for a simple hysterectomy.

B. She be referred to the radiation oncologist for consideration of radi-

ation therapy with possible chemotherapy.

C. You begin therapy with cisplatin 40 mg/m^2 weekly for six cycles.

D. She undergo cervical conization.