Devita, Hellman, and Rosenberg's Cancer

LWBK1006-21 LWW-Govindan-Review December 12, 2011 19:6

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

Question 21.12. All of the following are risk factors for cancer of the male urethra,

EXCEPT?

A. HPV-16

B. Chronic urethritis

C. Urethral stricture

D. Caucasian race

Questions

21.13.–21.14.

A 62-year-old woman is newly diagnosed with muscle-invasive bladder

cancer. She quit smoking 10 years ago, had a non-ST-elevated myocardial

infarction 4 years ago, underwent coronary artery bypass surgery and

has had no residual cardiac symptoms, takes only a beta-blocker and a

thiazide for hypertension, and has normal laboratory test results, includ-

ing a creatinine of 0.9. Cystoscopic biopsy revealed a muscle-invasive

bladder cancer without associated carcinoma in situ (Tcis), and CT of

the chest, abdomen, and pelvis is unremarkable.

Question 21.13. Which of the following statements about radical cystectomy is MOST

correct?

A. An orthotopic neobladder is less effective in women than in men.

B. An abdominal wall diversion will require a urostomy bag.

C. An orthotopic neobladder will require the patient to be willing and

able to perform self-catheterization.

D. Metabolic acidosis is not a significant problem with continent diver-

sions.

Question 21.14. Which of the following statements about combined radiation and

chemotherapy is MOST correct?

A. Toxicity profile and tolerability of combined radiation and

chemotherapy are significantly better than that of radical cystectomy.

B. Long-term cancer outcome is similar to cystectomy.

C. It is preferred over cystectomy because of her cardiac history.

D. It will obviate the need for cystectomy.

Question 21.15. Which of the following is CORRECT about neoadjuvant chemotherapy?

A. Three cycles of methotrexate, vinblastine, doxorubicin, and cisplatin

before cystectomy are a standard of care.

B. Gemcitabine/carboplatin should be considered to decrease the risk of

renal failure with cystectomy.

C. It increases the risk of surgical complications of cystectomy.

D. It should always be used with an organ preservation approach but is

optional if cystectomy is chosen.