Devita, Hellman, and Rosenberg's Cancer

LWBK1006-48 LWW-Govindan-Review December 12, 2011 20:53

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

Question 48.3. A 58-year-old African American man was diagnosed with advanced unre-

sectable squamous cell carcinoma of the head and neck (T4aN2Mo). He

began concurrent chemoradiation with cisplatin and radiation≥70 Gy

planned over 7 weeks. He comes to your office for a prechemotherapy

visit and enquires about the potential benefits from acupuncture therapy.

Which of the following statements is true regarding acupuncture in the

supportive care of patients with head and neck cancer?

A. Acupuncture reduces chemotherapy-induced nausea.

B. Acupuncture demonstrated significant reductions in pain, dysfunc-

tion, and xerostomia in patients with head and neck cancer undergo-

ing radiation.

C. Both A and B.

D. There are no data from prospective trials suggesting clinical benefit.

Question 48.4. A 39-year-old woman is on adjuvant tamoxifen therapy for breast cancer

and is experiencing significant hot flashes. She is taking a herbal supple-

ment which has been helping. Which of the following herbal medications

may oppose the antitumor activity of tamoxifen, and should be avoided?

A. Tea tree oil

B. Fish oil (omega-3)

C. Soy supplements

D. Kava

Question 48.5. A 70-year-old Caucasian man with refractory multiple myeloma was

treated with lenalidomide plus dexamethasone. After two cycles the

patient developed pulmonary embolism and deep vein thrombosis of the

right leg. Chemotherapy was discontinued, and the patient was started

on anticoagulation with home enoxaparin injections. He comes to your

office for a scheduled visit and reports taking a herbal remedy containing

Ginkgo extract to help his memory and cognitive function. Which of the

following statement is TRUE regarding the effects of Ginkgo?

A. Increases the risk of serious bleeds

B. Will increase the metabolism of enoxaparin

C. Decreases the responsiveness of myeloma to further chemotherapy

D. May increase risk of infection from immunosuppression