Doctor & Healthcare Professionals FAQs

Biopsy is avoided in highly vascular tumours (e.g., pheochromocytoma, RCC without imaging confirmation) or when surgical resection is planned directly (e.g., resectable testicular mass).

Commonly seen in squamous cell carcinomas (lung, head & neck), renal cell carcinoma, and multiple myeloma due to PTHrP or bone metastasis.

In select advanced cancers, liquid biopsy (circulating tumour DNA) can help detect mutations (e.g., EGFR in lung cancer) non-invasively when tissue biopsy is risky.

Cervical cancer remains prevalent in rural India due to lack of screening and awareness. VIA and Pap smears are cost-effective screening tools.

Not always. Some aggressive prostate cancers may not raise PSA significantly. PSA density, velocity, and DRE findings also matter.

Rule out GI malignancy via fecal occult blood test and colonoscopy. Iron deficiency in elderly males or postmenopausal women warrants malignancy workup.

ECOG (0–5) quantifies functional status. It guides treatment decisions — chemo is generally not advised if ECOG ≥3 due to high risk and poor tolerance.

Neoadjuvant chemo helps shrink tumours, makes inoperable tumours operable, allows breast conservation, and offers early insight into chemo responsiveness.

Change in bowel habits, rectal bleeding, anemia, tenesmus, or abdominal mass in elderly patients should prompt early colonoscopy.

No. It is also relevant in ovarian, pancreatic, and prostate cancers with family history. It helps guide surveillance and prophylactic surgery in relatives.

Ki-67 is a proliferation index. A high value suggests aggressive tumour behavior and may guide chemo decision-making, especially in breast cancer.

Usually 5 years minimum with tapering frequency: every 3 months in year 1–2, every 6 months in year 3–5. Some cancers require lifelong surveillance.

Checkpoint inhibitors like PD-1/PD-L1 blockers release the brakes on T-cells to fight cancer. They are used in melanoma, lung, bladder, and head & neck cancers.

Febrile neutropenia is an oncologic emergency. It requires hospital admission, broad-spectrum antibiotics, and urgent referral to oncology.

Fever, night sweats, and weight loss (B symptoms) indicate systemic involvement and worse prognosis in Hodgkin’s and non-Hodgkin’s lymphoma.

Only if clinically indicated in emergencies like spinal cord compression or SVC syndrome. Otherwise, wait for histopathological confirmation.

TLS occurs when a large tumour burden is rapidly destroyed, releasing electrolytes. Seen in leukemias/lymphomas post-chemo. Prophylaxis with hydration/allopurinol is key.

Not always. It depends on margin status, node involvement, and tumour grade. Multidisciplinary review is essential.

Cluster Differentiation (CD) markers help classify hematological malignancies (e.g., CD20 in B-cell lymphomas) and guide targeted therapy.

MRD refers to the small number of cancer cells remaining after treatment, detectable by flow cytometry or PCR. It helps guide prognosis and further therapy.

Suspect in patients with unexplained bone pain, anemia, hypercalcemia, or renal dysfunction. Check serum protein electrophoresis and Bence-Jones proteins.

Breast, prostate, lung, kidney, and thyroid cancers are notorious for bone metastases. Present with pain, fractures, or spinal cord compression.

Used in small cell lung cancer after response to chemo/radiation to reduce brain metastasis risk. Decision depends on disease extent and response.

Yes, for symptomatic relief. However, they must inform the treating oncologist and ensure compatibility with ongoing therapy.

Unexplained hyponatremia, hypercalcemia, hypoglycemia, or polycythemia may suggest underlying malignancy.

Oral cavity cancer, largely due to tobacco use. GPs should examine oral mucosa routinely in high-risk individuals.

A procedure to identify and test the first draining lymph node from a tumour site. Common in breast and melanoma to avoid extensive nodal dissection.

Lacks ER/PR/HER2. Requires chemotherapy as hormonal and HER2-targeted therapies are ineffective. Has poorer prognosis.

Renal function, electrolytes (esp. Mg, K), hearing tests (for ototoxicity), and hydration status must be closely tracked.

Early in the course of any metastatic or advanced cancer. It improves symptom control, emotional well-being, and sometimes even survival.

Malignant effusions are often exudative, recurrent, hemorrhagic, and associated with weight loss or underlying mass. Cytology confirms malignancy.

Cancer cachexia is metabolic weight loss with muscle wasting, often refractory to nutrition. Managed with supportive care, appetite stimulants, and palliative interventions.

By boosting immune activity, they can cause colitis, hepatitis, pneumonitis, and endocrinopathies. Requires high suspicion and steroids.

Yes. Most patients should be vaccinated, though timing should be optimized around chemotherapy or bone marrow suppression.

Scrotal ultrasound for diagnosis; CT chest, abdomen, and pelvis for staging. Tumour markers (AFP, β-HCG, LDH) are also essential.

Some studies show long-term aspirin use may reduce colorectal cancer risk. Discuss with caution in patients at risk for GI bleeding.

Tumour lysis syndrome, leukostasis (esp. in AML), and DIC (esp. in APL). Needs urgent haematology referral.

Promptly assess severity, communicate with oncology, and avoid empirical treatment unless emergency. Document thoroughly.

Rarely, unless bone marrow involvement is suspected (e.g., small cell lung cancer with cytopenias). Mostly done for hematological malignancies.

HER2 overexpression indicates aggressive breast cancer subtype. Treated with anti-HER2 agents like trastuzumab and pertuzumab.

Genetic counseling helps patients understand hereditary cancer risks (e.g., BRCA, Lynch syndrome), guides preventive strategies, and informs family members for testing or surveillance.

In metastatic cancers where cure is not possible, palliative chemo may be offered to prolong survival, reduce tumour burden, and improve symptoms — considering performance status and patient wishes.

No. While CT can detect masses, endoscopy with biopsy remains the gold standard for diagnosing esophageal, gastric, and colorectal cancers.

An apparent increase in tumour size due to immune cell infiltration, not true progression. Confirmed via follow-up imaging or biopsy. Common with PD-1/PD-L1 inhibitors.

Start high-dose corticosteroids, obtain MRI urgently, and refer for radiation or surgery. Delay can result in irreversible neurological damage.

A state where cancer has limited metastases (usually <5 sites). Aggressive local therapy (e.g., SBRT or metastasectomy) may be curative or prolong survival.

Cardiotoxicity (esp. with anthracyclines), neuropathy, secondary malignancies, infertility, and cognitive dysfunction (“chemo brain”).

Brain mets are usually multiple, located at grey-white junction; primary tumours are solitary. MRI with contrast and biopsy assist diagnosis.

MSI-high tumours (e.g., in colorectal or endometrial cancer) respond well to immunotherapy and may indicate Lynch syndrome.

Yes, especially in ER-positive breast cancer or metastatic prostate cancer. Duration depends on tolerance, disease response, and recurrence risk.

Subacute memory loss, psychiatric symptoms, seizures, or ataxia without infection may suggest autoimmune/paraneoplastic encephalitis. Urgent referral and workup are needed.

Curative RT aims to eradicate disease. Consolidative RT is given after systemic therapy to reinforce response (common in lymphoma, lung cancer).

TMB reflects the number of mutations in a tumour. High TMB may predict better response to immunotherapy in some cancers.

Triple therapy (PPI + clarithromycin + amoxicillin/metronidazole) for 14 days. Recommended in high-risk populations to reduce gastric cancer incidence.

Before radiation or surgery. Dental infections can worsen mucositis or osteoradionecrosis post-radiation.

Metastatic cancer with no identifiable primary despite extensive workup. Managed based on histology and site — biopsy and IHC are crucial.

Multidisciplinary tumour boards improve decision-making by involving oncologists, surgeons, pathologists, radiologists, and other specialists for personalized care.

Yes, under guidance. Tamoxifen, aromatase inhibitors, or androgen deprivation agents can be continued in stable patients with oncologist input.

In cases of relapse, resistance, or atypical progression to assess for mutation changes (e.g., EGFR T790M in lung cancer) and guide next-line treatment.

Multiparametric MRI helps in diagnosis, staging, and guiding biopsy (PI-RADS scoring system). It improves accuracy in detecting clinically significant cancer.

They block CTLA-4 or PD-1/PD-L1 pathways, boosting T-cell response. Used in melanoma, lung, RCC, bladder, HNSCC, and MSI-high tumours.

A minimally invasive technique using thermal energy to destroy small tumours (commonly in liver or lung), useful in selected oligometastatic cases.

Heated intraperitoneal chemotherapy is used during surgery for peritoneal carcinomatosis (e.g., ovarian, colon). Requires expert centres.

New-onset headache, seizures, vision changes, focal deficits, or altered sensorium. Prompt neuroimaging is essential.

Surgical removal of as much tumour as possible (e.g., ovarian cancer) before or during chemotherapy. It improves outcomes in selected patients.

Granulocyte colony-stimulating factor prevents/treats neutropenia. Used prophylactically when febrile neutropenia risk exceeds 20%.

An electric-shock sensation down the spine with neck flexion — a delayed effect of spinal cord radiation. Usually self-limiting.

Using immune-related response criteria (iRECIST), as pseudo-progression can occur. Clinical judgment is vital.

Yes. Most can tolerate standard treatments. Drug interactions and immune status (CD4 count) must be considered.

PMJAY, MJPJAY (Maharashtra), NGO funding, Tata Trusts, and hospital-based social work departments assist eligible patients.

Yes. Both may present with weight loss, lymphadenopathy, or lung lesions. Tissue diagnosis (biopsy) is key.

It guides treatment: ER/PR-positive cancers need hormonal therapy; HER2-positive cancers require trastuzumab. Triple-negative needs chemo.

Used in prostate cancer to reduce testosterone levels via GnRH agonists/antagonists or orchiectomy. Slows disease progression.

Flu, COVID-19, pneumococcal, and Hepatitis B (if not immune). Avoid live vaccines during immunosuppression.

Immunohistochemistry helps determine tumour origin and receptor status — critical in CUP, breast cancer, and lymphomas.

Use WHO analgesic ladder. Morphine is safe and effective. Consider palliative consult and adjuvants for neuropathic pain.

High-dose, focused radiation delivered in 1–5 sessions for small brain/spine metastases. Requires precise planning.

Post-treatment care focusing on surveillance, secondary prevention, psychosocial support, and managing late effects.

Many can. Fertility assessment before treatment is vital. Pregnancy is safe after remission depending on cancer type and treatment history.

Adjuvant chemo is given post-radiation or surgery. Concurrent chemoradiation is delivered together to maximize synergy (e.g., cervical cancer).

LMWH or DOACs (e.g., apixaban) are used for DVT/PE in cancer. Duration often extends beyond 6 months depending on cancer activity.

A systematic database of cancer cases. It helps with epidemiology, research, resource planning, and improving patient outcomes.

Persistent headache, cranial nerve palsies, confusion, or seizures in cancer patients. Diagnosed via MRI and CSF cytology.

Massive PE, arrhythmias (from chemo), brain herniation, hemorrhage, and infection. Advance care planning is crucial.

Pain, swelling, and redness at IV site. Stop infusion immediately. Some agents require antidotes (e.g., dexrazoxane for anthracyclines).

Aspirin may reduce colorectal cancer risk in select high-risk groups. Benefits must be weighed against bleeding risk.

Hypothyroidism, adrenal insufficiency, and Type 1 DM are common. Monitor TSH, cortisol regularly. Treat with hormone replacement.

Refer when curative options are exhausted and patient wishes focus on comfort, dignity, and quality of life. Early referrals improve outcomes.

Anxiety, depression, adjustment disorders, and suicidal ideation are not uncommon. Screen regularly and refer to psycho-oncology services.

Avoid empirical treatment. Focus on stabilization, supportive care, and urgent referral. Coordinate with the oncology team for continuity.

Tumour heterogeneity refers to genetic and phenotypic variability within tumours. It can lead to differential drug response, resistance, and challenges in biopsy-based treatment planning. Multiregion biopsies or liquid biopsies can help overcome this limitation.

Cancer evolves by accumulating mutations. Treatment can select resistant clones. Understanding clonal dynamics is crucial for adapting therapy, especially in hematological malignancies.

ctDNA helps in early detection of relapse, real-time monitoring of tumour burden, and identifying actionable mutations without tissue biopsy. It's especially useful in lung, colon, and breast cancers.

If the patient responded well initially and had a long treatment-free interval, re-challenge may be beneficial, especially with platinum-based agents in ovarian and lung cancer.

Driver mutations are essential for tumour growth (e.g., EGFR, ALK, BRAF). Targeting them with precision therapies leads to better outcomes and fewer side effects.

TME includes immune cells, fibroblasts, and blood vessels. It affects drug delivery and immune evasion. Therapies targeting the TME (e.g., angiogenesis inhibitors) are emerging.

PD-L1 expression helps predict response to checkpoint inhibitors. However, not all PD-L1-positive patients respond, and some PD-L1-negative may still benefit.

NGS is useful in advanced/metastatic cancers to identify actionable mutations. It's standard in NSCLC, melanoma, cholangiocarcinoma, and others.

Progression shows consistent increase in tumour burden; pseudo-progression is transient enlargement due to immune infiltration, commonly seen with immunotherapy.

Discontinue immunotherapy, start corticosteroids (prednisone 1–2 mg/kg), escalate to infliximab if refractory. Rule out infections like C. difficile.

Surveillance includes yearly thyroid function tests, cardiac evaluation post-radiation, breast cancer screening starting early in women, and fertility monitoring.

Chimeric antigen receptor T-cells are engineered to target tumour antigens. Used in refractory B-cell malignancies like ALL and DLBCL with impressive remission rates.

BRAF mutations, especially V600E, are common in melanoma, colorectal, and thyroid cancers. They can be targeted with BRAF inhibitors (vemurafenib, dabrafenib).

In low-grade, asymptomatic cancers (e.g., CLL, prostate cancer), delaying treatment may avoid unnecessary toxicity without compromising outcomes.

Refers to the economic burden of treatment. Physicians should discuss generic options, help patients access insurance/government schemes, and consider cost-effectiveness.

A paradoxical acceleration of tumour growth following immunotherapy. Mechanism unclear. Requires early imaging follow-up and therapy change.

Sometimes yes, if pseudo-progression is suspected or if the patient is clinically stable. Multidisciplinary decision-making is essential.

MR-LINAC combines MRI imaging with linear accelerator, allowing real-time adaptive radiotherapy. Offers superior precision for tumours near critical structures.

Multidisciplinary approach is crucial. Many treatments (like surgery and certain chemo agents) are safe in 2nd/3rd trimester, but radiation is generally avoided.

Includes thyroiditis, adrenal insufficiency, Type 1 diabetes, and hypophysitis. Lifelong hormone replacement may be needed.

TNT involves chemo and chemoradiation before surgery. Improves compliance and pathological complete response. Increasingly used in locally advanced rectal cancer.

A field that uses AI to extract quantitative features from medical images to predict treatment response and prognosis.

AI is used in pathology (digital slide reading), radiology (nodule detection), prognosis prediction, and treatment planning.

Evidence is inconclusive, but delays in diagnosis/treatment due to the pandemic have led to advanced presentations.

Cachexia leads to poor tolerance to chemo, decreased survival, and lower QoL. Nutritional interventions and early palliative care help.

Cancer fatigue is persistent and not relieved by rest. Depression includes anhedonia, hopelessness, sleep/appetite changes. Both may co-exist and require assessment tools.

Used in small cell lung cancer to prevent brain metastases. Indicated in patients with good response to first-line treatment.

Used to treat small tumours with high precision in few sessions. Indicated in early-stage lung cancer, spinal mets, and oligometastases.

Fibrosis, lymphedema, secondary malignancies, hypothyroidism, xerostomia, and infertility, depending on the irradiated site.

Low-dose, continuous chemo aimed at antiangiogenic effects with fewer side effects. Used in palliative and pediatric oncology.

To prolong remission using low-intensity treatment (e.g., bevacizumab in colorectal cancer, PARP inhibitors in ovarian cancer).

In peritoneal carcinomatosis from colorectal, ovarian, or pseudomyxoma peritonei. Requires specialized centres and patient selection.

Clinical trials enrolling patients based on molecular markers rather than tumour type (e.g., NTRK fusions).

LMWH or DOACs are preferred. Duration is typically 3–6 months, extended if active cancer persists.

Undetectable cancer cells post-treatment identified by sensitive tests like PCR or flow cytometry. Predicts relapse risk in leukemias.

Gut flora can influence immunotherapy efficacy and chemo toxicity. Probiotics and dietary modulation are being explored.

Refer early to fertility specialists. Options include sperm banking, oocyte/embryo cryopreservation, and ovarian suppression.

Assess functional status, comorbidities, polypharmacy, and life expectancy. Geriatric assessment helps personalize treatment.

Generally contraindicated during active treatment or immunosuppression. Killed/inactivated vaccines are safe.

An interdisciplinary field addressing fertility preservation in cancer patients, integrating oncology and reproductive medicine.

Examples: Spinal cord compression, febrile neutropenia, SVC syndrome, tumour lysis syndrome. GPs should stabilize and urgently refer.

Used for cerebral edema, antiemesis, appetite stimulation, and to reduce inflammation in immunotherapy side effects.

Possible causes include marrow infiltration, aplasia from chemo, MDS, or drug-induced cytopenia. Needs bone marrow evaluation.

Chemo brain is reversible and affects memory, focus, and multitasking. Dementia shows progressive, structural changes.

Maintains weight, improves immunity and treatment tolerance. High-protein, high-calorie diets and supplementation may be needed.

High-risk patients (e.g., BRCA mutation carriers). Done with counseling on benefits, risks, and reconstructive options.

Overestimating success rates because only survivors are included in data, while those lost to follow-up are missed.

Virtual tumour boards ensure evidence-based, multidisciplinary decisions, especially where oncology services are limited.

Yes, especially with immunotherapy. Patients may develop autoimmune thyroiditis, diabetes, or arthritis.

Symptoms include emotional exhaustion, depersonalization, and reduced personal accomplishment. Regular peer support and mindfulness help.

These are tests used to determine whether a patient is likely to benefit from a specific targeted therapy. Example: EGFR mutation testing before prescribing osimertinib in NSCLC.

NTRK fusions are rare but actionable mutations. Tumours with this fusion respond to TRK inhibitors like larotrectinib — regardless of tumour origin.

MSI-High status indicates defective mismatch repair (dMMR). Such tumours respond well to immunotherapy (e.g., pembrolizumab) and are common in colorectal and endometrial cancers.

When IHC is 2+, confirm with FISH (fluorescence in situ hybridization). Accurate HER2 status is critical for selecting HER2-targeted therapies.

High TMB suggests a higher number of mutations and predicts better immunotherapy response. Measured via NGS, it is a pan-cancer biomarker.

If pain is nocturnal, progressive, associated with weight loss, neurological signs, or prior cancer history — urgent imaging is warranted.

Rule out metastasis via PET-CT. Biochemical workup and size (>4cm), attenuation on CT, and growth rate help in decision-making.

Asymmetry, irregular borders, color variation, diameter >6mm, and evolving nature ("ABCDE") suggest melanoma. Refer to dermatology urgently.

Hypercalcemia, SIADH, dermatomyositis, cerebellar degeneration, and hypertrophic osteoarthropathy may precede cancer diagnosis by months.

Routine use of stimulant laxatives (e.g., senna) and stool softeners. Consider PAMORAs like naloxegol for refractory cases.

Lung, breast, melanoma, renal, and colorectal cancers. Brain mets may be the initial sign of cancer in some cases.

Cancer spread to the leptomeninges, seen in breast, lung, and leukemia/lymphoma. Diagnosed via CSF cytology and MRI.

Include cognitive decline, leukoencephalopathy, necrosis, seizures, and rarely Lhermitte’s sign or stroke-like episodes.

Caused by drugs like taxanes, platinum agents, and vincristine. Presents with numbness, tingling, and gait instability. Dose reduction or change may be needed.

MRI with diffusion-weighted imaging helps. Abscess shows restricted diffusion, while metastases usually don’t. Biopsy or clinical context often needed.

Size, borders, growth rate, and PET uptake guide malignancy risk. Consider CT surveillance, biopsy, or surgical resection based on risk stratification.

Used to detect actionable mutations (e.g., EGFR, ALK) when tissue biopsy is inadequate or inaccessible.

In small-cell lung cancer with good response to chemoradiation, PCI reduces brain metastasis risk and improves survival.

NSCLC is treated based on stage with surgery, targeted therapy, or immunotherapy. SCLC is usually treated with chemoradiation due to rapid growth and early spread.

High PD-L1 (≥50%) in NSCLC supports use of first-line immunotherapy (e.g., pembrolizumab) without chemo in select cases.

p16 overexpression is a surrogate marker for high-risk HPV infection and is used to confirm dysplasia in equivocal cases.

Options like radical trachelectomy preserve fertility. Requires strict selection and monitoring.

Includes infertility, vaginal stenosis, premature menopause, and bladder/bowel dysfunction.

If diagnosed <50 years, with personal/family history of colorectal or other Lynch-related cancers. MSI testing and genetic counseling are recommended.

It’s a sensitive marker for monitoring recurrence but should not be used in isolation for diagnosis or treatment decisions.

It offers superior sensitivity and specificity for detecting metastatic and recurrent disease compared to conventional imaging.

In low-risk, localized disease (Gleason ≤6, PSA <10). Involves regular PSA, MRI, and biopsy monitoring.

It grades prostate cancer based on architecture. Higher scores (≥8) indicate aggressive disease and worse prognosis.

Include hot flashes, osteoporosis, sarcopenia, fatigue, and metabolic syndrome. Bone health and cardiovascular risk must be monitored.

Used in metastatic castrate-resistant prostate cancer (mCRPC). These androgen pathway inhibitors improve survival significantly.

HPV-positive oropharyngeal cancers have better response and survival. Less aggressive treatment may be appropriate in select cases.

Primarily in early-stage oral cavity cancers to assess occult nodal metastases without full neck dissection.

Include loss of natural speech, stoma care requirements, tracheoesophageal puncture issues, and risk of aspiration.

Good oral hygiene, topical anesthetics, saline rinses, and agents like benzydamine or palifermin help reduce severity.

It is associated with poor prognosis and indicates the need for adjuvant radiation or chemoradiation.

They assist in chemotherapy dose calculations, drug interactions, patient education, and toxicity management — improving safety and adherence.

Nutritional counseling, appetite stimulants like megestrol, and emotional support. Focus shifts to comfort, not weight gain.

EGFR inhibitors cause acneiform rash, checkpoint inhibitors may cause vitiligo or lichenoid eruptions. Topical or systemic steroids are often needed.

Tumour flare is temporary increase in symptoms or size post-therapy, seen with hormonal or immunotherapies. Monitor clinically and radiologically.

G-CSF, dose reduction, proactive hydration, fall prevention, and managing comorbidities improve tolerability.

Ensures collaborative decision-making, improves outcomes, reduces variation, and aligns care with best practices.

A trained nurse who guides patients through the care continuum, helping with appointments, coordination, education, and emotional support.

Use of culturally sensitive education, community leaders, survivors’ stories, and dispelling myths through outreach programs is key.

They offer financial aid, awareness, transportation, screening, rehabilitation, and psychosocial support services.

Sliding scale models, empanelment in schemes (PMJAY, MJPJAY), in-house social work teams, and partnership with charitable funds.

HPV vaccine (cervical, head-neck cancers), Hepatitis B vaccine (liver cancer) — both are WHO-recommended cancer-preventing vaccines.

Linked to lung, bladder, and breast cancers. Fine particulate matter (PM2.5) is classified as a Group 1 carcinogen.

Aims to reduce preventable cancer deaths by scaling up screening, tobacco control, HPV vaccination, and universal access to palliative care.

Improves access to expert consultations, follow-ups, tumour boards, and survivorship planning — especially in rural or underserved areas.

Training in red flag recognition, low-threshold referrals, timely diagnostics, and patient education are foundational.