Soft Tissue Sarcoma Navigator Quiz

Soft tissue sarcomas can develop in:

Tendons, fat, and blood vessels

Cartilage and smooth muscle

Connective tissue and skeletal muscle

All of the above

Soft tissue sarcomas include all of the following except:

Rhabdomyosarcoma

Colorectal carcinoma

Liposarcoma

Gastrointestinal stromal tumor

When training a new nurse on your team, you explain the difference between carcinomas and sarcomas. Which statement indicates that the new nurse fully understands your teaching?

Carcinoma is a malignancy of tissues that cover internal organs, but sarcoma are a malignancy of cells that line internal organs

Sarcoma is a malignancy of connective tissue, carcinoma is a malignancy of cells that cover or line internal organs

Sarcoma is a malignancy of the connective tissue, but carcinomas are benign tumors of cells that cover internal organs

Carcinoma is a malignancy of cells that line organs, but sarcoma is a malignancy of cells that cover internal organs

Which is the most commonly seen type of soft tissue sarcoma?

Urothelial carcinoma

Osteosarcoma

Undifferentiated pleomorphic sarcoma

Fibroma

Which statement regarding the pathophysiology of soft tissue sarcomas are correct?

Sarcomas are the most common type of benign tumor in adults between 60-70 years of age and develop in the pigment producing cells of the skin

The most commonly seen soft tissue sarcoma in children is Angiosarcoma, which develop in blood vessels or lymph vessels

Sarcomas are rare malignancies of various connective tissues with over 50 different subtypes that affect all ages

Sarcomas are commonly diagnosed in immunosuppressed patients and are known as rhabdomysarcoma

General work-up for a diagnosis of soft tissue sarcoma includes with of the following type(s) of imaging?

Computed Tomography (CT)

Magnetic Resonance Imaging (MRI)

Positron Emission Tomography (PET)

All of the above

The TNM system is utilized for staging soft tissue sarcomas located in the trunk and extremities. TNM stands for:

Time, Neoplasm, Mode of growth

Tumor, Node, Metastasis

Tumor, Neoplasm, Mode of growth

Time, Node, Metastasis

The MOST important objective of soft tissue sarcoma staging is:

To provide information regarding risk factors

To identify individuals at high risk for disease recurrence

To determine performance status and eligibility for research protocols

To provide the necessary information for individual treatment planning

Grade refers to histology of tumor cells. Which statement regarding grading is accurate?

Low grade tumor cells have a more abnormal appearance when compared to normal cells

High grade tumor cells have a more normal appearance than low grade tumor cells

Low grade tumor cells are more likely to spread and grow

High grade tumor cells are more likely to have nests of dead cells, a more abnormal appearance when compared to normal cells, and more dividing cells

You train a new colleague in your department and explain the various types of biopsies. Which statement by the new colleague demonstrates an understanding of the types of biopsies to determine a diagnosis of soft tissue sarcoma?

During an excisional biopsy, the physician uses a small gauge needle to remove a core piece of suspicious tissue

During a core biopsy, the physician uses a needle to remove a tube-like piece of tissue

CT scans or Ultrasound guide biopsies are used when the physician can palpate the tumor

During a core needle biopsy, the physician uses a small gauge needle to obtain small pieces of the tumor

The French (or FNCLCC System) determines the grading of soft tissue sarcomas. Select the three factors on which grading is based.

Tumor necrosis, Mitotic count, Differentiation

Mitotic count, Location, Tumor necrosis

Differentiation, Tumor necrosis, Nodal status

Cytogenetics, Tumor necrosis, Nodal status

Which statement accurately describes the difference between clinical staging and pathologic staging?

Pathologic staging and clinical staging are the same

Medical oncologists use the pathologic stage, and surgical oncologists use the clinical stage to treat patients

Clinical staging may be done first if surgery cannot be done to determine the pathologic stage, while pathologic stage can provide a more accurate prognosis

Clinical staging encompasses information obtained during surgery, while pathologic staging uses information from diagnostic imaging

Additional tissue testing can be performed on biopsy specimens. Which statement reflects the information obtained in these additional tests?

Fluorescence in situ hybridization (FISH) uses created markers to look for various genetic aberrations

Polymerase chain reaction (PCR) looks for multiple copies of genes in cancer cells

Cytogenetics evaluates chromosomes in cancer cells under a microscope to look for changes

All of the above

A 58 year-old man is going to have chemotherapy for lung cancer. He asks how the chemotherapeutic drugs will work. The most accurate explanation is which of the following?

Chemotherapy affects rapidly dividing cells

The molecular structure of DNA is altered

Cancer cells are susceptible to drug toxins

Chemotherapy encourages cancer cells to divide

Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?

Faster growing cells are less susceptible to chemotherapy

Non-dividing cells are more susceptible to chemotherapy

Faster growing cells are more susceptible to chemotherapy

Slower growing cells are more susceptible to chemotherapy

The following are teaching guidelines regarding radiation therapy EXCEPT:

The therapy is painless

To promote safety, the client is assisted in the therapy room by therapy personnel while the machine is in operation

The client may communicate all concerns/needs while the machine is operating

Safety precautions are necessary only during the time of actual irradiation

Neoadjuvant chemotherapy is:

Chemotherapy administered prior to surgery

Chemotherapy administered after surgery

Chemotherapy administered during surgery

Chemotherapy administered directly to the central nervous system

Mrs. Wagner, a 28 year-old woman, undergoes surgical treatment for osteosarcoma. The surgical oncologist tells the patient that he made a wide excision around the tumor and obtained clear margins. Which statement by Mrs. Wagner indicates she understands the outcome of the surgery?

The surgeon removed the tumor along with good tissue, without any cancer cells left behind

The surgeon was unable to remove all of the tumor

The surgeon was able to remove all of the tumor, but some of the cancer cells are still in the tissue surrounding the tumor

The surgeon was unable to remove the tumor

Limb sparing surgery can be defined as:

An amputation of the extremity

Removal of the cancer along with nearby tissue, cartilage, and surrounding bone

Excision of the tumor

Removal of the cancer along with muscle and nerves

Mr. Allen is a 45 year-old male with Gastrointestinal Stromal Tumor (GIST). He asks you how Imatinib will work to treat his cancer. You explain that:

Imatinib is like chemotherapy and kills all fast growing cells

Physicians do not have a good understanding of how exactly Imatinib works in the body

Imatinib blocks all communication between cells telling them to grow

Imatinib is not indicated for GIST, and that you will work with the physician for a new treatment

Mrs. Esser is a 21 year-old woman with stage IV soft tissue sarcoma. Her treatment includes doxorubicin and olaratumab. Which statement indicates she understands how the olaratumab will work to treat the sarcoma?

I may have an allergic-like reaction while olarutumab is given

The medicine will protect my bladder from the harmful effects of chemotherapy

Olaratumab blocks receptors on the cancer cells and works with chemotherapy to stop the cancer from growing

Both are true: I may have an allergic-like reaction to olarutumab and olarutumab blocks receptors on the cancer cells

The use of chemotherapy given in only a limb for unresectable intermediate or high-grade sarcoma is known as:

Systemic Chemotherapy

Regional or isolated limb perfusion

Targeted Therapy

Radiation Therapy

Which type of treatment is used most often for stage II and III soft tissue sarcoma?

Systemic chemotherapy

Radiation Therapy

Targeted Therapy

Surgery

You teach a class at a local high school on the importance of minimizing risk factors and explain that risk factors may include:

Smoking cigarettes

Family history of cancer

Any factor that increases your likelihood of getting a disease

All of the above are true

Gastrointestinal stromal tumors (GIST) are linked to which hereditary genetic syndrome?

Carney-Stratakis Syndrome

Beta Thalassemia

Neurofibromatosis type 1 (NF1)

Both are true: Carney-Stratakis Syndrome and Neurofibromatosis type 1 (NF1)

You are caring for a 25 year-old male with a history of lymphoma from ten years ago. He received radiation to the chest as part of his treatment plan. You know that:

Previous radiation therapy is a risk factor for developing soft tissue sarcoma

Only lifestyle risk factors (extrinsic) lead to soft tissue sarcoma

Previous radiation therapy does not impact the risk for developing soft tissue sarcoma

Exposure to radiation leads to over 75% of all soft tissue sarcomas

Li-Fraumeni Syndrome is a risk factor for the development of soft tissue sarcomas and is associated with a defect in which gene?

BRCA

ALK

TP53

BRAF

In early cases, most individuals report a ____________________ that has increased over ______________.

A nagging cough; 2-3 years

Pain in the chest; 7 months

Lump in the arm or leg; a few weeks to a few months

No specific symptoms

Mrs. Robertson is confused to why her soft tissue sarcoma in her arm didn't cause any pain. You explain that:

Soft tissue sarcomas always cause pain and its off that she didn't report pain at the time of diagnosis

Soft tissue sarcomas may not cause pain unless they impede function of an organ or extremity

Soft tissues sarcomas never cause pain

She must have had a very high pain threshold

Soft tissue sarcomas found in the retroperitoneum can cause which of the following symptoms?

Flatulence

Diarrhea

Mechanical Ileus

Shortness of breath

The most common and lethal side effect of chemotherapy is:

Myelosuppression

Respiratory distress

Increased liver function tests

Electrolyte imbalance from nausea, vomiting, and diarrhea

Ms. Elliott is a 19 year-old female diagnosed with stage III soft tissue sarcoma. She asks you about her ability to have children after treatment with chemotherapy. You respond by telling her:

Chemotherapy will not impact her ability to have children

She can receive chemotherapy and then have oocyte cryopreservation

It is important to discuss fertility-preserving options with the providers prior to undergoing chemotherapy

Fertility-preservation is not an option for her

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