General Medicine
Common Malignancies
Common malignancies for MBBS: risk factors and oncogenic infections, screening, biopsy and tumour markers, cancer pain and end-of-life ethics, mapped to NMC codes IM13.1 to IM13.19.
MedNext Academy | 3 min read
Common Malignancies
Common malignancies for MBBS: risk factors and oncogenic infections, screening, biopsy and tumour markers, cancer pain and end-of-life ethics, mapped to NMC codes IM13.1 to IM13.19.
This chapter covers the common malignancies in the Indian context, their risk factors including tobacco and oncogenic infections, and the principles of diagnosis by examination, imaging and biopsy. It emphasises the distinction between curative and palliative intent, cancer pain control with opioids and the ethics of end-of-life care.
High-yield: Common Malignancies
- Tobacco use is the single largest preventable cause of cancer in India, driving oral and lung cancers.
- Some cancers have a genetic basis, such as BRCA-related breast and ovarian cancer.
- Several infections cause cancer, including human papillomavirus and cervical cancer and hepatitis viruses and liver cancer.
- Cervical cancer is a leading cancer in Indian women and is largely preventable by vaccination and screening.
- The Pap smear detects premalignant cervical changes and reduces cervical cancer incidence.
- Breast, cervical and rectal examinations are core clinical screening skills.
- Tumour markers support monitoring and, in selected settings, diagnosis, but are not standalone screening tools.
- Biopsy provides the definitive tissue diagnosis and guides treatment.
- Curative and palliative care are distinct goals, and recognising when to shift is a key clinical skill.
- Cancer pain is assessed objectively and managed by the analgesic ladder, escalating to opioids when needed.
- Opioids are the mainstay of moderate to severe cancer pain and should not be withheld for fear of addiction.
- The three main treatment modalities are surgery, radiotherapy and chemotherapy, often used in combination.
- Early warning symptoms such as unexplained weight loss, bleeding or a persistent lump warrant prompt investigation.
- End-of-life care raises specific ethical and medico-legal issues around consent and disclosure.
- Screening programmes aim to detect common cancers early when treatment is most effective.
Common malignancies essentials
- **Leading risk factor:** Tobacco drives oral and lung cancer; oncogenic infections cause cervical and liver cancer.
- **Screening:** Pap smear for cervix, clinical breast examination, and other programme-based screening.
- **Diagnosis:** Biopsy gives the definitive tissue diagnosis; tumour markers support monitoring.
- **Pain:** Follow the analgesic ladder; opioids are the mainstay of moderate to severe cancer pain.
NMC competencies in this chapter
- **IM13.1:** Clinical epidemiology and risk factors in India
- **IM13.3:** Relationship between infection and cancer
- **IM13.6:** Curative versus palliative care in cancer
- **IM13.9:** Breast, rectal and cervical examination and Pap smear technique
- **IM13.12:** Imaging, biopsy and tumour markers in common cancers
- **IM13.14:** Indications for surgery, radiation and chemotherapy
- **IM13.17:** Narcotics for pain relief in cancer
- **IM13.18:** Ethical and medico-legal issues in end-of-life care
Frequently Asked Questions
Which infections are linked to common cancers?
Human papillomavirus causes cervical cancer, hepatitis B and C cause liver cancer, and Helicobacter pylori is linked to gastric cancer, among other infection-associated malignancies.
What is the role of biopsy versus tumour markers?
Biopsy provides the definitive tissue diagnosis that guides treatment, while tumour markers are mainly used for monitoring and are not reliable standalone screening or diagnostic tests.
How is cancer pain managed?
Cancer pain is assessed objectively and treated by the analgesic ladder, escalating from non-opioids to opioids, which should not be withheld out of unfounded fear of addiction.
How does this chapter help for NEET-PG?
Infection-cancer links, screening tests, the analgesic ladder and end-of-life ethics are recurring exam themes that map directly to questions.
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