skip to main content

Synchronous Primary Cancers — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGI CancersSynchronous Primary CancersSCE Medical Oncology

A 62-year-old man with colon cancer is diagnosed with a synchronous primary lung cancer on staging CT. Both cancers appear resectable. How should this be managed?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Each cancer should be staged and treated independently

Synchronous second primary cancers (distinct histology or meeting Martini-Melamed criteria) should be managed as two independent cancers, each staged and treated individually. It is critical to distinguish a second primary from a metastasis — this requires pathological review (histology, IHC: CDX2 for colorectal, TTF-1 for lung), clinical context and MDT discussion. If both are early-stage and resectable, sequential curative surgeries may be appropriate. The higher-risk/more urgent cancer is typically treated first.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer