- Flashcards
Which are the most common cancers?
Breast
Prostate
Lung
Bowel
What screening programmes exist?
Breast cancer
Bowel cancer
Cervical screening
Why are screening programmes good?
Identify apparently healthy people who have a malignancy
Offer screening to those who are most likely to benefit from it
What is the difference between grade and stage?
Grade = how well differentiated and proliferative capacity (based on histopathology)
Staging = TNM (tumour volume / burden)
In relation to chemotherapy define the following terms:
Adjuvant
Neoadjuvant
Induction
Consolidation
Maintenance
Palliative
Curative
Adjuvant = to destroy left over cells present after tumour is removed
Neoadjuvant = given before surgery to shrink tumour
Induction = given to induce remission
Consolidation = given once remission is achieved, to sustain remission
Maintenance = lower doses to prolong remission
Palliative = chemo for symptom management without expecting to reduce cancer
Curative = chemo aims to cure includes adjuvant chemo
Why is staging cancers important?
Guides treatment (which clinical trials can be entered)
Guides prognosis
What are the advantages and disadvantages of an MDT?
Advantages = collaborative care ensuring best treatment, improves coordination of services, increases recruitment into clinical trials
Disadvantages = requires frequent collaboration, resource dependent (not able to implement all recommendations), lack of patient involvement
What is the difference between watchful waiting and active surveillance?
Watchful waiting = if you do have treatment, aim = control rather than cure
Active surveillance = a rim of treatment would be cure, more regular testing e.g. MRI scans
What do at PET scan show?
Glucose uptake as a proxy marker for metabolic activity (uses flurodeoxyglucose)
What call of drugs are the following and when are they commonly used for nausea and vomiting?
Dexamathasone
Cyclizine
Domperidone
Haloperidol
Ondansetron
Metoclopramide
Dexamathasone - steroid used to shrink intracranial tumours
Cyclizine - histamine antagonist used for N&V caused by gastric irritation
Domperidone - dopamine antagonist used for chemo induced (safe in Parkinson’s as doesn’t cross BBB)
Ondansetron - 5HT3 receptor antagonist used in gastroenteritis / chemo induced
Haloperidol - dopamine antagonist used for drug / endotoxin induced in palliative care (not safe in Parkinson’s)
Metoclopramide - D2-antagonist used to promote bowel motility
What are the tumour markers for:
Ovarian cancer
Pancreatic cancer
Breast cancer
Prostate cancer
Hepatocellular cancer, teratoma
Colorectal cancer
Melanoma, schwannoma
Small cell lung cancer, gastric cancer, neuroblastoma
Monoclonal antibodies
Ovarian cancer = CA125
Pancreatic cancer = CA19-9
Breast cancer = CA15-3
Tumour antigens
Prostate cancer = PSA
Hepatocellular carcinoma, teratoma = Alpha feto protein
Colorectal cancer = CEA (carcinoembryonic antigen)
Melanoma, Schwannoma = S-100
Small cell lung cancer, gastric cancer, neuroblastoma = Bomesin
What is calcitonin a tumour marker for and where does it arise from?
Medullary thyroid cancer from the parafollicular cells (where calcitonin is from)
How do the following cytotoxic agents work and what are their side effects?
Alkylating agents
Cyclophosphamide
Cytotoxic antibiotics
Bleomyin
Antracyclines
Antimetabolites
Methotrexate
Fluorouracil
6-mercaptopurine
Cytarabine
Acts on microtubules
Vincristine
Docetaxel
Topoisomerase inhibitors
Irinotecan
Others
Cisplatin
Hydroxyurea
Alkylating agents
Cyclophosphamide = alkylating agent causes DNA cross linking (haemorrhagic cystitis, myelosuppression, transitional cell carcinoma)
Cytotoxic antibiotics
Bleomyin = degrades preformed DNA (lung fibrosis)
Antracyclines e.g. doxorubicin = inhibits DNA and RNA formation (cardiomyopathy)
Antimetabolites
Methotrexate = inhibits dihydrofolate reductase (myelosuppression, mucositis, liver fibrosis, lung fibrosis)
Fluorouracil = induces cell cycle arrest (myelosuppression, mucositis, dermatitis)
6-mercaptopurine = decreases purine synthesis (myelosuppression)
Cytarabine = pyrimidine antagonist (myelosuppression, ataxia)
Acts on microtubules
Vincristine = inhibits formation (peripheral neuropathy, paralytic ileus)
Docetaxel = inhibits disassembly (neutropaenia)
Topoisomerase inhibitors
Irinotecan (myelosuppression)
Others
Cisplatin = causes cross-linking in DNA (ototoxicity, peripheral neuropathy, hypomagnesaemia)
Hydroxyurea = inhibits ribonucleotide (myelosuppression)
