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11 Oncology Flashcards

1
Q

MC CA in women

A

Breast

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2
Q

MC cause of CA related death in women

A

Lung

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3
Q

MC CA in mend

A

Prostate

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4
Q

MC cause of CA related death in men

A

Lung

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5
Q

MOA PET

A

Detects fluorodeoxyglucose molecules

Used to identify metastases

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6
Q

What do cytotoxic T cells need to attach tumors?

A

MHC complex

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7
Q

What do natural killer cells need to attack tumor cells?

A

Nothing - they can attack independently

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8
Q

Hyperplasia

A

increase in number of cells

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9
Q

Metaplasia

A

Replacement of one tissue without another

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10
Q

Dysplasia

A

Altered size, shape and organization

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11
Q

CEA

A

Colon CA

Half-life: 18 days

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12
Q

AFP

A

Liver CA

Half-life: 5 days

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13
Q

CA 19-9

A

Pancreatic CA

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14
Q

CA 125

A

Ovarian CA

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15
Q

Beta-HCG

A

Testicular CA, choriocarcionoma

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16
Q

PSA

A

Prostate CA
Highest sensitivity, low specificity
Half-life: 18 days

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17
Q

NSE

A

Small cell lung CA, neuroblastoma

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18
Q

BRCA 1/2

A

Breast cancer

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19
Q

Chromogranin A

A

Carcinoid tumor

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20
Q

Ret oncogene

A

Thyroid medullary CA

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21
Q

Cancer transformation requires:

A

1) Heritable alteration in genome

2) Loss of growth regulation

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22
Q

Latency period

A

Time between exposure and formation of clinically detectable tumor

  • Initiation (carcinogen acts with DNA)
  • Promotion of cancer cells
  • Progression of cancer cells to clinically detectable tumor
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23
Q

Epstien bar virus

A 
Burkitt's lymphoma (8;14 translocation)
Nasopharyngeal CA (c-myc)
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24
Q

Human papillomavirus

A

Cervical cancer

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25
Helicobacter pylori
Gastric cancer
26
Hep B, Hep C
Hepatocellular carcinoma
27
What stages is most vulnerable to radiation therapy?
M phase
28
How is damage done via radiation therapy?
Formation of oxygen radicals
29
Target of radiation therapy?
DNA - both oxygen radicals and XRT damages it
30
Fractionated XRT doses
Allows for repair of normal cells Allows re-oxygenation of tumor Allows redistribution of tumor cells in cell cycle
31
Very radiosensitive tumors?
Seminima | Lymphoma
32
Very radioresistant tumors?
Epithelial | Sarcoma
33
Why are large tumors resistant to XRT?
Less responsive to XRT due to lack of oxygen in the tumor
34
Brachytherapy
Source of radiation is placed in or next to tumor | Delivers, high concentrated doses of radiation
35
Cell cycle-specific agents
5-FU, Methotrexate | Exhibit plateau in cell-killing ability
36
Cell cycle-nonspecific agents
Linear response to cell killing
37
Tamoxifen
Blocks estrogen receptors Decreases short-term (5 year) risk of breast CA by 45% (1% risk of blood clots, 0.1% risk of endometrial CA)
38
Taxol
Promotes microtubule formation and stabilization that cannot be broke down Cells are ruptured
39
What chemo agents can cause pulmonary fibrosis?
Bleomycin | Busulfan
40
AE of cisplatin
Platinum alkylating agent | Nephrotoxic, neurotoxic, ototoxic
41
AE of carboplatin
Platinum alkylating agent | Bone marrow suppression
42
AE of vincristine
Microtubule inhibitor | Peripheral neuropathy, neurotoxic
43
AE of vinblastin
Microtuble inhibitor | Bone marrow suppression
44
Alkylating agents
Transfer alkyl groups | Form convalent bonds to DNA
45
Cyclophosphamide
Alkylating agent - acrolein is the active metabolite AE: gonadal dysfunction, SIADH, hemorrhagic cystitis Mesna can help with hemorrhagic cystitis
46
Levamisole
Antihelminthic dug | Stimulates immune system against cancer
47
Methotrexate
Inhibits dihydrofolate reductase - inhibits purine and DNA synthesis AE: Renal toxicity, radiation recall
48
Leucovorin rescue
Folinic acid | Reverses effects of methotrexate by re-supplying folate
49
5-Fluorouracil
Inhibits thymidylate synthetase - inhibits purine and DNA synthesis Leucovorin increases toxicity of 5FU
50
Doxorubicin
DNA intercalator - O2 radical formation | AE: heart toxicity (secondary to O2 radicals at total dose >500mg/m2)
51
Etoposide
Inhibits topoisomerase (normally unwinds DNA)
52
Which chemo agents are least myelosuppressive?
Bleomycin Vincristine Busulfan Cisplatin
53
Granulocyte colony-stimulating factor
Used for neutrophil recovery after chemo | AE: sweet's syndrome (acute febrile neutropenic dermatitis)
54
When is resection indicated of a normal organ to prevent cancer?
Breast - BRCA 1/2 with strong family history | Thyroid - RET proto-oncogene with family history of thyroid CA
55
Retinoblastoma RB1
Tumor suppressor gene Chromosome 13 Involved in cell cycle regulation
56
p53
Tumor suppressor gene Chromosome 17 Inovlved in cell cycle (normal gene induces cell cycle arrest and apoptosis; abnormal gene allows unrestrained cell growth)
57
APC
Tumor suppressor gene Chromosome 5 Cell cycle regulation and movement
58
DCC
Tumor suppressor gene Chromosome 18 Cell adhesion
59
bcl
Tumor suppressor gene | Apoptosis
60
ras
Proto-oncogene | G protein defect
61
src
Proto-oncogene | Tyrosine kinase defect
62
sis
Proto-oncogene | Platelet-derviced growth factor receptor defect
63
erb B
Proto-oncogene | Epidermal growth factor receptor defect
64
myc
``` Proto-oncogene Transcription factors (c-myc, n-myc, l-myc) ```
65
Li-Fraumeni syndrome
Defect in p53 gene | Childhood sarcomas; breast CA, brain tumors, leukemia, adrenal CA
66
Colon CA
APC, p53, DCC, K-ras APC thought to be the initial step in the evolution of CRC Does NOT go to bone
67
Coal tar
Larynx, skin, bronchial CA
68
Beta-naphthylamine
Urinary tract CA, bladder CA
69
Benzene
Leukemia
70
Asbestos
Mesothelioma
71
Suspicious supraclavicular nodes
Neck, breast, lung, stomach (Virchow's node), pancreas
72
Suspicious axillary node
Lymphoma* Breast Melanoma
73
Suspicious periumbilical node
Pancreas (Sister Mary Joseph's node)
74
Ovarian metastases
Stomach (Krukenberg tumor) | Colon
75
Bone metastases
Breast* | Prostate
76
Skin metastases
Breast | Melanoma
77
Small bowel metastases
Melanoma
78
Clinical trial - phase I
Is it safe and at what dose? (healthy people)
79
Clinical trial - phase II
Is it effective?
80
Clinical trial - phase III
Is it better than existing therapy?
81
Clinical trial - phase IV
Implementation and marketing (after release for sale)
82
Induction therapy
Sole treatment | Used for advanced disease or when no other treatment exists
83
Primary (neoaduvant) therapy
Chemo given first | Followed by another, secondary therapy
84
Adjuvant therapy
Combined with another modality | Given after other therapy is used
85
Salvage therapy
For tumors that fail to respond to initial chemotherapy
86
Prognostic indicators for survival after resection of hepatic colorectal metastases?
``` Disease-free interval >12 months Tumor number <3 CEA <200 Size <5cm Negative nodes ```
87
Which type of tumor has improvements in chemotherapy after debulking surgery?
Ovarian cancer
88
What solid tumors are curable with chemo only?
Hodgkin's and non-Hodgkin's lymphoma
89
T-cell lymphomas
``` HTLV-1 (skin lesions) Mycosis fungoides (Sezary cells) ```
90
HIV-related malignancies
Kaposi's sarcoma | Non-Hodgkin's lymphoma
91
Vascular epidermal growth factor
Cause angiogenesis | Involved in tumor metastasis

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