1.4 Basics - Cancer Management Flashcards
Which team looks after cancer patients
Multi Disciplinary team
MDT
What are 4 benefits of an MDT
The aims of an MDT are to:
- Earlier diagnosis leading to earlier treatment
- Co-ordinated care led by the right HCPs at the right time
- Improved chances of survival
- Improved patient satisfaction with the treatment
What are the factors which need to be considered when planning a SACT Treatment plan?
Disease
- Location
- Staging
- Grade
- Spread
- Biomarkers
Treatment
- Efficacy
- Safety
- Drug interactions
- Availability/Access
Patient factors
- Patient preference
- Patient co morbidity
- Patient general health - Performance Score.
In an ideal world what are the 3 priorities for cancer management?
- Prevention…Vaccines
- Early detection
- Total eradication
What are the 4 aims of cancer management in the real world?
- Cure
- Remission
- Symptomatic control
- Terminal care
Neo Adjuvant etc (DNAS)
What are the 4 different settings for cancer management?
Definitive
- Sole treatment modality
- e.g. Radiotherapy or Surgery or SACT
Neo adjuvent
- Treatment given befor the preimary treatment
- e.g.Neo adjuvant chemoradiation, prior to surgery for oesopohageal cancer
Adjuvant
- Treatment given after the primary treatment
- e.g. Adjuvant radiation following surgery
Salvage
- Treatment give after oter therapy has failed
What are the 3 ways doctors manage cancer?
- Surgery
- Radiation
- SACT
What is SACT an abbreviation for?
Systemic Anti Cancer Treatment
What are the 6 different classes of drugs which fall under the SACT umbrella?
- Chemotherapy
- Targeted therapy
- Immune therapy
- Hormone therapy
- Cellular therapies
- Supportive therapy
How is surgery used in cancer care?
Diagnosis
- via biopsy for example
**Treatment **
- Which can be Curative, Palliative, Emergency, Prophylactic
What adverse events ar associated with surgery in cancer patients?
The adverse events associated with surgery typically depend upon:
- The location of the cancer
- The size of the cancer
The adverse effects of surgery can include:
- Pain
- Inflammation
- Bleeding/Bruising
- Fatigue
- Anorexia
What other factors need to be considered
- Altered body image
- Sexual & reproduction issues
What is the role of radiation therapy in the management of cancer patients
Radiation therapy uses ioising radiation to treat patients with cancer
- It an be used in a curative, palliative, emergency or prophylactic scenarios
- it can be used as definitive, neo-adjuvant, ajuvant or salvage therapeutic regimen
What is the most common form of radiation therapy
External beam radation therapy
- A machine exerts beams of ionising radiation directly to the tumour site
What is another type of radiation therapy?
Brachytherapy
- A radio active source is inserted near or in the tumour on a permanent or temporarary basis
- Can be used in cervical or prostate cancer.
What is the mode of action of radiotherapy?
Ionsing radiation stopes cancer cells growting or dividing in 2 ways
- Drectly breaks DNA strands
- Creats unstable free radiaclas in the intracellular fluid which damages the cells DNA
Can cancer cells or normal cells overcome the damage caused by radiation?
- ## Cancer cells cannot overcome the damage caused by radiation
- Normal cells can overcome the damage caused by radiation
What are the 3 types of side effects associated with radiation therapy?
Acute reactions
- Appear shortly after the first administration e.g. Skin reactions
Sub acute reactions
- e.g. occur after the radiation therapy is complete e.g. pneumonitis
Late
- e.g. occurs years after radiation therapy is complete e.g. Cataracts
What factor typically determines the nature of radiation side effects
The part of the body which is targeted for radiation therapy
What does the abbreviation SACT stand for
Systemic
Anti
Cancer
Treatment
How is SACT prescribed
SACT is typically prescribed as a combination of drugs,
- with different modes of action,
- that target different phases of the cell cycle, to get a optimal effect.
HCPS also consider side effects when selecting combination therapy
- To ensure that drugs with similar side effect profiles are not duplicated
In addition supportive medication may also be given to manage nausea and vomiting and pain for example.
What are the 3 advantages of combination therapy in cancer management?
- Increases patient response rates by targeting different phases of the cell cycle
- Reduces the likelihood of cellular resistance by working on different cellular pathways and targets
- Limits toxicity by avoiding combination of drugs which have similar toxicity profiles
