14 - Cancer therapy Flashcards
1
Q
What are the hallmarks of cancer?
A
- GF independence or self-sufficiency
- insensitive to anti-growth signals
- avoidance of apoptosis
- angiogenesis
- immortalisation by reactivation of telomerase (enzyme that keeps cells alive)
- ability to invade adjacent tissues and metastasise
- reprogram energy metabolism
- evade immune destruction
2
Q
What is telomerase?
A
- enzyme that prevents DNA from being destroyed as cells divide
- allows cells to be immortal
- reactivated in cancer to prevent cell death
3
Q
Why is imaging used in cancer therapy?
A
- screening for early detection
- staging and assessment of an identified cancer
- planning of cancer treatment including radiotherapy
4
Q
What types of imaging are used in cancer therapy?
A
- ultrasound
- plain x-ray
- CT
- MRI
- radionucelotide (PET scans)
5
Q
What is a PET scan?
A
Positron emission tomography
6
Q
What are the different stagings of cancer?
A
- tumour stage (size)
- nodal stage (involvement of lymph nodes)
- metastasis
7
Q
What are the treatment options for cancer therapy?
A
- surgical
- chemotherapy
- radiotherapy
- combination
- palliative
8
Q
Who is involved in the MDT for treatment planning for cancer therapy?
A
- oncologist
- surgeon
- radiotherapist
- chemotherapist
- clinical nurse specialist
- radiologist
9
Q
What are the principles of surgery in cancer therapy?
A
- can be part of biopsy for diagnostic staging
- remove cancer completely before spread to other tissues
- regional lymph nodes are taken if suspicion of lymphatic spread
- clear margin required to reduced recurrence
10
Q
What are the side effects of surgery in cancer therapy?
A
- reduced tissue bulk can be cosmetic (breast) or functional (bowel)
- reconstruction is a secondary procedure
- GA has general health effects (DVT or HAI)
- lymphatic oedema in affected area
11
Q
What are the principles of chemotherapy in cancer therapy?
A
- aims to kills tumour cells without harming host cells
- targets cells with high turnover
12
Q
What are the side effects of chemotherapy?
A
- hair loss, oral ulceration and bone marrow suppression (as high turnover cells are targeted)
- risk of future cancer, damage to fertility and induction of menopause (damage to other cells DNA)
- taste loss
- nephrotoxicity
13
Q
What are the principles of radiotherapy in cancer therapy?
A
- ionising radiation damage to cellular DNA
- external beam is directed at tumour in direct that hits least tissue possible
- total dose is delivered across many appointments as not all cells are dividing at the same time
14
Q
What are the different types of radiotherapy used in cancer therapy?
A
- conformal
- intensity modulated
- image guided and tomotherapy
- stereotactic
15
Q
What are side effects of radiotherapy?
A
- skin burns that can leave permanent pigmentation
- oral ulceration
- fatigue
- hair loss in treatment area
- xerostomia/taste loss if H&N
- menopause if pelvic/abdominal
