4. Cancer

Question 1

chemotherapy

Answer 1

chemotherapy giveninto a vein (intravenous chemotherapy)–this isusually done in hospital andinvolves medicine being given through a tube in a vein in your hand, arm or chest
chemotherapy tablets (oral chemotherapy)– this usually involves taking a course of medicine at home, with regular check-ups in hospital

Side affects: (due to the cytotoxic drugs destroying some healthy cells that are rapidly dividing)
feeling tired most of the time, feeling and being sick, hair loss ,an increased risk of getting infections
ect.

Question 2

radiotherapy

Answer 2

Internal radiotherapy – from inside the body (sometimes called brachytherapy or radioisotope therapy)
External beam radiotherapy – from outside the body

Question 3

immunotherapy - checkpoint inhibitors

Answer 3

(Monoclonal antibodies/targeted treatment)
MABs trigger the immune system by attaching themselves to proteins on cancer cells. This makes it easier for the cells of the immune system to find and attack the cancer cells. This process is called antibody dependent cell mediated cytotoxicity (ADCC).

Question 4

immunotherapy - Cytokines

Answer 4

Interferon and interleukin are types of cytokines found in the body. Scientists have developed man made versions of these to treat some types of cancer
Work by - interfering with the way cancer cells grow and multiply,
stimulating the immune system and encouraging killer T cells and other cells to attack cancer cells, encouraging

Question 5

immunotherapy - CAR T-cell therapy

Answer 5

changes the genes in a person’s white blood cells (T cells) to help them recognise and kill cancer cells

Question 6

hormone therapy

Answer 6

uses medicines to block or lower the amount of hormones in the body to slow down or stop the growth of cancer
Works for hormone sensitive cancers such as breast cancer, prostate cancer, ovarian cancer, womb cancer
Side effects: tiredness, impotence, weight gain, osteoporosis, menopausal symptoms, mood swings

Question 7

neoadjuvant therapy

Answer 7

systemic therapy given before local treatment. Potential advantages: improved local and distant control, direct evaluation, and organ-sparing treatment. Potential disadvantages: increased toxicity and cost, potential delay in effective treatment, and obscuring of pathologic staging.

Question 8

risk factors for developing bowel cancer

Answer 8

Age - 9/10 cases develop in adults over 50
Diet - high red and processed meet diet increases risk of developing bowel cancer
Diet – a low fibre diet increases your risk of bowel cancer
Family history – if you have a 1st degree relative who has developed bowel cancer under the age of 50, this significantly increases your risk of developing bowel cancer
Smoking - those who smoke have an increased risk of developing bowel cancer
Alcohol - those who drink, particularly in excessive amounts have an increased risk of developing bowel cancer
Weight - bowel cancer is more common in those who are obese
Bowel diseases – having colitis and crohn’s disease for many years increases your risk of bowel cancer

Question 9

symptoms of bowel cancer

Answer 9

Bleeding from your rectum or having blood in your stools
Persistent change in bowl habits – looser more frequent stools
Abdominal pain or bloating brought on after eating. This often leads to a reduction in the amount of food eaten and therefore weight loss

Question 10

other causes of rectal bleeding

Answer 10

Hemorrhoids
Anal fissure
Diverticular bleeding
Inflammatory bowel diseases – swelling of the small or large intestine. There are main 2 types, colitis and Crohn’s disease. People with bowel disease may experience rectal bleeding.

Question 11

General Cancer Screening :

Wilsons criteria

Answer 11

The criteria consists of:
The condition should be an important health problem
The natural history of the condition should be understood
There should be a recognisable latent or early symptomatic stage
There should be a test that’s easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific.
There should be an accepted treatment recognised for the disease
Treatment should be more effective if started early
There should be a policy on who should be treated
Diagnosis and treatment should be cost effective
Case finding should be a continuous process

Question 12

National Screening Programmes in England

Answer 12

There are 3 national NHS cancer screening programmes in England:
Cervical Screening (offered people with a cervix aged 25 to 64)
Breast Screening (offered to women age 50 to 71)
Bowel screening (men and women aged 60-74)

Question 13

pathology of bowel cancer

Answer 13

More than 90% of colorectal carcinomas are adenocarcinomas originating from epithelial cells of the colorectal mucosa.
A carcinoma is a malignant neoplasm of epithelial cells..
Malignant meaning harmful and neoplasm meaning an abnormal growth of cells.
Other rare types of colorectal carcinomas include neuroendocrine, squamous cell, adenosquamous, spindle cell and undifferentiated carcinomas

Question 14

i) How much of the drug warfarin is bound to plasma proteins and how much is freely dissolved in plasma?

Answer 14

99% of warfarin is bound to plasma proteins and 1% is free in plasma (which is responsible for the action of the drug)

Question 15

iii) What happens if tamoxifen is given to a patient taking warfarin?

Answer 15

Tamoxifen increases the effects of warfarin and so increases the risk of bleeding by an unknown mechanism.