Anti-cancer treatment Flashcards
Give examples of types of chemotherapy
Alkylating agents/anthracyclines e.g. cyclophosphamide (breast), temozolomide (brain)
Platinum analogs e.g. cisplatin, oxaplatin (colorectal)
Antimetabolites e.g. Methotrexate (rheumatology), 5FU
Topoisomerase-interacting agents e.g. anthracyclines, irinotecan
Antimicrotubule agents e.g. taxanes, vincristine (plant-based)
Give examples of targeted agents
Tyrosine kinase inhibitors e.g. imatinib (CML), erlotinib (lung)
VEGFR inhibitors e.g. Bevacizumab, sunitiunib
EGFR e.g. cetuximab
mTor inhibitor e.g. Everolimus (breast, renal)
What are the different treatment intents for cancer
Radical: given with curative intent
Adjuvant: given to reduce the risk of recurrence
Neoadjuvant: given to improve chances of curative/extensive surgery
Palliative: Given with non-curative intent
What is performance status
Acts as a common rating system to reflect how the patient is doing
0
Fully active, able to carry on all pre-disease performance without restriction
1
Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work
2
Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours
3
Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours
4
Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair
5
Dead
Common side effects of chemotherapy
Neutropenia and bone marrow suppression
Nausea and vomiting
Diarrhoea
Hair loss (seen very commonly with anthracycline use)
Mucositis
Fatigue
Peripheral neuropathy (must assess at every visit)
What anti-emetics are used for nausea and vomiting from chemotherapy
Ondansetron
Domperidone
Management for hair loss from chemotherapy
Cold cap treatment/wigs (reduces blood supply so that there is reduced delivery of chemotoxic drugs to the head)
Cold cap is not suitable for haematological malignant/head RT as it is worn for several hours before and after treatment as well as during
What causes chemotherapy-induced peripheral neuropathy
platins, taxanes, vinca alkaloids, bortezomib and lenolidamide
Glove-stocking distribution
What are the late side effects of chemotherapy
Chemo brain
Fertility issues
Sexual dysfunction
Pneumonitis e.g. bleomycin (Hodgkin’s), CDK46 inhibitors (breast)
Cardiotoxicity e.g. anthracyclines
Secondary malignancy e.g. AML
What are the side effects of immune-related treatment
Skin toxicity
Colitis
Hepatitis
Endocrinopathies
Pneumonitis
Nephritis
Neurological
Others e.g. cardiac rheumatology, ocular, haematology
Complications of fluoropyrimidines (5FU)
Diarrhoea
Mucositis
Taste change (metallic)
Plantar-palmar syndrome (Rashes, peeling of skin)
Hair loss
