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Oncology > Breast Cancer Case - Overview of Chemotherapy > Flashcards

Breast Cancer Case - Overview of Chemotherapy Flashcards

1
Q

What is chemotherapy?

A

The use of cytotoxic drugs in the treatment of cancer.

Systemic treatment.

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2
Q

What are the goals of chemotherapy?

A

Provides cure, control, or palliation

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3
Q

When was chemotherapy first developed, and by who?

A

Developed by Paul Erhlich, the “father of chemotherapy” in the early 1900s

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4
Q

How was chemotherapy first discovered?

A

A result of the advances Paul Elrich made in the discovery of chemicals to treat infections.
During WWI and WWII it was discovered that through the use of mustard gas, alkylating agents, cause marrow and lymphoid suppression

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5
Q

When was chemotherapy first used as a treatment, and what was it used to treat?

A

Resulted in the treatment of Hodkin’s and other lymphoma.

Began in the 1950’s as a treatment modality, common practice in the 1970’s

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6
Q

how does chemotherapy work?

A

Interferes with the steps of the cell cycle specifically involved in synthesis of DNA and replication of tumour cells.

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7
Q

How are chemotherapeutic agents classified?

A

Can be cell cycle phase specific or cell cycle phase nonspecific.
Chemotherapeutic agents are classified according to their action/interference with the cell cycle.

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8
Q

What is application of chemotherapy based on?

A

Application is based on concepts of cellular kinetics: cell cycle, cell-cycle time, growth fraction, and tumor burden

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9
Q

What are the five stages of reproduction provess that occurs in both normal and malignant cells?

A 
G0 phase
S phase
G2 phase
M phase
G1 phase
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10
Q

What is cell-cycle time?

A

Time required for cell to move from one mitosis to another mitosis.

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11
Q

What is the major determinant in cell-cycle time?

A

Major determinant is the G1 phase

Varies with specific cells

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12
Q

What is the effect of a shorter cell-cycle?

A

Shorter cell-cycle time leads to higher cell kill with exposure to cell specific agents.

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13
Q

What is the growth fraction of a tumor?

A

Percent of cells actively dividing at one time

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14
Q

What is the effect of growth fraction of tumours?

A

Higher growth fraction leads to higher cell kill with cycle specific agents.

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15
Q

What kind of chemotherapy agents should be used for tumours with a higher fraction of cells in G0 (resting phase)?

A

Tumours with >fraction of cells in G0 are more sensitive to cell-cycle non-specific agents

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16
Q

What is tumour burden?

A

Number of cells present in the tumour

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17
Q

What is the effect of tumour burden?

A

Cancers with small tumour burden are more sensitive to antineoplastic therapy
As the tumour burden increases, the growth rate decreases, and active cell dicvision decreases.

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18
Q

What is the effect of a high tumour cell burden?

A

The higher the tumor cell burden, the greater chance of heterogeneity of tumour cells and the emergence of drug-resistant clones
Tumour burden increases -> growth rate decreases -> and active cell division dicreases

19
Q

What are four various approaches for chemotherapy?

A

Single agent
Combination
Regional
High dose

20
Q

How are chemotherapy agents delivered? (What routes)

A 
Oral
Subcutaneous
Intramuscular
Topical
Intraarterial
Intracavity
Intraperitoneal
Intrathecal
Intravenous
21
Q

What are alkylating agents (what classification, and examples of specific meds)?

A

CEll cycle nonspecific (platins, non-platins)
Ex. cyclophosphamide
Cisplatin

22
Q

What are antimetabolites? (classification and examples of specific meds)?

A

Cell cycle specific (s-phase)

Ex. 5-fluorouracil, capecitabine

23
Q

What are antitumour antibiotics? (classification and examples of specific meds)

A

Cell cycle specific (s-phase)

Ex. doxorubicin, bleomycin

24
Q

What are vinca alkaloids? (classification and examples of specific meds)

A

Cell cycle phase specific (m phase)

Ex. vincristine, vinblastine

25
Q

What are taxanes? (classification and examples of specific meds)

A

M-phase specific

Ex. paclitaxel, docetaxel

26
Q

What are podophyllotoxins? (classification and examples of specific meds)

A

M-phase specific

Ex. etoposide, teniposide

27
Q

What are camptothecins?(classification and examples of specific meds)

A

S-phase specific

ex. Irinotecan, topotecan

28
Q

What are the effects of steroids in cancer patients? What are some examples of steroids used in cancer treatment?

A

Reduces ICP, spinal cord compression

Ex. prednisone, deximethasone

29
Q

Are hormones cell cycle specific?

A

Non-cell cycle phase speciic

30
Q

What is an example of a hormone used to treat cancer?

A

Tamoxifen

31
Q

Which factors determine the chemotherapy regime prescribed?

A 
Pt eligibility
Cancer cell type
Rate of drug absorption
Tumour location
Tumour load
Tumour resistance
Staging and grading
32
Q

Which three things determine the selection of drug combinations?

A

The proven effectiveness of each drug when used alone against that cancer
A difference in each drug’s method of attacking the cancer (so that maximum cancer-kill can be achieved in each cycle while minimizing the chance of developing resistance to any one drug)
A difference in the side effects of each drug (minimally overlapping toxicity), so that your healthy tissue will not be badly damaged by the cancer drugs

33
Q

What are common hematopoetic adverse effects of chemotherapy?

A

Neutropenia
Thrombocytopenia
Anemia
(This triad is called pancytopenia)

34
Q

What are common GI adverse effects of chemotherapy?

A

Anorexia and vomiting
Mucositis
Stomatitis

35
Q

What are common skin adverse effects of chemotherapy?

A

Dermatitis
Alopecia
Nail cahnges

36
Q

What are some genitourinary adverse effects of chemotherapy?

A

Cystitis

ARF

37
Q

What are some cardiovascular adverse effects of chemotherapy?

A

Extravasation
Phlebitis
Cardiac toxicity

38
Q

What are some neurologic adverse effects of chemotherapy?

A

Ototoxicity

Peripheral neuropathies

39
Q

What are some pulmonary adverse effects of chemotherapy?

A

Pulmonary Edema

Pneumonitis

40
Q

What are some reproductive adverse effects of chemotherapy?

A

Infertility

Changes in libido

41
Q

What are some mood alterations that are side effects of chemotherapy?

A

Anxiety

Depression

42
Q

What are some metabolic alterations caused by chemotherapy?

A

Hypo/hypercalcemia

Hypo/hyperglycemia

43
Q

What are some latent effects of chemotherapy?

A

Changes in memory

Secondary malignancies

44
Q

What are some other adverse effects of chemotherapy not specified to a body system?

A

Hypersensitivity

Fatigue (CRF)

Oncology (7 decks)

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