Cancer Flashcards
Phases of cell cycle (5)
G1-Presynthetic S-DNa synthesis G2-Pre-mitotic M-Mitotic G0-Quiescent
Phases of Mitosis
Interphase-G1, S, G2 (Chromosomes double to 92)
Prophase: Centrioles
Prometaphase: Nuclear membrane dissolves and chromosomes migrate out
Metaphase: Spindle fibres align centrally
Anaphase: Paired chromosomes separate and dragged to opposite sides of the cells
Telophase: Chromatids arrive at opposite poles
Cytokinesis: Actin fibre creates two new cells
Cell cycle control: Intracellular enzymes
Upregulation by Cyclin dependent kinases:
- PDGF
- EDGF
- IGF-1
Downregulation by: TGF-b
Protein p53
Blocks G1
Proto-oncogenes
Ras (p21)
ERB1 and ERB2
Telomerase
Tumour Suppressors
APC
E-Cadherin
P53
Anti-apoptosis bcl2
Angiogenesis promotors
Fibroblast growth factors
Vascular endothelial growth factors
Angioproteins 1 and 2
Inhibitors of angiogenesis
Angiostatin
Endostatin
Thrombostatin
PSA
PSA velocity (>0/75ng/dl/yr malignant)
PSA density PSA value with volume (>0/15)
Free-total PSA ratio (<25%)
Tumour markers
CEA-Colorectal cancer
AFP-Liver, NSGT (testes)
bHCG-Choriocarcinoma, NSGCT
Thyroglobulin-Thyroid cancer
Calcitonin-MTC
ACTH/ADH-Small cell lung cancers
Chemotherapeutic Agents
Classical Alkylating agents Non-classical alkylating agents Anti-metabolites Anthracycline agents Non-anthracycline agents Vinca alkaloids Taxanes Topoisomerase inhibitors
Classical Alkylating agents
Form covalent bonds with nucleic acids, amino acids, proteins etc
Mustargen
- CML
- CLL
- Hodgkins
- Non-hodgkins
Cyclophosphamide
- Lymphoma
- Breast
- Lung
- Ovary
Chlorambucil
-CLL
NHL
Ovary
Melphalan
-Multiple myeloma
Non-Classical Alkylating agents
Cross link DNA strands
Cisplatin
- Testis, ovart
- Head and neck cancer
- Lung cancer
- Oesophageal and stomach
- Bladder
Carboplatin
- Lung
- Ovary
- Seminoma
Antimetabolistes
Interfere with purine, pyramiding synthesis
Methotrexate (s-phase)
-ALL
Breast
Lung
F-FU Colon Breast stomach oesophagus Pancreas
Anthracycline
Multiple actions)
Doxorubicin
- Leukaemia
- Lymphoma
- breast cancer
- small cell lung
- sarcoma
Non-anthracycline
Alkylation
Bleomycin
-Lymphoma
Mitomycin
- Breast
- Bladder
Vinca alkaloids
Inhibit mitosis-M phase specific
Vincristine
acute leukaemia
lymphoma
neuroblastoma
Vinblastine
Testis
Hodgkins and non
choriocarcinoma
Taxanes
Stabilise microtubules
Docetaxel
Breast
Ovarian
Paclitaxel
Ovary
Breast
Lung
Topoisomerase inhibitors
Irinotecan
-Colorectal cancer
Hormonal Therapy
Prostate
- Bilateral orchidectomy
- Antiandrogens
- LHRH analogues
- Stilboestrol (oestrogen)
Breast
- Tamoxifen (ER - and PR -)
- Aromatase inhibitors
- Progestogens
- LHRH analogues
Thyroid tumours
Thyroxine suppresses TSH
Monoclonal abs
Rituximab
-Monoclonal ab against B cells
For low grade lymphoma
Trastuzumab (Herceptin)
-HER-2
Bevacizumab
-VEGF angiogenic activity
Oncological Emergencies
Neutropenia and sepsis
Hypercalcaemia
SVC obstruction
Spinal cord compression
Neutropenia and sepsis
Bone marrow depression due to malignancy cell infiltration
Treatment causing suppression of bone marrow
Hypercalcaemia
Bones, moans, stones, psychic groans May resolve with treatment of primary cancer Fluids replacement Stop thiazide diuretics Oral phosphatesm calcitonin and NSAIDs
SVC
Plethoric facies Obstructed dilated neck veins Dizziness on bending Dyspnoea and pulmonary oedema Headache Venous thrombosis
Management: Local radiotherapy
Dexamethasone 4mg/6hrs
Spinal Cord Compression
70% Thoracic 20% lumbosacral 10% cervical
Back pain
Leg weakness
Urinary retention
Upper motor neurone signs, sensory signs
