Cancer in adults and children Flashcards
Anti-cancer approaches
surgery: remove tumor
radiation: kill rapidly dev. cells (tumor and adjacent tissues)
chemotherapy: kill rapidly dev. cells
hormone therapy: inhibit growth and survival of hormone dependent tumor cells
targeted therapy: inhibit processes required for tumor growth
immunotherapy : recruit immune system to attack tumor cells
How to quantify toxicity
National cancer institute (NCI)
Common Terminology criteria for adverse events (CTCAE)
1-5
5= death
Myelosuppression
Bone marrow suppression, is a decrease in bone marrow activity that results in reduced production of blood cells.
most common dose dependent toxicity
Neutropenia
decrease in neuraphil count
WBC
decrease exposure
normal : 1,200 cells / mm^3
Thrombocytopenia
decrease in platelets
increase bleeding risk
CV: <50,000 to 20,000
Anemia
Decrease in RBC (hemoglobin)
Hemoglobin CV : <7-8 g/dL
Alopecia
decreased hair on scalp
Chemo brain
chemo fog , shift in cognitive function , may improve over 6 months -2 years follwoing treatment
Taxanes and Vinca Alkaloids
Interfere with M phase
Mitosis prevented by tubulin disruption
Side effects of Taxanes and Vinca Alkaloids
Peripheral neuropathy
stocking glove
Cardiotoxicity (arrhythmias, Bradycardia , HF)
Alkylating agents
prevents cell division
S phase
Side effects of alkylating agents
Mylosuppression
hemorrhagic cystitis
cardiotoxicity
neurotoxicity
Anthracycline
“rubicins”
prevents cell devision
inhibits DNA replication (G1, 2 phase)
Side effect for anthracycline
cardiotoxixity
Doxiorubicin
hand foot syndrome:
erythema and swelling, painful itching /burning
blistering, desquamation
HER2 monoclonal antibodies
human epidermal growth factor : over expressed in some brest cancers, MOA: binds to HER2 receptor preventing receptor activation and slows growth
Hormone therapy
anti-estrogenic agents
antiestrogens
Androgen deprivation therapy : prostate cancer
Luteinizing hormone releasing hormone agonist
estrogen fuels growth and division of breast cancer cells
hormone therapy inhibits estrogen molecule from receptor
Radiation therapy
XRT: damages DNA of exposed tissue
targets tumor : limits normal tissue
non selective
Brachytherapy
internal radiotherapy
prostate , skin , cervical , breast brain
Side effects to radiation
immunosuppression
skin changes
GI changes
Fatigue
Radiation myelitis : nerve damage
Avascular necrosis
Bone marrow transplant
side effect GVDH: graft versus host disease donated cells recognize the recipient cells as foreign
DNA vs RNA ATG and C base pairs
DNA: AGCT
RNA: AGCU
Genotype vs phenotype
Genotype is genetic composition of ind. organism
Phenotype is observable traits
what is cancer
abnormal cell devision : neoplasia
Carcinogenesis the drivers of cancer
- Increase in Proto-oncogenes and oncogene
(promote cancer growth) - Decrease in tumor suppressor genes (anti-concogenes)
- Decrease in DNA repair genes
Benign
slow growth , non invasive , no metastasis
Malignant
Rapid growth , invasive , potential for metastasis
TNM staging
T-tumor size
N: spread to regional lymph nodes
M: presence of distant metastasis
Tumor grades
Gx: cannot be assessed
G1: low grade
G2: moderately differentiated
G3:poorly differentiated high grade
G4 undifferentiated (high grade)
Diagnostic testing cancer
PET
FDG: fluorodeoxyglucose
Multiple myeloma
disease of the plasma cells of the immune system
Leukemia
cancer cells originate in the bone barrow and blood
Lymphoma
cancer cells originate in lymph node and lymphatic system
most common cancer diagnosis for children
28 % Leukemia: bone marrow and blood
brain and CNS tumors 26%
two most common treatment side effects in children
- peripheral neuropathy
- cancer related fatigue
