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
