Cancer Management Flashcards
1
Q
What are the biological hallmarks of cancer?
A
- growth factor independence/self-sufficiency
- insensitivity to anti-growth signals
- avoidance of apoptosis
- ability to recruit a dedicated blood supply
- immortalization by reactivation of telomerase
- ability to invade adjacent normal tissues/metastasise
- reprogrammed energy metabolism
- evasion of immune destruction
2
Q
What types of imaging are used in cancer diagnosis and treatment?
A
- ultrasound scanning
- plain x-ray
- CT imaging
- radionucleotide imaging
- SPECT
- positron emission tomography and PET-CT
3
Q
What are the different treatments used for cancer?
A
- surgical
- biopsy
- removal of tumour
- removal of regional lymph nodes
- chemotherapy
- aims to kill rapidly dividing cells
- drugs targeted to cell markers or growth factors
- radiotherapy
- ionising radiation damages cellular DNA
- kills tumour cells
- combination treatments
- palliative therapy
4
Q
What is the role of the dentist in managing cancer patients?
A
- early detection of soft tissue lesions
- pretreatment assessment and dental care
- maintenance of oral and dental health post treatment
- palliative care
5
Q
What does a pre-cancer treatment treatment plan look like?
A
- oral and dental assessment
- radiographs
- OPT
- periapicals
- necessary treatment carried out
- removal of potential sources of infection
- PMPR
- impressions for soft splints
- fluoride therapy
- for dentate patients
- oral hygiene instruction
6
Q
What may a cancer patient present to the dentist with during treatment?
A
- oral ulceration
- traumatic
- oral mucositis
- radiotherapy induced
- chemotherapy induced
- oral infection
- oral candidiasis
- reactivation of herpes simplex virus
- xerostomia
- dental erosion
- caries
- xerostomia
- diet and oral hygiene changes
- radiation induced
- periodontal disease
- osteoradionecrosis
- MRONJ
- osteonecrosis related to use of bisphosphonate like medications
7
Q
What is oral mucositis?
A
- inflammation and ulceration
- severe pain
- impacts on eating and oral health
8
Q
How can mucositis be managed?
A
- prescription of analgesics
- general lifestyle changes
- avoid smoking
- do not drink spirits
- do not eat spicy foods
- do not drink tea and coffee
- do not use non-prescription mouthwash
- application of topical medications
- topical lidocaine
- saline mouthwash
- sodium bicarbonate
- benztdamine hydrochloride
- gelclair
- caphasol
- tea tree oil mouthwash
- ice (oral cooling)
9
Q
What does post treatment care of a cancer patient involve?
A
- prevention
- diet advice
- oral hygiene instruction
- fluoride application
- smoking cessation
- monitoring
- increased frequency of check ups
- dry mouth management
- use of prosthodontics
- appropriate referrals
10
Q
What is trismus?
A
- fibrosis of the muscles of mastication
- irreversible
- impacts on eating, smoking, oral hygiene
- changes possible dental treatment, including dentures
11
Q
Summarise the role of the dental team managing cancer patients
A
- pre cancer treatment
- prevention of chemo/radiotherapy complications
- planning of rehabilitation
- during cancer treatment
- treatment of mucositis if required
- providing emergency treatment
- post cancer treatment
- prevention
- rehabilitation
- long term care and monitoring
