Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PM3B: Spring > Cancer Therapeutics: Modes of treatment > Flashcards

Cancer Therapeutics: Modes of treatment Flashcards

1
Q

What are the three management aims and objectives for cancer treatment

A

Prevention
Early Detection
Total Eradication

PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe each hierarchy cancer management aims

A
  1. Cure: eradication of tumour and metastasis
  2. Remission and mitigation: significant reduction in tumour load
  3. Symptomatic/Palliation:
    Treatment of secondary complications, relief of these symptoms
  4. Terminal Care:
    Improvement of quality of life to optimise symptom control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is possible for solid tumours in terms of a cure and why is this the case?

A
  1. Local control but not sufficient for cure

2. Due to presence of systemic (microscopic) disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Even if bulky metastases are present, which rare cancers are chemosensitive

A

Leukaemia

Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is palliation

A

The relief of tumour symptoms and prolongation of life when a cure is no longer possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the average life expectancy for someone with a solid tumour or leukaemia and lymphomas

A

Solid: 2-18 months

Leukaemia and lymphomas: 5-8 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the four different modes of therapy

A

Surgery: excision of primary tumour

Bone marrow transplant: for some leukaemia’s

Radiotherapy

Drugs: cytotoxic chemotherapy, hormone therapy, immunotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give an example of adjuvant therapy

A

Radiotherapy for local invasion and lymph nodes spread: drugs for more disseminated cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe what to use surgery on (tumour type etc)

A

Well defined tumour
Non vital region (mastectomy- breast removal)
Non-mutilating result
Resection and reconstruction possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe what to use radiotherapy on (tumour type etc)

A

Diffuse but localised tumour (lymphoma)
Vital Organ/region (head, neck, CNS)
Adjuvant Therapy: post mastectomy
Palliation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe what to use chemotherapy on (tumour type etc)

A

Diffuse tumour (leukaemia)
Palliation
Primary tumour (hodgkin’s lymphoma)
Adjuvant therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does neo-adjuvant therapy take place

A

Prior to surgery or radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do chemotherapy agents exert their effect

A

Killing cells which are rapidly dividing

Agents are not tumour specific but also kill normal rapid dividing cells like hair follicles and GI mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do radiotherapy agents exert their effect

A

Application of ionising radiation to treat disease

Electromagnetic radiation and elementary particles deposit particles through excitation and ionisation

Common forms: ionising radiation include photon beams (X rays and gamma rays) and electrons (Beta particles)

Causes double strands of DNA to break which is completely irrepairable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the palliative benefits of radiotherapy

A
  1. Pain relief (bone metastases)
  2. Reduction of headache and vomiting of raised intracranial pressure from CNS metastases
  3. Relief of obstruction of bronchus, oesophagus, ureter and lymphatics
  4. Preservation of skeletal integrity form metastases in weight bearing bones
  5. Reversal of neurological impairment from spinal cord or optic nerve compression by metastases- can cause neurological issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the acute side effects of radiotherapy

A

Anorexia, Nausea, malaise

Mucositis e.g. diarrhoea, oesophagitis

Alopecia

Myelosuppression (bone marrow suppression)

17
Q

What are the chronic side effects of radiotherapy

A

Skin: ischaemia, ulceration

Bone: necrosis and fracture

Mouth: Sialitis and ulceration

Bowel: stenosis, fistula, diarrhoea

Bladder: cystitis

Vagina: Stenosis

Lung: fibrosis

Heart: pericardial fibrosis, cardiomyopathy

CNS: myelopathy (spinal cord)

18
Q

What is the rationale of chemotherapy

A
  1. Systemic treatment for advanced cancers: sometimes only sole treatment for advanced cancers like leukaemia
  2. Majority of solid tumours: chemotherapy for reducing disease volume and palliative symptoms- good in fast growing tumour phase
  3. Used as adjuvant after primary tumour has been controlled by surgery or radiotherapy
  4. Form: systemically, intravenously or orally
19
Q

When is adjuvant therapy given

A

In absence of macroscopic evidence of metastases to patients at risk of recurring micro-metastases

20
Q

How are micro-metastases spread

A

Lymphatic or haematological dissemination

21
Q

What are the different ways/possibilities for chemotherapy in targeting cancer

A
  1. Synergistic drugs: Oxaliplatin (targets DNA) and 5-fluorouracil (stops DNA building blocks)
  2. Use of drugs combination to kill cancer cells at different cell cycle stages
  3. Alternating cycles of different drugs from less effective to stronger then repeat (allows tissue time to recover)
22
Q

Give examples of chemotherapy drugs to target each stage of the cell cycle

A
  1. G1: synthesis of DNA components
    - Use of anti-metabolites such as Methotrexate, Azathioprine, 6-MP
  2. S phase: DNA synthesis
    - Alkylating agents, anti-tumour antibiotics, platinum compounds
  3. G2 Phase: synthesis of components for cell division: use of microtubule inhibitors- stops making components needed to separate
    - VINCA ALKALOIDS, Docetaxol, vincristine
  4. Inhibition of RNA synthesis
    Doxorubicin
23
Q

What are the chemotherapy side effects experienced from cytotoxic drugs and explain each one

A
  1. Myelosuppression: rapid fall in peripheral blood count with a low point for white cells and platelets at 7 days
  2. Leucopenia: reduction in white cells leads to immunosuppression
  3. Thrombocytopenia (reduced platelet count): impairs coagulation leading to bruising and bleeding
  4. GI and bladder: erosion in mucous membranes
  5. Falling out of skin and hair
  6. Fertility: spermatogenesis is inhibited (alkylating agents)- can also cause genetic damage
  7. Teratogenic action: first trimester affected
24
Q

What are the side effects experienced from chemotherapy drugs in general

A

Nausea and vomiting: stimulation of chemoreceptor leads to patients not wanting to continue therapy: Methotrexate, fluorouracil, doxorubicin, cisplatin

Other effects: class of drugs with its own characteristic adverse effect on major organs

Bone Marrow: immunosuppression, bleeding, anaemia, almost all drugs

GI tract: mucositis, ulceration, diarrhoea

Liver: cirrhosis, fibrosis (methotrexate)

25
Q

How do you minimise side effects?

A
  1. Reduce discomfort, morbidity and mortality or to increase tolerable dose threshold
  2. Close monitoring: important in particular blood counts (patients can be immunocompromised)
  3. Allowing adequate recovery between treatments
  4. Forced diuresis: given when nephrotoxic or bladder toxic drugs are given- involves modest over hydration before therapy followed with diuretic.
26
Q

How do you counteract myelosuppresion and growth factors

A

Myelosuppresion: blood transfusion, blood platelets, granulocytes

GF: Filgrastism

Timing of doses:

27
Q

Give examples of antiemetics used

A

Prochlorperazine

Ondansteron

Lorazepam

Metoclopramide

Dexamethasone

28
Q

How do you counteract a antifolate overdose

A

Folinic acid

29
Q

What is a partial response

A

More than 50% reduction in tumour

30
Q

What is a stable disease

A

No change or <50% reduction and <25% increase

31
Q

What is progressive disease

A

Increase in size or tumour by at least 25% of site

PM3B: Spring (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions