Cancer Therapy Flashcards
List 4 common Cancers
- Breast Cancer
- Prostate Cancer
- Cervical Cancer
- Lung Cancer
What are the biological reasons for Cancer?
- Aberrant patterns of gene expression (Oncogenes + Tumor suppressor genes)
- Abnormal expression of normal growth triggers due to mutation
- Abnormal inhibition of apoptic signals due to mutation
- Changes either–> Cumulative mutation w/ division or non mutational changes
What are the Hallmarks of Cancer?
- growth factor independence/self-suffciency
- Insensitivity to anti-growth signals
- Avoidance of programmed cell death (apoptosis)
- Ability to recruit a dedicated bood supply
- Immortalization by reactivation of tekomerase
- Ability to invade adjacent normal tissues and metastatize to distant surfaces
- Reprogrammed energy metabolism
- Evading immune destruction
What is imaging used for in cancer?
- Early detection of cancer - Screening
- Assessment of identified cancer - Staging
- Planning cancer treatment - Radiotherapy
Imaging is usually functional or anatomically based
What are the diff types of imaging in cancer?
- Ultrasound
- X-ray
- CT imaging
- MRI
- Radionucleotide imaging - SPECT & PET-CT
What are the different kind of cancner tx?
- Surgical
- Chemotherapy
- Radiotherapy
- Combination of Tx
- Pallatiative therapy
When Tx planning, who is part of the MDT? (for cancer)
- Surgeon
- Radiotherapist
- Chemotherapist
- Clin Nurse specialtst
- Radiologist
- Others - indicated by type of cancer
What are the diff aims of Cancer Tx?
- Curative
- Life extending
- Pallatative
What are the different Tx choices for cancer?
- Staging investigation results
- Genetic testing of cancer
- Evidence from clin trials
Tx is tailored to ‘best fit’ the Px
What are diff principles of Cancer surgery?
- Often part of diagnostic staging - biposy
- Cancer tx w/ surgery
- Remove tumor completely before spread (remove regional lymph nodes if potential lymphatic spread)
- Most effective of small encapsulated tumors
- Need clear margin to reduce reaccurance
What are the effects of Cancer surgery? And what needs to be considered?
- Red rissue bulk - cosmetic (breast/oral) or Func (colorrectal)
- Often reconstruction needed - a secondary procedure
- Req GA - look into side effects - can Px w/stand
What are side effects of cancer surgery that need to be considered?
- Func/Cosmetic deficit
- Local infection/wound dehiscence
- Lymphatic oedema in affected area
- Gen surgical consequences (DVT or Hospital acquired infection (HAI))
- Often not curative - but rediced bulk of tumor and may help palliation
What are the principles of Chemo?
- Kill tumor cells without harming host cells
(is rare and relies on tumor cells having faster replication rate than host cells) - targeting drugs to cell markers or growth factors now reduces toxicity - hormone Tx & hrowth factor Tx
Side effects of Chemo are?
- Rapidly dividing cells killed - hair loss/oral ulceration/bone marrow suppression (WBC & platelets)
- Damage to DNA of remaining cells (risk of later cancers/damage to fertility/induction of menopause
- Drug specific effects - taste loss/Nephrotoxicity
What are the principles of radiotherapy in Cancerr?
Ionising radiation damage to cellular DNA
Total dose is delivered over multiple sessions
What are the effects of Radiotherapy?
- Kills tumor cells - needs to be delivered over days as not all cels are dividing @ same time
- Gives mod/high dose to overlying tissue - causing tissue burn or mucosal ulceration
What are the side effects of Radiotherapy?
- Gen tiredness
- Burns - clothing/shaving/sunlight issues
- hair loss in Tx area
- Dry mouth/taste loss if H&N
- Menopause induction if premenopausal women
What is Adjuvant therapy??
- Additional Tx to improve cancer outcome - target tumor cells more effectively and reduce the risk of metastatic or recurrant Dx
- E.g - Hormone Tx - tamoxifen
Targeted chemo - herceptin
Metastases prevention - bisphosphonates
What are new immune modulating drugs for Cancer?
Anti cancer therapies - Target specific pathways in tumor growth/spread
Anti-resorptive therapy ( RANKL)
What are New Immune Modulating therapies?
- Lymphocyte action modulators
- Rituximab
- Alemtuzumab
- Lymphocyte activators
