Cancer therapy Flashcards
What factors affect choice of therapy?
- site
- spread
- stage
- histology
- patient’s general condition
- sensitivity of tumour
- patient preference
- resources
What are the different treatment approaches?
- radical / palliative
- sole treatment modality
- part of a combined therapy
- adjuvant therapy
- neo-adjuvant
- prophylactic therapy
What are the 3 parts to the surgical treatment of cancer?
- management of primary tumour
- management of regional lymph nodes
- palliative surgery
What is primary tumour management?
- tissue biopsy to establish diagnosis
- removal of malignant disease w a clear margin of normal tissue
- repair, recon + restoration of normal function
Give examples of surgical excision of regional lymph nodes
- axillary nodes - breast cancer
- radical neck dissection - head & neck
- inguinal node dissection - vulva, anal, penile
What is palliative surgery?
- relief of obstructive symptoms
- control of haemorrhage
- tumour fungation
- fracture fixation
What is radiotherapy?
- treatment of malignant disease w/ high energy x-rays or gamma
- radical + palliative approaches
- used in few benign situs
- can be used as a single treatment option or as part of combo
- wide range of tumour sites
- external beam - particle therapy
- internal radiotherapy - brachytherapy
Describe the linear accelerator
- 360 movements -> access to any part of body
- laser system + imaging system
- range of high energy photons + electrons allow a range of tumours to be treated from superficial skin lesions to deep seated pelvic tumours
Describe characteristics observed with external beam treatment planning
- tumour volume
- critical structures
- isodose curves
- wedges
- homogenous distribution
What is conformal radiotherapy?
- multileaf collimators
- increase dose to tumour
- decrease dose to surrounding normal structures
What does 3D localisation allow for?
- CT plan
- volume definition
- identification of organs at risk
- dose calculation
What is positron emission tomography?
- PET/CT fusion
- functional imaging can also be used to define the tumour priot to radiotherapy
- PET demonstrates metabolically active tissue
Side-effects of radiotherapy can be site or dose dependent, or due to early/late responding tissues. What do the side-effects include?
- skin rxn
- hair loss
- GI disturbance
- tissue fibrosis
Describe the role of chemotherapy
- adjuvant therapy
- high sensitivity: leukaemia, lymphoma, germ cell tumours, small cell lung cancer
- modest sensitivity: breast, colorectal, bladder, ovary, cervix
- low sensitivity: prostate, kidney, primary brain tumours, melanoma
- combination drugs
Endocrine therapy drugs are commonly used in patients with breast or prostate cancer - what drugs for each?
- breast - tamoxifen
- prostate - zoladex
