Cancer Treatment Flashcards
Goal of cancer treatment
Kill every CA cell and produce a cure
what if cancer can not be cured
control growth
offer palliation
Cell cycle
G0 - Rest phase
G1 - Cell growth
S - DNA synthesis
G2 - Prepare to divide
M – Mitosis (division)
what is the Growth fraction
ratio of proliferating cells to rest cells
T/F Malignant tumors initially grow very rapidly, ie high growth fraction
True
what happens as tumors increase in size
rate of proliferation decreases, ie low growth fraction /// Large tumors have a necrotic core Decreased nutrient supply at core More cells in resting phase (G0) More difficult to treat
Barriers to success
100% kill required Toxicity Late detection Tumor response Drug resistance Cell heterogeneity
Cannot kill the _____ to cure the ______
patient, cancer
consequence of late detection
Metastasis
Less responsive
Patient more debilitated by disease
why do solid tumors respond poorly
low growth fraction
limited blood supply
heterogeneity in Cancer cells
Ongoing mutation
Cells differ greatly- different responses to drugs
As tumor ages, heterogeneity increases
Startegies for success in chemotherapy
Intermittent chemo
Combination therapy
Optimal dosing
Regional therapy
Goal of intermitent chemo
100% CA cell death with limited normal cell injury
ADV of combo therapy
Reduces:
Drug resistance
Normal cell injury
Increases:
Cancer cell kill
Regional drug therapy
Access to tumors
High drug concentrations
Decrease systemic toxicity
Examples: Intraarterial, Intrathecal, Intraperitoneal, Intravesical
Usual toxicities of chemo
Nausea and vomiting for several days after chemo
1-2 weeks after first round: Decreased WBC’s, RBC’s, platelets Diarrhea Alopecia Fatigue
bone marrow complications
Three major complications
Neutropenia: infection
Erythrocytopenia: anemia
Thrombocytopenia: bleeding
Digestive tract injury
Stomatitis (focus in MedSurg)
Defined
Onset
Manifestations
Magic Mouthwash
Prescription “cocktail” for stomatitis
Example Rx (equal parts of) Viscous lidocaine 2% Mylanta Diphenhydramine 12.5 mg per 5 ml elixir Nystatin 100,000 units suspension Prednisolone 15 mg per 5ml solution Distilled water
Swish, gargle, and spit 5-10 mL every six hours prn. May be swallowed if esophageal involvement.
Not curative
Reproductive toxicity
Developing Fetus Germinal epithelium of testes Clinical significance Women: \_\_\_pregnancy/malformation\_\_ Men: testes/sperm banking
Hyperuricemia toxicity
Def: Excessive level of uric acid in blood
Cause: Cell death/destruction of DNA
