Cancer Treatment

Question 1

what are the goals of cancer tx?

Answer 1

potentially cure the px
prolong survival
relieve symptoms

Question 2

what are the 3 types of systemic cancer tx?

Answer 2

cytotoxic chemotherapy
molecular target therapies
Biologic therapies

Question 3

what is the diff betwen adjuvant and neoadjuvant?

Answer 3

adjuvant - given after surgery

neoadjuvant - given before surgery

Question 4

what are acute complications of cancer tx?

Answer 4

myelosuppression
hair loss
nausea & vomiting
diarrhea
constipation

Question 5

what are the common manifestations of myelosuppression?

Answer 5

thrombocytopenia
neutropenia

Question 6

what is Nadir Neutrophil count?

Answer 6

lowest neutrophil count ff chemotherapy every 3-4 weeks around 10th day of tx

Question 7

what is the duration of Nadir neutrophil count?

Answer 7

14th day and completed by 21st day

Question 8

when do we compute for absolute neutrophil count?

Answer 8

if WBC is below normal range

Question 9

what is the formula for absolute neutrophil count?

Answer 9

[(%neutros + %bands) x WBC]/100

Question 10

what are common causes of bacterial and fungal infections in cancer px?

Answer 10

gram neg pathogens
S. aureus
Candida
Aspergillus
Mucor

Question 11

what are the diff recombinant hematopoietic growth factors for tx of neutropenia in cancer px?

Answer 11

Recombinant G-CSF
GM-CSF

Question 12

what is the main risk of thrombocytopenia <1003/uL?

Answer 12

hemorrhage

Question 13

how do you manage thrombocytopenia?

Answer 13

platelet transfusion
Thrombopoiteitn mimetics (Romiplostim & Eltrombopag)

Question 14

what are the sites involved in nausea and vomiting of cancer px durign chemo?

Answer 14

area postrema or chemoreceptor triggering zone

lateral reticular formation of the medulla: vomiting center

Question 15

what is the only platinum analog classified as high risk agents while the rest are alkylating agents?

Answer 15

Cisplatin

Question 16

what is the only monoclonal Ab clasified under moderate risk while others are minimal risk?

Answer 16

Alemtuzumab

Question 17

what are the classes of antiemetic agents used?

Answer 17

5-HT3 antagonists
Neurokinin-1 receptor antagonist
cortiicosteroids

Question 18

what is a new 2nd generation 5-Ht3 antagonist given to px having chemo for 2-3 days instead of short acting 5-HT3 antagonists?

Answer 18

Palonosetron

Question 19

what premedication is given to low emetic risk category?

Answer 19

Dexamethasone

prevention of delayed emesis = none

Question 20

what are chemotherapeutic agents that commonly causes constipation?

Answer 20

5-fluorouracil
Capecitabine
Irinoctecan

Question 21

what chemotherapeutic agents causes hair loss (alopecia)?

Answer 21

anthracyclines (Doxorubicin)

Question 22

what should be done to prevent alopecia in cancer px taking chemo?

Answer 22

scalp temp= <24C
Topical Minoxidil and a-tocopherol

Question 23

what are chronic complications of cancer px taking chemo?

Answer 23

CV dysfunction
Pulmonary dysf
neurologic dysf
hepatic dysf
renal/bladder dysf
reproductive and endocrine dysf
oral complications
reynaud’s phenomenon
second malignancies