Cancer treatment Flashcards
What is meant by radical/ curative treatment?
- aim to completely cure disease rather than relieve symptoms
- classically surgical
- now radical radiotherapy in high doses (eg: bladder cancer with chemo)
What is meant by palliative treatment?
active, total care of the patients whose disease is not responsive to curative treatment
What is meant by adjuvant treatment?
therapy that is given in addition to the primary or initial therapy to maximise its effectiveness
*radiotherapy, chemo, hormone therapies, immunotherapies
What is meant by neo-adjuvant treatment?
administration of therapeutic agents before a main treatment
- reduce the size or extent of the cancer
- acts on micromets
- can be chemo, radiotherapy or other targeted therapies
What is meant by maintenance therapy?
- maintenance therapy is the ongoing treatment of cancer with medication after a response to first line treatment
- used to prevent cancer returning, to delay growth of advanced caner after initial treatment
what are the principles of cancer surgery?
- curative
- biopsy
- palliative
- consideration: bleeding, anaesthesia, recovery time etc
What are the possible side effects of cancer surgery?
- pain
- infection
- loss of organ function
- fatigue
- bleeding
- clots
- altered bowel and bladder function
What are the principles of radiotherapy?
- aim is to deliver carefully calculated doses of radiation to cancer cells, minimising the radiation exposure to surrounding tissues
- high energy radiation which is ionising (charged particles which deposit the energy into cells as they pass through) triggering direct apoptosis via DNA damage or causing DNA strand breaks preventing proliferation
what is the indication of radiotherapy?
- sole radical treatment eg: prostate
- neo-adjuvant to shrink before resection
- intra-operative
- adjuvant
- in conjunction to systemic therapies like chemo and immunotherapy
- palliative - spinal cord compression
what methods of radiotherapy are available?
- external beam radiation - from outside body aiming high energy rays towards location of cancer
- brachytherapy - radioactive sources in catheters or seeds to deliver radiation from inside body directly into tumour site, placed next to tumour and deliver high dose radiation eg: prostate, cervical
what are some early side effects of radiotherapy?
- within first few weeks, resolves within few weeks of onset
- skin reactions - erythema, desquamation
- fatigue
- mucositis
- diarrhoea
- nausea
what are some late side effects of radiotherapy?
- months to years after which may be irreversible and progressive
- excessive extracellular matrix, deposition of collagen, fibrinogenesis
- radiation-induced fibrosis
- atrophy
- neural or vascular damage
- range of endocrine effects like diabetes, hypothyroidism
what is the principle of chemotherapy?
systemic drug therapy use to kill cancer cells by causing cytotoxicity or apoptosis - by attacking DNA, interfering with cell division or intefering with metabolism essential for replication
what are the main classes of chemo?
- antimetabolites
- anti-tumor antibiotics
- alkylating agents
- taxanes
- platinum agents
- topoisomerase inhibitors
what are some indications of chemo?
- induction of remission
- neo-adjuvant
- adjuvant
- maintenance
- palliative
what are some side effects of chemo?
- N+V
- myelosuppression
- degrade integrity of GI mucosa
- alopecia
- oral mucositis
- WL
- peripheral neuropathy
- secondary cancer
how is hormone manipulation used to manage breast, prostate and endometrial cancer?
breast - oestrogen receptor blocker, aromatase inhibitor
prostate - testosterone block, LH block, GnRH block
endometrial - progesterone affects hence manipulated
What are the principles of immunotherapy?
enables body’s own immune system to better recognise and eradicate cancer cells
What are the possible side effects of immunotherapy?
*immune checkpoint inhibitors
- skin - rashes, itching
- GI - diarrhoea
- CNS - neuropathy
- blood - bleeding, anaemia
- repro - fertility
What are the principles of biologically targeted therapy?
monoclonal antibodies against cell surface (growth factor receptors) or circulating antigens (receptor ligands)
What are the possible side effects of biologically targeted therapy?
- most common - diarrhoea, liver related problems
- clotting problems and would healing problems
- high BP, fatigue
- mouth sores, nail changes
- dry skin
