Cancers - Chapter 31 Flashcards

1
Q

Cancer

A
  • A disease that occurs when the normal cell renewal process fails.
  • Tumors may be benign or malignant
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2
Q

Cancer Naming

A
  • Cancers are named according to the site of the primary tumor
  • Carcinoma=skin or tissues covering internal organs
  • Leukemia=Blood
  • Lymphoma=Immune system
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3
Q

Cancer Staging

A

-A method used to describe how far the cancer has progressed

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4
Q

Risk Factors for Cancer

A
  • Increasing age
  • Tobacco use
  • Sunlight and tanning salons
  • Carcinogenic chemicals
  • Viruses, bacteria, hormone therapy
  • Alcohol
  • Family history
  • Etc.
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5
Q

Risk Factors for Breast Cancer

A
  • Family history
  • Nulliparity (0 pregnancies)
  • Late menopause
  • Advanced age
  • Personal history of breast cancer
  • History of HRT
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6
Q

Signs and Symptoms of Breast Cancer

A
  • Nipple tenderness
  • Lump or mass in the breast or near the underarm area
  • Fluid coming out of the nipples
  • Nipple that has turned inward
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7
Q

Skin Cancer

A
  • The most common type of cancer in Canada
  • Associated with excessive exposure to sunlight and UV rays
  • Divided into 2 categories: Melanoma and nonmelanoma
  • nonmelanoma is the most treatable form
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8
Q

Signs of Skin Cancer

A
  • Asymmetry
  • Border
  • Color
  • Diameter
  • Elevation
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9
Q

Lung Cancer

A
  • Excluding nonmelanoma cancer, lung cancer is the most common form of cancer in Canada.
  • 2 Types: Small cell lung cancer, and non-small cell lung cancer
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10
Q

Cancer Screening Tests

A

-Screening tests are recommended for early diagnosis of breast, colon, cervical and prostate cancer

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11
Q

Treatment of Cancers

A
  • Chemotherapy
  • Biological therapy
  • Radiation therapy
  • Surgery
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12
Q

Chemotherapy

A

Use of drugs to kill or slow the growth of cancerous cells

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13
Q

Biological Therapy

A

Administration of immune system modulators to boost the body’s natural defense against cancerous cells

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14
Q

Chemotherapeutic/Antineoplastic Agents MOA

A
  • Chemotherapeutic agents work my various mechanisms to interrupt the cell replication cycle
  • May interrupt a specific stage of the cell cycle
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15
Q

Types of Breast Cancer

A
  • Hormone Receptor-Positive Breast Cancer
  • HER2-Positive Breast Cancer
  • Triple-Negative Breast Cancer
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16
Q

Hormone Receptor-Positive Breast Cancer

A

-About 75% of all breast cancers are ER positive. about 65% of these are also PR positive

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17
Q

HER2-Positive Breast Cancer

A

-In about 20-25% of breast cancers, the cancer cells make too much of a protein called HER2/neu. They tend to be much more aggressive and fast growing

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18
Q

Triple-Negative Breast Cancer

A
  • Some breast cancers are known as triple negative because they lack estrogen and progesterone receptors and do not overexpress the HER2 protein.
  • These cancers generally respond well to chemotherapy, but overall they have a poorer prognosis than other types
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19
Q

Breast Cancer Treatment

A

-Hormone therapy is the treatment of choice for breast cancer

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20
Q

Classification of Hormone Therapy

A
  • Selective estrogen receptor modulators (SERMs)(SERMs)
  • Estrogen receptor down-regulators
  • Aromatase inhibitors
  • Gonadotropin-releasing hormone (GnRH)
  • Progestins
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21
Q

SERM’s (antiestrogens)

A

tamoxifen is indicated for noninvasive and invasive estrogen receptor (+) breast cancer in women and men

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22
Q

Generic: tamoxifen

A

Nolvadex D, Tamofen

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23
Q

SERM’s ADR’s

A
  • Hot flashes
  • Sweating
  • Vaginal itchiness
  • Nausea and Vomiting
  • Menstrual changes
  • DVT
  • Pulmonary embolism
  • Lowered platelets and WBC count
  • Hair loss
  • Cataracts
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24
Q

Estrogen Receptor (ER) Downregulators

A

fulvestrant is indicated for the treatment of estrogen-receptor positive metastatic breast cancer in postmenopausal women
-For disease progression, following antiestrogen therapy

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25
Q

Generic: fulvestrant

A

Faslodex

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26
Q

fulvestrant ADR’s

A
  • Bone and back pain
  • Hot flashes
  • Nausea/vomiting
  • Diarrhea
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27
Q

Aromatase Inhibitors

A
  • Block the conversion of androgens to estrone and estradiol

- For first-line treatment of metastatic ER-positive breast cancer in postmenopausal women

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28
Q

Aromatase Inhibitors Examples

A
  • anastrozole
  • exemestane
  • letrozole
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29
Q

Generic: anastrozole

A

Arimidex

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30
Q

Generic: exemestane

A

Aromasin

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31
Q

Generic: letrozole

A

Femara

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32
Q

Aromatase Inhibitors ADR’s

A
  • Menopause-like symptoms
  • Nausea/vomiting
  • Dizziness
  • Cough
  • Headache
  • Hairloss
  • Mood changes
  • Constipation
  • Bone pain
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33
Q

Gonadotropin-Releasing Hormone (GnRH) Agonists and Luteinizing Hormone– Releasing (LHRH) Agonists

A

-Goserelin is indicated for the treatment of advanced estrogen-receptor (+) breast cancer in premenopausal and perimenopausal women

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34
Q

Generic: goserelin

A

Zoladex

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35
Q

Progestin

A

Megestrol acetate is indicated for the treatment of inoperable, advanced metastatic breast cancer following treatment with tamoxifen or aromatase inhibitors
-also indicated for the treatment of endometrial cancer

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36
Q

Generic: megestrol acetate

A

Megestrol, Megace OS

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37
Q

Chemotherapeutic Agents:

Alkylating Agents

A
  • One of the oldest classes of antineoplastic agents
  • Damage DNA and impair DNA replication and the growth phase of the cell lifecycle
  • They are toxic to cancer cells and non-cancerous cells
  • Are carcinogenic
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38
Q

Alkylating Agents Examples

A
  • cyclophosphamide
  • busulfan
  • ifosfamide
  • melphalan
  • chlorambucil
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39
Q

Generic: cyclophosphamide

A

Cytoxan, Procytox

-Only cyclophosphamide is used for breast cancer

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40
Q

Cyclophosphamide ADR’s

A
  • Hair loss
  • Appetite loss and weight loss
  • Skin discoloration
  • Mouth sores
  • Fatigue
41
Q

Generic: busulfan

A

Myleran

42
Q

Generic: ifosfamide

A

Ifex

43
Q

Generic: melphalan

A

Alkeran

44
Q

Generic: chlorambucil

A

Leukeran

45
Q

Microtubule Targeting Drugs (Taxanes)

A
  • Common ending: “taxal.”
  • Approved for the treatment of breast cancer, ovarian cancer, and lung cancer
  • Interfere with mitosis
46
Q

Taxanes examples

A
  • docetaxel

- paclitaxel

47
Q

Generic: docetaxel

A

Taxotere

Warning Labels:

  • DO NOT SHAKE
  • REFRIGERATE;DON’T FREEZE
  • DO NOT MIX IN PVC BAGS OR USE PVC SETS
  • EXERCISE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
48
Q

Generic: paclitaxel

A

Taxol, Abraxane

Warning Labels:
-STORE AT ROOM TEMP
DO NOT MIX IN PVC BAGS OR USE PVC SETS
-EXERCISE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING

49
Q

Taxanes ADR’s

A
  • Diarrhea
  • Total body hair loss
  • Nausea
  • Flushing
  • Sweating
  • Decreased RBC, WBC, platelets
  • Mouth sores
50
Q

Taxanes Warning Labels

A

AVOID ASPIRINS AND NSAIDS

51
Q

Microtubule Targeting Drugs: Vinca Alkaloids

A
  • Work similarly to taxanes

- Inhibit microtubule formation

52
Q

Vinca Alkaloids Examples

A
  • vinorelbine
  • vinblastine
  • vincristine
53
Q

Generic: vinorelbine

A

Navelbine

Warning Labels:
-REFRIGERATE; DO NOT FREEZE

54
Q

Generic: vinblastine

A

Vinblastine Sulfate Injection

55
Q

Generic: vincristine

A

Vincristine Injection

56
Q

Vinca Alkaloids ADR’s

A
  • Hair loss
  • Nausea/vomiting
  • Constipation
  • Joint and muscle pain
  • Mouth sores
  • Pain at injection site
57
Q

Vinca Alkaloid Warning Labels

A
  • AVOID ASPIRINS AND NSAIDS
  • FATAL IF GIVEN INTRATHECALLY. FOR IV USE ONLY
  • EXERCISE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINSTERING
58
Q

Anthracyclines

A
  • Common ending: “rubicin.”

- Impair DNA replication and the growth phase of the cell life cycle

59
Q

Anthracyclines Examples

A
  • doxorubicin
  • doxorubicin liposomal
  • epirubicin
  • mitoxantrone
60
Q

Generic: doxorubicin

A

Adriamycin PFS

61
Q

Generic: doxorubicin liposomal

A

Caelyx, Myocet

62
Q

Generic: epirubicin

A

Pharmorubicin PFS

63
Q

Generic: mitoxantrone

A

Mitoxantrone Injection

64
Q

Anthracyclines Warning Labels

A
  • AVOID PREGNANCY
  • SHAKE WELL (powder for injection)
  • PROTECT FROM LIGHT
  • MAY CAUSE DISCOLORATION OF URINE
  • EXERCISE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
65
Q

Topoisomerase Inhibitors

A

Enzymes that cleave to

DNA strands, a step needed for DNA replication and RNA transcription

66
Q

Topoisomerase Inhibitors Examples

A
  • etoposide
  • teniposide
  • irinotecan
  • topotecan
67
Q

Generic: etoposide

A

Vepesid

Warning Labels:

  • RECONSTITUTED SOLUTION IS STABLE FOR 24 HOURS
  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
68
Q

Generic: teniposide

A

Vumon

Warning Labels:

  • RECONSTITUTED SOLUTION IS STABLE FOR 24 HOURS
  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
69
Q

Generic: irinotecan

A

Camptosar

Warning Labels:

  • RECONSTITUTED SOLUTION IS STABLE FOR 48 HOURS (6 if not refrigerated)
  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
70
Q

Generic: topotecan

A

Hycamtin

Warning Labels:

  • RECONSTITUTED SOLUTION IS STABLE FOR 24 HOURS
  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
71
Q

Platinum Compounds

A

-Common ending: “platin”

act on purine bases to cause faulty cross linkages and defective DNA

72
Q

PLatinum Compounds Examples

A
  • carboplatin
  • cisplatin
  • oxaliplatin
73
Q

Generic: carboplatin

A

Paraplatin

Warning Labels:

  • RECONSTITUTED SOLUTION IS STABLE FOR 24 HOURS
  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
74
Q

Generic: cisplatin

A

Cisplatin

Warning Labels:

  • STABLE FOR 28 DAYS ONCE VIAL IS PENETRATED
  • PROTECT FROM LIGHT
75
Q

Generic: oxaliplatin

A

Eloxatin

Warning Labels:
-RECONSTITUTED SOLUTION AND IVS ARE STABLE FOR 24 HOURS IF REFRIGERATED

76
Q

Fluoropyrimidines

A

Indicated for the treatment of several cancers

77
Q

Fluoropyrimidines Examples

A
  • capecitabine
  • cytarabine
  • cytarabine liposomal
  • fludarabine
  • gemcitabine
78
Q

Generic: capecitabine

A

Xeloda

Warning Labels:

  • TAKE WITH FOOD
  • AVOID PREGNANCY
79
Q

Generic: cytarabine

A

Cytosar

80
Q

Generic: cytarabine liposomal

A

Depocyt

Warning Labels:

  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
  • REFRIGERATE; DO NOT FREEZE
81
Q

Generic: fludarabine

A

Fludara

Warning Labels:

  • RECONSTITUTED SOLUTION IS STABLE FOR 8 HOURS
  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
  • REFRIGERATE; DO NOT FREEZE
82
Q

Generic: gemcitabine

A

Gemzar

Warning Labels:

  • EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING
  • STORE AT ROOM TEMPERATURE
  • IV SOLUTION IS STABLE FOR 24 HOURS
83
Q

Antimetabolites

A

-Chemotherapeutic agents that work most effectively against rapidly dividing cancerous cells by inhibiting DNA synthesis

84
Q

Antimetabolites Examples

A

Methotrexate

85
Q

Generic: methotrexate

A

Methotrexate

Warning Labels:

  • AVOID ALCOHOL
  • AVOID ASPIRIN AND NSAIDS
86
Q

Antimetabolites ADR’s

A
  • Hair loss
  • Photosensitivity
  • Appetite loss
  • Nausea
  • Decreased WBC, RBC, and platelets
87
Q

Antimetabolites Warning Labels

A

-AVOID ALCOHOL
AVOID PROLONGUED EXPOSURE TO SUNLIGHT
-AVOID PREGNANCY
-EXERCIZE PRECAUTIONS FOR HANDLING, PREPARING, AND ADMINISTERING

88
Q

Misc.

A
  • bleomycin
  • dactinomycin
  • hydroxyurea
89
Q

Generic: bleomycin

A

Blenoxane

ADR’s:

  • pulmonary fibrosis and death
  • bone marrow suppression
  • anemia
  • MI
90
Q

Generic: dactinomycin

A

Cosmegen

ADR’s:

  • pulmonary fibrosis and death
  • bone marrow suppression
  • anemia
  • MI
91
Q

Generic: hydroxyurea

A

Hydrea

92
Q

Biological Response Modifiers

A

-Modify the relationship between the tumor and the patient by strengthening the patients biological response to tumor cells

93
Q

3 categories of BRM’s

A

BRMs can be divided into three major categories according to mechanism of action:

  • agents that restore, augment, or modulate the patient’s normal immunological mechanisms
  • agents that have direct antitumor effects
  • agents that have other biologic effects
94
Q

Monoclonal Antibodies

A

-mimic the antibodies your body naturally produces as part of your immune system’s response to bacteria, viruses, etc.

95
Q

Monoclonal Antibodies Examples

A
  • bevacizumab

- trastuzumab

96
Q

Generic: bevacizumab

A

Avastin

97
Q

Generic: trastuzumab

A

Herceptin

98
Q

Supportive Therapy

A
  • Antifungals
  • Pain medications
  • Steroids
  • Anti-Emetics
99
Q

Anti-emetics

A

-Prevent or alleviate nausea and vomiting due to chemotherapy