Cancers - Chapter 31 Flashcards
Cancer
- A disease that occurs when the normal cell renewal process fails.
- Tumors may be benign or malignant
Cancer Naming
- Cancers are named according to the site of the primary tumor
- Carcinoma=skin or tissues covering internal organs
- Leukemia=Blood
- Lymphoma=Immune system
Cancer Staging
-A method used to describe how far the cancer has progressed
Risk Factors for Cancer
- Increasing age
- Tobacco use
- Sunlight and tanning salons
- Carcinogenic chemicals
- Viruses, bacteria, hormone therapy
- Alcohol
- Family history
- Etc.
Risk Factors for Breast Cancer
- Family history
- Nulliparity (0 pregnancies)
- Late menopause
- Advanced age
- Personal history of breast cancer
- History of HRT
Signs and Symptoms of Breast Cancer
- Nipple tenderness
- Lump or mass in the breast or near the underarm area
- Fluid coming out of the nipples
- Nipple that has turned inward
Skin Cancer
- 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
Signs of Skin Cancer
- Asymmetry
- Border
- Color
- Diameter
- Elevation
Lung Cancer
- 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
Cancer Screening Tests
-Screening tests are recommended for early diagnosis of breast, colon, cervical and prostate cancer
Treatment of Cancers
- Chemotherapy
- Biological therapy
- Radiation therapy
- Surgery
Chemotherapy
Use of drugs to kill or slow the growth of cancerous cells
Biological Therapy
Administration of immune system modulators to boost the body’s natural defense against cancerous cells
Chemotherapeutic/Antineoplastic Agents MOA
- Chemotherapeutic agents work my various mechanisms to interrupt the cell replication cycle
- May interrupt a specific stage of the cell cycle
Types of Breast Cancer
- Hormone Receptor-Positive Breast Cancer
- HER2-Positive Breast Cancer
- Triple-Negative Breast Cancer
Hormone Receptor-Positive Breast Cancer
-About 75% of all breast cancers are ER positive. about 65% of these are also PR positive
HER2-Positive Breast Cancer
-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
Triple-Negative Breast Cancer
- 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
Breast Cancer Treatment
-Hormone therapy is the treatment of choice for breast cancer
Classification of Hormone Therapy
- Selective estrogen receptor modulators (SERMs)(SERMs)
- Estrogen receptor down-regulators
- Aromatase inhibitors
- Gonadotropin-releasing hormone (GnRH)
- Progestins
SERM’s (antiestrogens)
tamoxifen is indicated for noninvasive and invasive estrogen receptor (+) breast cancer in women and men
Generic: tamoxifen
Nolvadex D, Tamofen
SERM’s ADR’s
- Hot flashes
- Sweating
- Vaginal itchiness
- Nausea and Vomiting
- Menstrual changes
- DVT
- Pulmonary embolism
- Lowered platelets and WBC count
- Hair loss
- Cataracts
Estrogen Receptor (ER) Downregulators
fulvestrant is indicated for the treatment of estrogen-receptor positive metastatic breast cancer in postmenopausal women
-For disease progression, following antiestrogen therapy
Generic: fulvestrant
Faslodex
fulvestrant ADR’s
- Bone and back pain
- Hot flashes
- Nausea/vomiting
- Diarrhea
Aromatase Inhibitors
- Block the conversion of androgens to estrone and estradiol
- For first-line treatment of metastatic ER-positive breast cancer in postmenopausal women
Aromatase Inhibitors Examples
- anastrozole
- exemestane
- letrozole
Generic: anastrozole
Arimidex
Generic: exemestane
Aromasin
Generic: letrozole
Femara
Aromatase Inhibitors ADR’s
- Menopause-like symptoms
- Nausea/vomiting
- Dizziness
- Cough
- Headache
- Hairloss
- Mood changes
- Constipation
- Bone pain
Gonadotropin-Releasing Hormone (GnRH) Agonists and Luteinizing Hormone– Releasing (LHRH) Agonists
-Goserelin is indicated for the treatment of advanced estrogen-receptor (+) breast cancer in premenopausal and perimenopausal women
Generic: goserelin
Zoladex
Progestin
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
Generic: megestrol acetate
Megestrol, Megace OS
Chemotherapeutic Agents:
Alkylating Agents
- 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
Alkylating Agents Examples
- cyclophosphamide
- busulfan
- ifosfamide
- melphalan
- chlorambucil
Generic: cyclophosphamide
Cytoxan, Procytox
-Only cyclophosphamide is used for breast cancer