CCC- cancer intro Flashcards
Which cancer has highest incidence
Lung
Top 4 cancer women
Breast Lung Bowel Uterus
Top 4 cancer men
Prostate Lung Bowel Bladder
Name of the interval between symptom onset and presentation
patient interval
name of the interval between presentation and referral
primary care interval
name of interval between referral and secondary care
referral interval
What are the five types of systemic anti-cancer treatment?
Cytotoxic Hormone Biologic/targeted Immunotherapy Radioisotopes
Two types of biologic/targeted therapy?
monoclonal antibodies tyrosine kinase inhibs
What is radical chemo?
Curative intent
What is primary chemo?
The main treatment
What is neo-adjuvant chemo?
Before surgery or radio
What is adjuvant chemo?
After surgery
What is chemoradiation
chemo with radio
What is palliative chemo
incurative advanced disease
when is high dose chemo given?
With bone marrow or stem cell transplant
A repeating pattern of treatment and rest days is called
a cycle
The complete pattern of cycles is the
course
What is the ‘line’ in cancer treatment?
Order of treatments
Three haem side effects of chemo
anaemia thrombocytopenia neutropenia
What is the name of the nail change seen in chemo? what are they?
Bow lines- lines of weakness as they stop growing for a bit- they may correspond to timing of chemo delivery
What is hand-foot syndrome? What might it indicate?
side effect of chemo- redness, pain and peeling of hands, soles of feet and sometiems scrotum. Can be a warning that sensitive to the drug
Could hand-foot syndrome happen with all chemo?
No only certain drugs
Which organs with a low rate of renewal might chemo effect?
heart, peripheral nerves, hearing
True or false, chemo is a risk factor for VTE but cancer itself is not
False- both are. And it is also made worse by being immobile, old etc.
Which chemos are especially bad for VTE risk
Platinum based
What two things determine how a patient tolerates chemo?
Patient fitness (co-morbs, WHO performance status, frailty index) Dose
What is the WHO performance status
0=fit 5=dead if can hoover, >/=1
Immunotherapy side effects can mimic ____. How do you manage them, broadly?
Infection Steroids
True or false immunotherapy side effects only occur during the course of treatment
False, can occur after
Radiotherapy can be delivered by which two types of particle?
Photons (deeper, produce secondary electrons in tissue) or electrons (superficial)
Radiotherapy is delivered by what machine?
Linear accelerator
How does RT work?
Damaging DNA- cancer cells can’t repair damage like normal cells can. Mitotic or apoptotic cell death
What unit is RT dose in?
Gray (Gy)
What is each dose of RT called?
A fraction
Does radical or palliative RT have a longer course, more RT and more fractions?
Radical
7 stages of RT
- consent 2. immobilisation 3. ct simulation 4. tattoos 5. volume definition 6. RT 7. follow up
Name each area
Top to bottom:
Gross tumour volume
Clinical target volume
Planning target volume
Treated volume
Irradiated volume
What is tungsten used for in RT?
Constantly shapes the beam to the shape of the tumour as it is delivered
Why does RT toxicity occur?
Transient damage to normal cells
Short term reactions to RT are often ‘-_ _ _ _ ‘
-itis
Long term reactions to RT are often ‘-_ _ _ _’
-osis
Examples of RT side effect to head and neck and some possible supportive treatments
Raditaion dermatitis (skin care)
Mucositis (mouth care)
Thick oral secretions (pain swallowing and salivary gland damage- may be permament fibrosis) (nutritional support, analgesia, mouth care)
Loss of taste
Fatigue
Dry mouth
(analgesia, admission)
What could you give to help prostatitis caused by prostate ca RT
Alpha blocker to increase flow
What is the benefit of giving RT as well as CT?
Makes radio more effective
What is ‘verification’ in RT?
Pt in same position each time
Which four cancers are the source of 80% bone mets?
Lung
Breast
Renal
Prostate
How are mets normally spread to bones?
Haematogenous
Likely sites of bone mets?
Skull
Prox humerus
Vertebrae
Pelvis
Prox femur
3 types bone mets
Lytic
Sclerotic
Mixed
Bone mets can be bone ____ or bone _____
Loss or formation
Which imaging modalities are good to see bone mets?
X-ray: difficult to see if <30-50% density loss
CT good
MRI sens to bone marrow changes
