Chapter 105: Basic Principles of Cancer Chemotherapy

Question 1

what is the second most common cancer in males and females

Answer 1

lung and bronchus cancer

Question 2

cancer mostly affects people age __-__ in canada

Answer 2

65-74

Question 3

most common cancers

Answer 3

• tumors of breast, lung, prostate, colon and rectum
• low growth fraction and responds poorly to drugs

Question 4

rarer cancers

Answer 4

• lymphocytic leukemia, hodgkin’s disease, certain testicular cancers
• high growth fraction and respond well to drugs

Question 5

cancer

Answer 5

unregulated cellular proliferation

Question 6

cancer treatments

Answer 6

• surgerys
• radiation
• drug therapy

Question 7

what are the 4 drug classes

Answer 7

• cytotoxic agents
• hormones and hormone antagonists
• biologic response modifiers
• targeted drugs

Question 8

what drug class is most often used

Answer 8

cytotoxic agents

Question 9

persistant proliferation

Answer 9

• unrestrained growth and division
• do not grow more rapidly than normal cells

Question 10

invasive growth

Answer 10

tissue penetration

Question 11

formation of metastases

Answer 11

secondary tumors away from site or orgin

Question 12

immortality

Answer 12

endless cell dividion

Question 13

malignant transformation results form

Answer 13

a combination of activating oncogenes (cancer-causing genes) and inactivating tumor suppressor genes (prevent replication of cells that have become cancerous)

Question 14

what are the 3 stages of malignant transformation

Answer 14

• initiation
• promotion
• progression

Question 15

Chemotherapy drugs are more toxic to tissues with ___________

Answer 15

high growth fraction

Question 16

human structures with high growth factor

Answer 16

• bone marrow
• skin
• hair follicles
• sperm
• GI tract

Question 17

cure requires

Answer 17

100% cell kill

Question 18

obstacles to successful chemotherapy

Answer 18

• drugs lack selective toxicity
• host defenses contribute to little cell kill (body doesnt recognize cancer cells)
• cure requires 100% cell kill
• absense of early detection
• solid tumors respond poorly
• drug resistance
• heterogeneity of tumor cells (mutations)

Question 19

benefits of intermittent chemotherapy

Answer 19

allows normal cells to regrow between sessions

Question 20

myelosupression (bone marrow supression)

Answer 20

reduces the number of circulating neutriophils, platelets and erythrocytes

Question 21

consequences of myelosuppression

Answer 21

• infection (loss of neutrophils)
• bleeding/thrombocytopenia (loss of platelets)
• anemia (loss of erythrocytes)

Question 22

considerations in patient care with thrombocytopenia

Answer 22

• use caution when preforming procedures that might promote bleeding
• avoid IM injections
• caution with BP cuffs

Question 23

toxicities of cancer chemotherapy in the digestive tract

Answer 23

• stomatitis
• diarrhea
• nausea and vomiting

Question 24

stomatitis

Answer 24

inflammation of the oral mucosa

Question 25

stomatitis management

Answer 25

- good oral hygiene, bland diet, medicated mouthwash

Question 26

regimine of choice for nausea and vomiting

Answer 26

combination of Aprepitant [Emend] dexamethasone and a serotonin antagonist such as ondansetron [Zofran]

Question 27

daunorubicin can cause

Answer 27

serious damage to the heart

Question 28

cisplatin can cause

Answer 28

injury to the kidneys

Question 29

vincristine can cause

Answer 29

injury to the peripheral nerves

Question 30

what scale can we use to determine if treatment is effective

Answer 30

Karnofsky performace scale