Chapter 11: Nutritional Effects of Cancer Therapies Flashcards
What are the six different types Biotherapies used either alone or with chemotherapy?
Monoclonal Antibodies Protein-Targeted Therapies Angiogensis Inhibitors Cytokines Cancer Vaccine Therapies Radiopharmaceuticals
What are monoclonal Antibodies?
therapies that signal external cellular pathway targets
What are protein-targeted therapies?
Therapies that signal internal cellular pathway targets
What are angiogenesis inhibitors?
Therapies that target tumor vasculature and angiogenesis
What are cytokines?
therapies that stimulate a broad-based immune response as opposted to generating a targeted response to a specific tumor antigen
What are Cancer Vaccine Therapies?
Therapies that signal an individual’s own immune system against tumor antigens
What are Radiopharmaceuticals?
Monoclonal antibody therapies that deliver radioactive molecules to specific cancer cells
What are the two classifications of Chemotherapy?
Cell cycle non-specific agents - damage cells in all phases of cell cycle (alkylating agents, antitumor antibiotics, hormone therapies, and nitrosoureas)
Cell cycle-specific agents - exert their effect within a specific phase of the cell cycle (antimetabolites and campotothecins (sythesis phase), plant alkaloids and taxanes (mitosis phase) and others)
How are Antineoplastic Agents administered?
Oral IV Intrathecal/Intraventicular (IT) Intrapleural (IP) Intra-arterial (IA) Subcutaneous (SC) Intramuscular (IM) Topically
Given in Cycles
What are the three factors to note with Antineoplastic Agents?
Frequency of cycles (daily, weekly, every 14 days, every 21 days, monthly, continuously)
Length of cycles (Injection, bolus, or continuous)
Number of cycles (determined by research/trials)
Goal of Chemoprevention
use of meds, vit/min, or other agents to reduce the risk of, or delay the development of cancer
example: hormone therapy to reduce risk of breast CA in woman determined to be a high risk
Goal of Adjuvant Therapy
use of additional cancer treatment given after primary therapy to reduce risk of recurrence and decrease incidence of metastatic disease
example: chemo after lobectomy for lung CA; chemo, hormone therapy, and monoclonal antibody therapy after lumpectomy for breast CA
Goal of Definitive Therapy
use of radiation therapy prescribed as primary treatment modality, with or without chemo.
example: xrt as primary for prostate CA
Goal of Neoadjuvant Therapy
use of one or more treatment modalities given before the primary therapy to reduce size of primary tumor to improve the effectiveness of surgery/decrease incidence of mets
example: chemo and external beam XRT before an esophagectomy for esophageal CA
Goal of Palliation
use of cancer treatment modalities when cure/control of disease can’t be achieved to relief of side effects/symptoms cause by cancer and other serious illness to improve QOL
example: external beam XRT to palliate painful bony lesions related to met prostate CA
Goal of Prophylaxis Therapy
use of radiation therapy for relief of symptoms such as pain, bleeding, neurological compromise, or airway obstruction to improve QOL or treat life-threatening problems
example: whole brain irradiation given for asymptomatic individuals diagnosed with CA that have high risk of occurrence of mets (like sc lung CA)
Define Tumor Burden or Tumor Load
the size of the tumor or amount in the body. As increases in size, growth rate can slow, thus reducing the effectiveness of the treatment
Define Tumor Growth Rate
what proportion of cancer cells within the tumor are growing/dividing to form new ca cells. rapidly growing are usually more responsive to treatment
Principles of Chemotherapy
chemical agents or drugs to systemically kill cancer cells. Has a cytotoxic effect to all cells, side effects/toxicities are often the result of damage to rapidly dividing cells. Normal cells are able to better repair themselves, making most toxicities reversible.
What body cells are susceptible to the effects of chemotherapy?
Bone Marrow, hair follicles, gonads (testes/ovaries) and gastrointestinal mucosa
Five phases of cell cycle
G0 - Resting - cells are temporarily out of the cycle and have stopped dividing
G1 - Post-Mitotic - cells begin t the 1st phase of reproduction by synthesizing protein and RNA necessary for cell division
S - Synthesis - DNA is synthesized
G2 - Pre-Mitotic - cells prepare to divide
M - Mitosis - cell growth and protein production stops. Cellular energy is focused on the orderly division of two daughter cells
What is Biotherapy?
treatment to boost or restore the ability of the immune system to fight cancer, infection, and other diseases by inducing, enhancing, or suppressing an individual’s own immune response
Also called immunotherapy or Biological Response modifier (BMR) therapy
What are possible side effects/nutritional implications of Monoclonal antibodies?
Infusion-related symptoms - fever/chills/fatigue/headache
Gastrointestinal - N/V/D - usually mild*** Primary Nutrition Concern
Cardiotoxicity - dyspnea, peripheral edema
myelosuppression - increased risk if with chemo
pulmonary toxicity - cough, PIs, PEs
skin issues - rash, facial erythema, hand-food syndrome
What are the five molecular targets for monoclonal antibodies? Name an example of each.
CD20: B-lymphocyte agtigen CD20 – Rituxan
EGFR: epidermal growth factor receptor – Erbitux
HER-2/neu: human epidermal growth factor receptor 2 – Herceptin
RANKL: receptor activator of nuclear factor kappa-B ligand – Xgeva
VEGF: vascular endothelial growth factor – Prolia
