Chapter 62 - Oncology 2 Flashcards
The five most common types of cancer are:
1- basal and squamous cell skin cancer (i.e., non-melanoma)
2 - breast
3 - lung
4 - prostate
5 - colorectal cancer
1- The patient’s physical functioning (Performance status) is assessed with rating systems such as:
2- Performance status can help determine:
3- Treatment goals:
1- Karnofsky
- Eastern Cooperative Oncology Group (ECOG)
2- Treatment goal.
3- Remission (with curative intent)
- Palliative (provide comfort, control sx (pain).
The response to treatment can be complete or partial:
-CR:
-PR:
■ A complete response, or complete remission, means that the treatment has destroyed all known tumors.
■ A partial response, or partial remission, means that at least 30% of the tumor was eliminated.
Fluorouracil, “5-FU”
- brand?
- route of administration?
- why do you give … with it?
- Efudexis also used for basal cell carcinoma
- Continuous intravenous infusion
- Leucovorin is given with fluorouracil to i the efficacy; helps fluorouracil bind more tightly to its target enzyme, thymidylate synthetase
Capecitabine
- brand?
- dose?
- BBW
- CI
- Xeloda
- 2 divided doses 12 hrs
apart, given with water within 30 min after a meal - Oral prodrug of fluorouracil
- BBW: Significant inc in INR during and up to 1 month after treatment, monitor INR frequently
- CI: Severe renal impairment (CrCI < 30 ml/min) (capecitabine)
5-FU & capecitabine and DPD deficiency
Antidote?
dihydropyrimidine dehydrogenase (DPD) deficiency inc risk of severe toxicity
ANTIDOTE: Uridine triacetate (Vistogard) can be given as an antidote for overdose or severe or early toxicity due to DPD deficiency
5-FU & capecitabine SE
- Hand-foot syndrome,
- diarrhea,
- mucositis,
- cardiotoxicity,
- photosensitivity,
- dermatitis
Cytarabine conventional
- Brand?
- Cytarabine Syndrome?
- Administration?
- BBW
- SE
- ara-C
- Cytarabine Syndrome: fever, flu-like symptoms, myalgia, bone pain, rash; responds to steroids
-Given via intrathecal (IT) administration for CNS leukemias/lymphomas
-BBW: Myelosuppression, hepatotoxicity and GI toxicities
SE:
- Pulmonary toxicity, encephalopathy,
- hand-foot syndrome,
- neuropathy,
- conjunctivitis (higher doses require use of steroid eye drops)
- IT administration can cause nausea, vomiting, fever and headache
Gemcitabine
- Gemzar
- Infusion rate affects efficacy and toxicity
SE:
- Myelosuppression,
- flu-like symptoms,
- hepatotoxicity,
- pulmonary toxicity
Stages of lung cancer
- Stage 1
- Stage 2
- Stage 3
- Stage 4
Stage 1: Tumor < 3 cm. There’s no metastasis.
Stage 2: Tumor < 6 cm. 1 metastasis has occurred
Stage 3: Tumor > 6 cm. Metastasis in lymph nodes.
Stage 4: The tumor passed to other organs.
Most common cancer in the US:
skin cancer
The three types of skin cancer are:
- basal cell (survivable)
- squamous cell (survivable)
- melanoma (rare but severe)
ABCDE - WARNING SIGNS OF MELANOMA SKIN CANCER
- ASYMMETRY: One half of the mole does not match the other.
- BORDER: Edges are irregular, notched.
- COLOR: Color is not the same all over.
- DIAMETER: Larger than 6 mm, or the size of the tip of a pencil eraser.
- EVOLVING: Mole is changing in size, color, shape or sx (itching, bleeding, tenderness)
After skin cancer, … is the most common cancer diagnosed in the United States.
breast cancer
Males have higher risk of breast cancer when they have a condition that increases … production, including … syndrome
estrogen
Klinefelter syndrome
