Chemotherapy Flashcards
Chemo definitions:
Radical = curative intent Primary: alone for cure Neo-adjuvant: before an operation Adjuvant: after an operation Chemoradiation: with radiotherapy Palliative: incurable advanced disease High-dose: with bone marrow transplant or stem cell support.
Which type of cancer has shown an increase in incidence but a decrease in mortality?
Testicular cancer
What is the difference between primary chemotherapy and neoadjuvant chemotherapy?
In primary chemo, the tumour is INOPERABLE, where a reduction in the tumour bulk in a pre-defined manner may make surgery with curative intent feasible. In neoadjuvant, the tumour is OPERABLE so the aims are to make the tumour smaller to allow less radical surgery, while at the same time treating the occult mets.
Which cancers can cause hypercalcaemia?
Non-small cell lung cancer (squamos), breast ca, renal ca, multiple myeloma and lymphoma, head & neck cancer..
Which cancers cause bone mets commonly?
Myeloma, lymphoma, breast ca, lung ca, prostate ca
What is the aim of adjuvant chemotherapy?
This is chemo following a complete macroscopic clearance in surgery, chemo in this setting treats the occult microscopic mets which we know tend to relapse after surgery for lymph-node positive disease (e.g. breast and colorectal).
Which types of cells are usually affected by chemotherapy at standard doses?
Haemotopoietic stem cells and the lining of the GI tract, producing low blood counts (myelosuppression) and mucositis.
How long in between cycles allows the haematopoeitic cells to recover?
3-4 weeks
What type of agent is cyclophosphamide?
This is an alkylating agent
How does cyclophosphamide work?
It causes cross-linking in DNA
What are the side effects associated with cyclophosphamide?
Haemorrhagic cystitis, myelosuppression, transitional cell carcinoma
Name the two cytotoxic antibiotics?
Bleomycin & Doxorubicin
How does bleomycin work?
It degrades performed DNA
What are the side effects associated with bleomycin?
Lung fibrosis
How does doxorubicin work?
Stabilizes DNA-topoisomerase II complex inhibits DNA & RNA synthesis
What is the side effect associated with doxorubicin?
Cardiomyopathy
How does methotrexate work?
Inhibits dihydrofolate reductase and thymidylate synthesis
What are the side effects of methotrexate?
Myelosuppression, mucositis, liver fibrosis, lung fibrosis
Name the antimetabolite chemo drugs?
Methotrexate, Fluorouracil (5-FU), 6-mercaptopurine, Cytarabine
How does 5-FU work?
Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (works during S phase)
What are the side effects of 5-FU?
Myelosuppression, mucositis, dermatitis
How does 6-mercaptopurine work?
Purine analogue that is activated by HGPRTase, decreasing purine synthesis
What are the side effects associated with 6-mercaptopurine?
Myelosuppression
How does cytarabine work?
Pyrimidine antagonist. Interferes with DNA synthesis specifically at the S-phase of the cell cycle and inhibits DNA polymerase
