Chemotherapy

Question 1

What is meant by neoadjuvant?

Answer 1

Chemotherapy given to shrink tumors prior to definitive treatment (in order to optimise the definitie treatment)

Question 2

What is meant by adjuvant?

Answer 2

Treatment given after definitive treatment to reduce risk of reoccurence

Question 3

What’s the purpose of palliative chemotherapy?

Answer 3

Reduce the burden of disease and symptom control

Question 4

How can cancer cells be resistant to chemotherapy?

Answer 4

Decrease uptake of drug into cell
Efflux pumps
Increase drug metabolism
Alter drug targets
Alter cell cycle checkpoint so cells are unable to identify a problem with replication
Impair apoptotic pathway - so cancer cells do not die regardless of what the drug has done

Question 5

What factors inform the dose a patient receives? Why is this important?

Answer 5

BMI/Surface area
Liver and renal function
Performance status

Question 6

Outline the scoring for performance status

Answer 6

0 - normal energy levels
1 - can do normal activities but get tired more easily
2 - can do ADLs, spend <50% of day resting
3 - spend >50% of day resting
4 - bed bound
5 - dead

Question 7

What are the side effects of chemotherapy?

Answer 7

Vomiting (Inc anticipatory)
Alopecia
Neutropenia
Mucositis 
Peripheral neuropathy 
Skin rashes
Diarrhoea or constipation 
Imapired fertility
Haemorrhagic cystitis 
Pneumonitis 
Nail riding 
Arrhythmia 
Cardiomyopathy

Question 8

Define and give examples of late effects of chemotherapy

Answer 8

Side effects patient still has 6 months after chemotherapy or that begin years later:
Secondary cancer
Pneumonitis
Cardiomyopathy
Infertility
Peripheral neuropathy
Osteoporosis