Chemotherapy Flashcards
What is cancer mainly caused by
- acquired mutations caused by chemical, viruses, radiation
- inherited mutations
what do oncogenes lead to
- uncontrolled cell proliferation
- dedifferentiation
What do loss of suppressor genes lead to
- decrease in apoptosis
- alterations in telomerase
what malignancies can our immune system contain
T cells can help contain early malignancies and prevent from them developing into clinical cancers
how do you stage cancer
TNM
T
- tumour - so is in in situ, local tumour mass or has it locally infiltrated and is advanced
N
- lymphatic spread
M
- metastasis (systemic spread)
What is the role of chemotherpay in cancer treatment
- Metastatic cancer
- adjuvant chemotherapy
- neo-adjuvant chemotherapy
- hematological malignancies
what is the role of chemotherapy in metastatic cancer
Palliative or Curative Chemotherapy
What is the role of chemotherapy in adjuvant therapy
to eradicate or control micro-metastasis
What is the role of cancer in neo-adjuvant chemotherapy
- makes the tumour smaller in order to make surgery or radiotherapy possible
- alleviate surgical damage
- eradicate micrometasis
What is the role of chemotherapy is haematological malignancies
chemotherapy Primary Treatment as they are very chemotherapy sensitive
What are the two places that chemotherapy acts
- phase of the cell cycle
- cellular level
what are the two cell cycle types of chemotherapy agents
- cell cycle phase - specific
- cell cycle phase non specific
Why is chemotherapy given every 3 weeks
- most chemotherapy treatment damages the bone marrow and causes the blood concentration to drop
- by 3 weeks this will be normal again and the bone marrow has recovered
- if you are using a smaller dose of chemotherapy that is less toxic to the bone marrow it can be given weekly
describe specific cell cycle phase chemotherapy drug characteristics
- agents with major activity in a particular phase of cell cycle
- schedule dependent
- Kills actively dividing cells
describe nonspecific cell cycle phase chemotherapy drug characteristics
- agents with significant activity in multiple phases
- dose dependent
- kills resting cells and dividing cells
give example of cell cycle non specific chemotherapy drugs
Cisplatin Cyclophosphamide Chlorambucil Actinomycin-D L-Asparaginase
give examples of cell cycle specific chemotherpay drugs for the
- G1
- S
- G2
- M phase
G1 – vinblastine
S – Methotrexate, 6-Mercaptopurine, 5-Fluorouracil
G2 – Bleomycin, Etoposide, Topotecan, Daunorubicin
M- Vincristine, Vinblastine, Paclitaxel, Docetaxel
Name the sites of action of cytotoxic agents
Antimetabolites - acts on DNA synthesis
Alkylating agents act on DNA
Intercalating agents act on DNA transcription and DNA duplication
Spindle poisons - act on mitossi
Name examples of directly acting cytotoxic drugs
Alkylating agents
Antimetabolites
Natural products - Antibiotics - Vinca Alkaloids - Taxanes - Enzymes - Biological response modifiers Miscellaneous; cisplatin, carboplatin
Name the indirectly acting by altering the hormonal mileau drugs
Corticosteroids Oestrogens 5 alpha reductase inhibitors GnRH agonists Progestins
name some alkylating agetnts
Nitrogen mustands - Meclorethamine, melphalan, chlorambucil, cyclophosphamide, ifosfamide Ethyleneimine - Thiotepa Alkyl Sulfonate - Busulfan Nitrosureas - Carmustine - Iomustine - Streptozocin Triazine - Decarbazine - Temozolamide
name some anti metabolites
Folate antagonists - Methotrexate Purine antagonists - 6 mercaptopurine - 6 thioguanine - Azathioprine Pyrimidine antagonists - 5 Fluorouracil - Cytarabine - Gemcitabine
name some antibiotic drugs
Actinomycin D Doxorubicin Daunorubicin Bleomycin Mitomycin C
name vinca alkaloids
Vincristine
Vinblastine
Vinorelbine
name some taxanes
Paclitaxel
Docetaxel
name some enzymes
L-Asparginase
name some Epipodophyllotoxins
Etoposide
Tenoposide
name some Camptothecin analogs
Topotecan
Irinotecan
naem soem biological response modifiers
Interferons
Interleukins
name soem corticosteroids
Prednisolone
name some oestrogens
Ethinyl Oestradiol
name some SERM
Tamooxifene
Toremifene
name some aromatase inhibitors
Letrozole
Anastrazole
Exemestane
Name some anti-androgens
Flutamide
Bicalutamide
Name som 5 alpha reductase inhibitors
Finasteride
Dutasteride
Name some GnRH analogs
Naferelin
Goserelin
Leuoprolide
what are estrogens used to treat
Gynacological cancers and breast cancers
What are anti androgens used to treat
prostate cancer
what drugs are classed as miscellaneous agents
- cisplatin
- carboplatin
- hydroxurea
- procarbazine
- mitotane
- imatinib
what are the aims of combining chemotherapy
- increased effiancy of the drug against the cancer
-
Name the chemo resistance cancer
Non-Small Cell Lung Cancer
G.I. Cancers
Pancreatic Cancer
Melanoma
what are the ways in which chemotherapy can take
Oral
Subcutaneous & intra-muscular
Topical
Intra-arterial
Intra-cavity
- Intra-vesical
- Intra-peritoneal
- Intra-pleural
Intrathecal
Intravenous
How long is chemotherapy given for
6 months duration , 3-4 weekly cycles
What are the side effects of chemotherapy
Tiredness
Nausea
Vomiting
Hair loss
Risk of infection requiring hospitalisation
Infertility
Long term 2ary malignancies
Hazard to staff
cardiotoxicity
What is the role of the MDT
MDTs need to bring together staff with the necessary knowledge, skills and experience
to ensure high quality diagnosis, treatment and care
