Clinical Aspects of Cancer Treatment

Question 1

What are the different type of chemotherapy treatment settings?

Answer 1

Adjuvant – following surgery, no way of assessing response.
Metastatic – palliative, control spread of disease. Measure the size of change of metastatic lesions.
Neoadjuvant – shrink tumour before surgery or radiotherapy, improving chance of cure. Allows clinical, radiological and pathological response assessments and change to alternative therapy in non responders.

Question 2

How can breast lumps be assessed?

Answer 2

History and examination
Mammography
Ultrasounds
MRI

Question 3

What is the role of cell surface receptors in cancer?

Answer 3

Cellular receptors are responsible for translating signals from outside the cell into signals within the cells. These signals have numerous effects such as growth and proliferation and cell survival. Receptor activation and cellular signalling are tightly regulated in normal cells.
When signalling pathways are inappropriately activated, growth and spread of cancer cells may result.

Question 4

What is endocrine therapy?

Answer 4

ER positive tumours are susceptible to endocrine therapy.
Tamoxifen, aromatase inhibitors.
There are less side effects and a similar response rate to single agent chemotherapy. Lack of cross resistance so some merit in changing hormone therapy on progression.

Question 5

What are examples of anti HER2 directed therapy?

Answer 5

Trastuzumab, Pertuzumab, Kadcyla

Question 6

How is prostate cancer usually diagnosed?

Answer 6

Through raised PSA blood test.
MRI scan
Transrectal biopsy

Question 7

What is metastatic prostate cancer?

Answer 7

Prostate cancer which has spread from the prostate. Usually to the bones. Backbone of treatment is suppression and blockade.
Chemotherapy – docetaxel, cabazitaxel.