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SBL Final > Clinical Strategies for Cancer Treatment and Prevention (Part 1 of 2) > Flashcards

Clinical Strategies for Cancer Treatment and Prevention (Part 1 of 2) Flashcards

1
Q

What are 5 examples of local cancer treatments?

A

surgery, radiation, ablation, cryosurgery, and radiofrequency

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2
Q

What are 4 examples of systemic cancer treatments?

A

chemotherapy- cytotoxic, hormone, or biologic

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3
Q

what are three things to ask prior to pursuing local therapy?

A

can you remove all of the cancer? are there limited options for systemic therapy? If cure cannot be achieved, could treatment palliate?

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4
Q

what are three examples of commonly treated cancers with local therapy?

A

sarcomas, non-melanoma skin cancer, and in situ carcinomas

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5
Q

what are three different approaches to local therapy?

A

local only, adjuvant, and neoadjuvant

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6
Q

what is adjuvant therapy?

A

you have your surgery to provide cytoreduction and then after surgery you add chemotherapy or radiation therapy to fully eliminate those tumor cells

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7
Q

what is neoadjuvant therapy?

A

surgery is not as effective upfront; cytoreduction is initially provided via chemotherapy and radiation and then surgical removal; and then after surgery you add more adjuvant therapy with chemo and/or radiation therapy

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8
Q

what is neoadjuvant therapy usually applied to?

A

a very large mass- most commonly seen in lung cancer patients

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9
Q

what is the sequential cancer treatment?

A

neoadjuvant therapy–> primary therapy–> adjuvant therapy

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10
Q

what is the purpose of neoadjuvant therapy?

A

reduce the primary tumor size; eliminate cancer cells that spread to other locations

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11
Q

what is the purpose of primary therapy?

A

eliminate the tumor

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12
Q

what is the purpose of adjuvant therapy?

A

eliminate the remaining cancer cells

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13
Q

what are the treatment options for neoadjuvant therapy?

A

chemotherapy, hormone therapy, targeted therapy, radiation therapy

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14
Q

what are the treatment options for primary therapy?

A

surgery, radiation therapy

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15
Q

what are the treatment options for adjuvant therapy?

A

chemotherapy, hormone therapy, targeted therapy, radiation therapy

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16
Q

when is surgery not indicated in local therapy?

A

metastatic disease removes the advantage of surgery; leukemia/lymphoma; systemic therapy is so effective that surgery is unnecessary

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17
Q

what are the three different types of radiation therapy?

A

external beam radiation, brachytherapy, systemic radionucleotides

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18
Q

what is the most common form of radiation therapy?

A

external beam radiation

19
Q

how does external beam radiation work?

A

there is a linear accelerator delivering direct radiation beams to affected sites

20
Q

what are two forms of external beam radiation?

A

intensity modulated radiotherapy (IMRT) and cyberknife

21
Q

what is brachytherapy?

A

a very localized high-dose therapy delivered continuously for a prolonged time through implanted devices

22
Q

when is brachytherapy most commonly used?

A

prostate cancer; putting radioactive seeds into the prostate through a needle- over time that radiation will kill off the malignant cells

23
Q

what is systemic radionucleotides?

A

a patient ingests a radioactive iodine and the thyroid takes it up and it will destroy cancerous and normal thyroid cells

24
Q

when is systemic radionucleotides commonly used?

A

most common in people with a hot thyroid nodule/ thyroid cancer

25
Q

when might you use radiation therapy? (4)

A

adjuvant therapy, neoadjuvant therapy, when surgery is contraindicated (e.g. patient of advanced age with prostate cancer), or palliative care

26
Q

how can radiation therapy be used for palliative care?

A

in cases of spinal metastasis to prevent cord compression, in cases of ENT carcinoma to prevent suffocation, and in cases of pelvic sidewall to prevent pain

27
Q

what is the conventional form of systemic therapy for cancer?

A

cytotoxic chemotherapy

28
Q

what is the therapeutic index like of cytotoxic chemotherapy?

A

it is very low–> your patients WILL have adverse side effects–> therefore it is important to cycle the medications and drugs

29
Q

a good drug has what kind of TI?

A

a high TI

30
Q

all members of the treatment team for a patient with cancer need to understand/ know what things about a patient?

A

the cancer the patient has, the treatment regiment and its side effects, and the cycle (including what cycle and day the patient is currently on)

31
Q

what could a common adverse side effect of hydroxydaunorubicin (doxorubicin) be?

A

cardiotoxicity

32
Q

what do you need to order before a patient is started on hydroxydaunorubicin (doxorubicin)?

A

an echocardiogram

33
Q

how would you treat a tumor dependent on hormone stimulation?

A

hormone therapy (look at the receptor status and inhibit (antagonize))

34
Q

what cancers are associated with hormone therapy?

A

breast and prostate

35
Q

how would you treat a tumor dependent on other growth factors?

A

look at the receptor status and inhibit (antagonize)

36
Q

what are two common growth factors that some tumors are dependent on?

A

epidermal growth factor and VEGF

37
Q

how would you treat a cancer with CD20 antigens on its surface? and what cancer has CD20 on its surface?

A

B Cell lymphomas; use recombinant antibodies (like rituximab)

38
Q

how would you treat a tumor that has PD-1 or CTLA on its surface that is diminishing our tumor immunity?

A

use immune checkpoint inhibitors

39
Q

what is another immune approach to treating tumors?

A

CAR-T therapy (chimeric antigen receptor therapy)

40
Q

how does CAR-T therapy work?

A

you take T cells out of a patient and expose them to a retrovirus, which is a vector that inserts itself into the T cells, the T cells then make these chimeric receptors; these chimeric antigen receptors will be the driven force to killing the tumor cells once they have multiplied and have been reinserted into the patient

41
Q

what is the current problem with CAR-T therapy?

A

cytokine release syndrome; however, it has been approved for ALL

42
Q

when is stem cell transplantation indicated?

A

when therapy involves ablation of the bone marrow (as seen in hematopoietic neoplasms and in advanced solid tumors needing high dose cytotoxic chemotherapy)

43
Q

What are the three types of stem cell transplantation?

A

allogenic (someone else), syngeneic (identical twin) and autologous (from oneself)

SBL Final (21 decks)

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