Fiser ABSITE Ch. 11 Oncology Flashcards
Most common CA in women
breast CA
Most common cause of CA related death in women
lung CA
Most common CA in men
Lung CA
Most common cause for CA related death in men
lung CA
Used to identify metastases, detects fluorodeoxyglucose molecules
PET scan
___ need MHC complex to attack tumor, while ___ cells can independently attack tumor cells
T cells, Natural killer cells
What is the tumor marker for colon CA and what is the half-life?
CEA, 18 days
What is the tumor marker for liver CA and what is the half life?
AFP, 5 days
What is the tumor marker for pancreatic CA?
CA 19-9
What is the tumor marker for ovarian CA?
CA 125
What is the tumor marker for testicular CA, choriocarcinoma?
Beta HCG
What is the tumor marker for prostate CA and what is the half-life?
PSA (thought to be the tumor marker with the highest sensitivity), 18 days
What is the tumor marker for small cell lung CA and neuroblastoma?
NSE (neuron specific enolase)
Time between exposure and formation of clinically detectable tumor
Latency period
What two cancers are associated with the Epstein-Barr virus?
Burkitt’s Lymphoma and nasopharyngeal CA
What infectious agent is associated with gastric CA?
Helicobacter pylori
What infectious agent is associated with hepatocellular carcinoma?
Hep B and C
What infectious agent is associated with Kaposi’s sarcoma and primary effusion lymphoma?
HHV-8
What infectious agent is associated with splenic lymphoma?
Hep C
What infectious agent is associated with adult T-cell leukemia/lymphoma
Human T-cell leukemia virus-1
What is the most vulerable stage of the cell cycle for XRT?
M phase
How is most damage done to DNA with XRT?
formation of oxygen radicals
In XRT, higher-energy radiation has a ___ effect (maximal ionizing potential not reached until deeper structures)
skin-preserving
Fractionate doses in XRT allow for:
___ of normal cells
___ of tumor
___ of tumor cells in cell cycle
repair
reoxygenation
redistribution
Name 2 very radiosensitive tumors
seminomas, lymphomas
Name 2 very radioresistant tumors
epithelial, sarcomas
Why are large tumors less responsive to XRT?
lack of oxygen in tumor
Lymphocytes as well as what 3 organs have increased sensitivity to XRT?
kidneys, liver, lungs
What is the difference in cell killing ability in cell cycle-specific agents (5FU, MTX) and cell cycle-nonspecific agents?
cell cycle-specific agents exhibit plateau in cell-killing ability while cell cycle-nonspecific agents have a linear response to cell killing
What chemotherapy agent decreases short-term (5 year) of breast CA but carries a 1% risk of blood clots and a 0.1% endometrial CA.
Tamoxifen (blocks estrogen receptor)
What chemotherapy agent promotes microtubule formation and stabilization that cannot be broken down; cells are ruptured
Taxol (Paclitaxel)
What 2 chemotherapy agents can cause pulmonary fibrosis?
Bleomycin and busulfan
Name 3 side effects of cisplatin (platinum alkylating agent).
nephrotoxic, neurotoxic, ototoxic
Name the primary side effect of carboplatin (platinum alkylating agent).
myelo suppression (carBoplatin = bone)
Primary side effect of Vincristine (microtubule inhibitor).
peripheral neuropathy
Primary side effect of Vinblastine (microtubule inhibitor).
myelo suppresion (vinBlastine = bone)
What is the active metabolite of cyclophosphamide?
acrolein
Name 3 side effects of cyclophosphamide?
gonadal dysfunction, SIADH, hemorrhagic cystitis
What drug can help with hemorrhagic cystitis associated with cyclophosphamide?
Mesna
What is the antihelminthic drug thought to stimulate the immune system against CA?
Levamisole
What is the MOA of methotrexate
inhibits dihydrofolate reductase which inhibits purine and DNA synthesis
What are two side effects of methotrexate?
renal toxicity, radiation recall (inflammatory reaction after radiation therapy, usually a rash with blistering)
What can be used to reverse the effects of methotrexate
Leucovorin rescue (folinic acid)
What is the mechanism of action of 5-Fluorouracil?
inhibits thymidylate synthesis, which inhibits purine and DNA synthesis,
What drug increases the effectiveness of 5FU
leucovorin
What is the mechanism of doxorubicin and what is it toxic to?
DNA intercalator, O2 radical formation;
heart toxicity secondary to O2 radicals at > 500 mg/m2
Etoposide inhibits ___
topoismerase (which normally unwinds DNA)
What can be used for neutrophil recover after chemo?
granulocyte colony-stimulating factor (GCSF)
What are the side effects of GCSF?
Sweet’s syndrome (acute febrile neutropenic dermatitis)
What are two indications for resection of normal thyroid to prevent CA
RET proto-oncogene or MENIN gene with family history of MEN or thyroid CA
Li-Fraumeni syndrome defect is in __ gene; pts get childhood sarcomas, breast CA, brain tumors, leukemia, adrenal CA
p53
What is the proto-oncogene associated with medullary CA of the thyroid?
Ret
What function is the APC gene involved with?
cell adhesion and cytoskeleton function
What 3 cancers is coal tar associated with?
larynx, skin, bronchial
What cancer is Beta-naphthylamine assoiciated with?
urinary tract CA
What cancer is benzen associated with?
leukemia
What cancer is asbestos associated with?
mesothelioma
What 4 cancers are associated with a suspicious supraclavicular node?
neck, breast, lung, stomach (Virchow’s), pancreas
What 3 cancers are associated with a suspicious axillary node?
lymphoma (#1), breast, melanoma
What cancer is associated with a suspicious periumbilical node?
pancreas (Sister Mary Joseph’s node)
What 2 cancers are associated with ovarian metastases?
stomach (Krukenberg tumor), colon
What 2 cancers are associated with bone metastases?
breast (#1), prostate
What 2 cancers are associated with skin metastases?
breast melanoma
What is the number one cancer associated with small bowel metastases?
melanoma
“Name the type of therapy:
sole treatment; often used for advanced disease or when no other treatment exists”
Induction
“Name the type of therapy:
chemotherapy given 1st, followed by another (secondary) therapy”
Primary (neoadjuvant)
“Name the type of therapy:
combined with another modality; given after other therapy is used”
Adjuvant
“Name the type of therapy:
for tumors that fail to respond to initial chemotherapy”
Salvage
Does colon CA go to bone?
not usually
Colon metastasis to the liver, if successfully resected what is the 5 year survival rate?
25%
What are the 2 most successfully cure metastases with surgery?
colon CA to liver, sarcoma to the lung
but survival still low overall for these
Name the main tumor for which surgical debulking improves chemotherapy (not seen in other tumors)
Ovarian CA
Name the 2 solid tumors curable with chemotherapy only
Hodgkin’s disease, non-Hodgkin’s lymphoma
What are most lymphomas?
B cell
Name 2 HIV-related malignancies
Kaposi’s sarcoma, NHL
Tumor suppressor gene: Chrom 13, cell cycle
Rb
Tumor suppressor gene: Chrom 17, cell cycle
p53
Tumor suppressor gene: Chrom 5
APC
Tumor suppressor gene: Chrom 18, cell adhesion
DCC
Tumor suppressor gene: Apoptosis
bcl and p53
Tumor suppressor gene: Breast CA
BRCA
Proto-oncogene: G-protein defect
ras
Proto-oncogene: Tyrosine kinase defect
src
Proto-oncogene: PDGF receptor defect
sis
Proto-oncogene: EGF receptor defect
erb B
Proto-oncogene: Transcription factors
myc