intro to oncology/pharmacology Flashcards
why are rates in cancer death decreasing
- prevention
- early detection
traits of cancer cells
- increased mutation rate
- replicate in absence of growth signal
- resist apoptosis
- contact independence
- epidermal mesenchymal transformation
- vascularize
- telomere extension
4 steps of carcinogenesis
- initiation
- promotion
- conversion/transformation
- progression
oncogene
mutated gene that leads to abnormal protein which drives malignant growth
“gain of function”
tumor suppressor gene
regulate and inhibit inappropriate cellular growth and proliferation
“loss of function”
in myelogenous leukemia bcr-abl does what
tells cell to grow independently of signaling
where does bcr-abl come from
piece of chromosome 9 gets put on chromosome 22
main tumor suppressor gene
p53
p53 action
- enforces negative regulation
- allows cell to halt growth to repair and make corrections
- inactivation allows for mutation
tests for breast screening
- self exam
- mammography
tests for colon/rectal screening
- FOBT/FIT
- flex sigmoidoscopy
- colonoscopy
tests for prostate screening
digital rectal exam/PSA
tests for cervical screening
pap smear
tests for endometrial screening
risk/symptoms only
7 warning signs of cancer
- Change in bowel or bladder habits
- A sore that does not heal
- Unusual bleeding or discharge
- Thickening or lump
- Indigestion or difficulty swallowing
- Obvious change in wart or mole
- Nagging cough or hoarseness
what do we need in cancer diagnosis before starting treatment
biopsy
TNM classification
- Tumor size
- Nodal involvement
- Metastases
stage I
localized tumor
stage 2 and 3
local and regional extension
stage 4
distant metastases
treatment modalities (pillars of cancer care)
surgery radiation chemotherapy biological/targeted immunotherapy
treatments for local control
surgery
radiation
complete response
disappearance of all cancer w/o evidence of new disease for at least 1 month after
partial response
50% or greater decrease in tumor size or objective tumor markers and no evidence of new disease within 1 month
stable disease
neither grows or shrinks by 25%
progression of cancer
25% increase in tumor size or development of new lesions
two types of toxicities
- dose related toxicity
- cumulative toxicity (each dose increases odds)
absolute neutrophil count equations
- WBC x PMNs+bands
- WBC x neutrophils
- WBC x granulocyte
BSA equation
= sqrt((ht x wt)/3600)
ClCr equation
((140-age) x weight) / SCr x 72
*0.85 for female
IBW equation for male
50 + 2.3(inches >5 feet)
IBW equation for females
45.5 + 2.3(inches >5 feet)
salvage chemotherapy
chemo given after relapse has occurred
doubling time
time to double cell population
growth fraction
fraction of cells in cell cycle
surgery is needed for what type of doubling time cancers
long doubling time
cancers with short doubling time
- burkitt’s lymphoma
- choriocarcioma
- ALL
- hodgkin’s disease
cancers that can be treated with a single drug
burkitt’s lymphoma
choriocarcioma
how tumor location in relation to vessels affects drug efficacy
cancer further away form blood supply makes it more difficult to get drugs to treat it
mechanisms of resistance to chemotherapy
- decrease in cellular uptake or increased efflux of drugs
- increased proficiency of repair of DNA
- increase in levels of target enzyme
- alterations in target enzyme
- decrease in drug activation
drug therapy outcomes are limited by
- metabolic capacity of liver and kidney
- ability to produce blood cells
- ability of GI tract to recover
hematologic toxicities of cancer drugs
anemia
thrombocytopenia
neutropenia
length of time to recover for rapid recovery drugs
17-21 days after therapy
length of time to recover for delayed recovery drugs
42-50 days after therapy
two broad categories of toxicity that cancer drugs show
dose related
cumulative
