Issues in Oncology Flashcards
How are immune checkpoint inhibitors useful in destroying cancer?
Immune checkpoint inhibitors are useful in destroying cancer because they deactivate checkpoints that would otherwise suppress the immune system, and so facilitate the patient’s own immune surveillance efforts to destroy the cancer.
Solid tumors are staged using what system of staging?
The T, M, N system of staging.
What do the letters in the staging system for solid tumors stand for?
T: (T1-T4) refers to the size or extent of local invasion of the primary tumor
N: (N0-N3) indicates loco-regional lymph node involvement
M: M indicates the absence (M0) or presence (M1) of distant metastases.
What are the two most commonly used scales for performance status?
Karnofsky Score
Eastern Cooperative Oncology Group (aka the Zubrod Scale)
What do studies suggest about initiating supportive care in addition to concurrent anti-cancer treatment?
Studies suggest that such supportive care, when instituted early in conjunction with anticancer therapy, helps patients better tolerate their cancer care and should not be delayed to the point at which no more active cancer therapy is considered.
Overall survival is defined as:
Overall survival is defined as the amount of time from the start of treatment until death.
Cure of cancer is defined as:
Cure means that the cancer is gone, no further treatment is required, and the patient can be expected to live out his or her life without seeing that cancer again.
Median survival from cancer studies is defined as:
Median survival values from cancer identify the center of an often-broad, bell-shaped curve, and may be meaningful for populations, but cannot predict an outcome for any one individual patient.
significant improvement in survival refers to what exactly?
significant refers to the statistical certainty of the finding but is often misinterpreted as a substantial improvement in survival.
Response rate is defined as:
Response rate is the percentage of patients in a clinical trial whose tumors shrink to a prespecified degree (as indicated on imaging studies such as CT or MRI) with treatment.
What is also important about response rate regarding overall survival and how it affects the patient emotionally and clinically?
Response rate may not correlate with overall survival, but there is a strong emotional benefit to patients when the tumor is regressing, and in symptomatic patients, such shrinkage is likely to alleviate or delay symptoms.
What are the classic cancer treatment modalities?
The classic cancer treatment modalities are surgery, irradiation, and chemotherapy.
With the advancement of cancer chemotherapies what are better nomenclature for the modalities of treatment besides surgery, chemotherapy and radiation?
As current technology has advanced, chemotherapy is best subdivided into:
- classical cytotoxic chemotherapies
- targeted or precision therapies
- Immunotherapies.
What do the terms neoadjuvant and adjuvant chemotherapy mean regarding its timing in the treatment of localized tumors?
Neoadjuvant (preoperative) or adjuvant (postoperative) treatment with irradiation, chemotherapy, or both may be used to eradicate residual microscopic disease and increase the chance for cure.
What is conversion therapy?
Conversion therapy seeks to convert an unresectable tumor to one that is resectable by shrinking it away from critical structures and creating a plane for resection that was previously lacking.
