Lecture 20 - Principles of Cancer Treatment Flashcards
Clinical presentations - primary tumour?
local effects - expansion, bleeding, bowel obstruction, hoarseness
Clinical presentations - Metastasis?
distant effects - lymph nodes, lungs, brain, liver, bone
Clinical presentations - paraneoplastic syndromes?
generalised effects due to hormones, autoimmune or undefined mechanisms
Principles of cancer diagnosis?
tumour biopsy and histopathology to exclude benign pathology; identify originating tissue, tumour grade, prognostic markers
Principles of cancer staging?
TNM system
Principle of functional assessment?
assessment into how the patient is likely to cope with disease and treatment
Key questions of cancer treatment?
is it surgically removable or curable, what treatment’s required for best outcome, different options
Uses of surgery?
most successful cure, diagnosis, staging, local control, palliation
Radiation therapy biochem?
damages DNA and generates free radicals from water damaging membranes, proteins and organelles`
Properties of selective toxicity?
unique target in pathogen, target structurally different in pathogen, target functionally different in host
Therapeutic index calculation?
EC50 killing normal cells/EC50 killing tumour cells
Tumour growth?
single malignant cell doubling over time, evident at 10^8, fatal at 10^12
Chemotherapy killing?
dose kills contant number of cells, repeated doses required, dosing continue after clinical disappearance of disease
Criteria for combination therapy?
some activity as a single agent, differing mechanisms of action, different side-effect profiles
Indications for chemotherapy?
cure, with surgery, with radiation, palliation
