Lecture 43- Intro to clinical oncology Flashcards

1
Q

Define the Following:
Cancer
Carcinoma
Sarcoma

A

Cancer - Neoplasm (“new growth”)

Carcinoma - derived from epithelial tissues

Sarcoma – derived from mesenchymal tissues

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2
Q

What type of cancer has the highest mortality?

What type of cancer has the highest incidence (morbidity) men vs women?

A

Mortality: Lung cancer
Followed by prostate (men), breast (women), and colo-rectal (both)

Morbidity:
Men - prostate
Women- breast

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3
Q

Describe the Presentation of Solid Tumors?

A

Local – Interference with normal organ function (such as bowel obstruction) vs extension into adjacent structures (such as CP from a lung mass)

Metastatic Symptoms – bone pain, seizures, headache

Paraneoplastic Syndromes - eg cushing’s symptoms from an ACTH secreting tumor

Incidental or Screening – asymptomatic

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4
Q

Describe the presentation of Hematologic malignancies?

A

Bone Marrow Failure - anemia, thrombocytopenia, leucopenia

Bone Marrow Proliferation – thrombosis, luekocytosis, splenomgaly

LAD, Thrombosis – altered function of bone marrow derived cells

Constitutional Symptoms – fevers, night sweats, weight loss

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5
Q

What is performance status? how is it measured? why is it significant ?

A

Ability of the patient to do things

Scales: Karnofsky, Eastern Cooperaitve Oncology Group

0 - No limitations; 5 - dead

Poor perfomance status — indicator that patient will not respond as well to treatment

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6
Q

What directs the treatment of cancer?

A

TMN Stating + other factors (patient performance status and patient preferences)

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7
Q

What are the classifications of disease that direct treatment?

how are they treated?

A
  • Localized Disease – Confined to tissue or origin, no invasion of adjacent structures; —- Surgical, Radiation
    • Locally Advanced – regional LN involvement, large tumors — Use of systemic therapy in combo with local therapies to improve outcomes from localized treatment
    • Systemic Therapy for Advanced Disease – Chemotherapy, hormonal, immunotherapy, rad/surg to symptomatic relief
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8
Q

What is the aim of radiation therapy?

A

○ AIM OF THERAPY: deliver as uniform a dose as possible to an accurately localized target; killing tumor cells with minimizing physical, physiological and psychological consequences to the patient

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9
Q

what is the unit to quantify radiation ?

what type of radiation must be used to to induce DNA damage?

what type of DNA damage is lethal?

A

Gray – (J/Kg)
1 gray = 100 cGy
1cGy = 100 Ergs/gram = 1 Rad

Ionizing radiation

DNA Double stranded breaks

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10
Q

Why are tumor cells more susceptible to ionizing radiation?

A

rapid proliferative tumors are more susceptible because of mitotic phases

Tumors are more susceptible bc of defects in DNA repair

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11
Q

What normal tissues are most sensitive to toxic effects of radiation therapy? which are not as sensitive?

A

High Sensitive – thyroid, lung, bone marrow, lining of colon

Low - bone, skin, gall bladder, kidneys

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12
Q

What are some acute and late side effects of radiation therapy?

A

Side Effects
Acute – Erythema, Epilation, desquamation, Re-epitheliazation

Late effects — atrophy, fibrosis, Necrosis, telangiectasia
Local Dysfunction: Stenosis, necrosis, fibrosis
Potential occurrence of Second Tumors

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13
Q

What factors determine the probability of long term toxicity?

A

○ Chances of Long term Toxicity
○ Dose
○ Fraction size – larger individual doses
○ Volume Treated
○ Nature of the cell Treated
○ Organization of the Tissue
□ Oxygen Content – -O2 interacts with the radiation and can form free radicals

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14
Q

Describe the dose profiles between Wave form radiation and particle radiation?
what is the significance ?

A

X rays – wide

Particle: Protons and carbon ions – narrow deposition range. Only at specific doses do they have deeper penetration

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15
Q

what are the forms of radiation delivery?

A

External Beam Radiation — aka Teletherapy

Brachytherapy – radioactive source administerd close to the tumor

Systemic – administer isotopes to circulation
Such as Radioactive Iodine

Radio-immunotherapy – isotopes attached to antibody

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