Medical Oncology

Question 1

Fine Needle aspiration for diagnosis of what cancers?

Answer 1

carcinomas specifically squamous cells…

bad for seeing tissue architecture

Question 2

core biopsy

Answer 2

adequate for almost all cancers..but takes the longest

Question 3

excisional biopsy for diagnosis of what cancers and how we do it?

Answer 3

take out the whole suspected area

good for melanomas and lymphoma diagnosis

Question 4

liquid biopsy mechanism and why its used?

Answer 4

tumor cell DNA products in the blood stream so get those

allows for longitudinal monitoring of the cancer

Question 5

will a late stage tumor have a high or low growth fraction?

Answer 5

will actually have a low growth fraction because its slowing down and becoming hypoxic

Question 6

how do administer non stage specific drugs?

Answer 6

can give in one big bolus dose

Question 7

How do we administer cell cycle specific drugs?

Answer 7

give as continuous infusion or multiple divided doses

Question 8

salvage, palliative and definitive treatment of cancer

Answer 8

salvage- cancer not responding to anything else
palliative- relieve symptoms
definitive- cure

Question 9

how do we give ourselves ability to give high toxicity treatment?

Answer 9

by being able to give autologous stem cell transplant to make the cells back

Question 10

neoadjuvant treatment

Answer 10

given before main treatment

Question 11

adjuvant treatment

Answer 11

in addition to primary treatment

Question 12

induction treatment

Answer 12

intense initial treatment to get handle on cancer

Question 13

consolidation treatment

Answer 13

used to solidify remission

Question 14

maintenance treatment

Answer 14

used to catch slow growing cells and increase disease free state

Question 15

5 targets of drugs for cancer

Answer 15

angiogenesis
surface antigens
signaling pathways
DNA rep and repair
specific oncogenes

Question 16

what cancer has a lot of angiogenesis?

Answer 16

kidney cancer

Question 17

VHL tumor suppressor pathway in kidney cancer

Answer 17

VHL usually helps ubiquinate the HIF and lead to its degradation but in kidney cancer the cells become hypoxic and the VHL does not break down the HIF which means it can lead to targeting factors that increase angiogenesis…this pathway is a great target for kidney cancer drugs

Question 18

what is characteristic of lymphomas that are a good drug target?

Answer 18

they have a lot of cell surface antigens and markers that are consistent between patients and the cancer cells..making them a nice target

Question 19

explain immune checkpoint inhibition treatment

Answer 19

T cells and cancer cells interact at checkpoints..often cancer cells are downregulating the T cells…well if you make an antibody against the molecules involved in this cancer and T cell checkpoint then the cancer cell cannot down regulate the T cells

Question 20

T cell cancer therapy

Answer 20

take T cells out, modify to target specific cancer cells and then reintroduce to patient

Question 21

treatment for a localized cancer

Answer 21

likely surgery and radiation

Question 22

oncologic emergencies (2)

Answer 22

spinal cord metastases and bowel perforation

Question 23

testicular cancer treatment effectiveness

Answer 23

super susceptible to treatment…great numbers

Question 24

why does slow growth make treatment of cancer difficult?

Answer 24

because a lot of treatment targets cell replication and if you are not growing you are not replicating so wont be as effective

Question 25

why do we treat past remission?

Answer 25

because probably still some slow growing cells lingering around that do not show up clinically

Question 26

ECOG performance scale and what it is used for

Answer 26

0-4 with 0 being low level of comorbidity and 4 being bed ridden

use this to determine what treatment and risk of toxicity we can take

Question 27

4 ways people die from cancer

Answer 27

local effects-organ failure, brain compression
infection
VTE
systemic effects- cachexia, anorexia