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Year 1- Respiratory > Non-Surgical Management of Cancer > Flashcards

Non-Surgical Management of Cancer Flashcards

1
Q

What are the two main subtypes for types of lung cancer?

A

Small cell lung cancer
Non-small cell lung cancer

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2
Q

Which type of lung cancer is more prevalent?

A

Non-small cell lung cancer

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3
Q

What are the main two types of non-small cell lung cancer?

A

Adenocarcinoma
Squamous

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4
Q

When discussing a new lung cancer diagnosis, what must be considered?

A

Staging
Tumour type
Patient history and wishes
Patient fitness (including ECOG performance status and pulmonary function tests)

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5
Q

What is the staging of lung cancer based on?

A

CT/PET

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6
Q

What is the tumour type confirmation based on?

A

Biopsy

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7
Q

List some of the therapeutic options for those with lung cancer?

A

Radiotherapy
Surgery
Chemotherapy
Immunotherapy
Targeted therapies

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8
Q

What are the two subdivisions when it comes to deciding which treatment is best for the patient?

A

Curative or palliative

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9
Q

What does a MDT meeting discuss?

A

Each new cancer diagnosis
Therapeutic options

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10
Q

What test is used to measure patient performance status?

A

ECOG

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11
Q

What does a 0 in the ECOG scale suggest?

A

Asymptomatic; well

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12
Q

What does a 1 in the ECOG scale suggest?

A

Symptomatic; able to do light work

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13
Q

What does a 2 in the ECOG scale suggest?

A

Has to rest but for <50% of the day

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14
Q

What does a 3 in the ECOG scale suggest?

A

Has to rest for >50% of the day

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15
Q

What does a 4 in the ECOG scale suggest?

A

Bedbound

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16
Q

What does a 5 in the ECOG scale suggest?

A

Dead

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17
Q

What is meant by doubling time?

A

The time taken for a cell to divide/double.

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18
Q

What is the doubling time for non-small cell lung cancers?

A

129 days

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19
Q

What is used to stage non-small cell lung cancer?

A

TNM

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20
Q

What can be used after surgery to reduce chances of reoccurence?

A

Chemotherapy

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21
Q

Is adjuvant therapy pre or post operation?

A

Post

22
Q

Is neoadjuvant therapy pre or post operation?

A

Pre

23
Q

How long does the planning process for radical radiotherapy take?

A

Around two weeks

24
Q

What are some of the acute side effects of radical radiotherapy?

A

Lethargy, oesophagitis, SOB due to pneumonitis

25
Q

What are some of the long term side effects of radical radiotherapy?

A

Pulmonary fibrosis, oesophageal stricture, cardiac problems

26
Q

What is the % of survival five years after radical radiotherapy?

A

Approx. 20%

27
Q

Discuss the benefits vs disadvantages of combining radiotherapy and chemotherapy.

A

Benefits- increased chances of survival

Disadvantages- addition of chemo means toxicity increases

28
Q

Name the therapy used for patients are that are not fit for surgery but still has similar outcomes to surgery.

A

SABR

29
Q

What are some of the options for palliative treatment?

A

Chemo
Immunotherapy
TKI
Palliative radiotherapy
Palliative immunotherapy

30
Q

What is PDL1?

A

Programmed death ligand

31
Q

What does PDL1 do?

A

Protein that prevents immune system attacking cells in the body

32
Q

When can palliative immunotherapy be used as a first line treatment?

A

If PDL1 score >50%

33
Q

What are palliative TKIs?

A

Targeted drugs for adenocarcinoma with driver mutation

34
Q

What are some of the side effects of chemotherapy?

A

Nausea
GI upset
Marrow suppression and risk of life threatening infection
VTE disease
Neuropathies
Hair loss
Nail changes

35
Q

Name some of the symptoms that palliative radiology can help with.

A

Bone metastasis
Cord compression
Haemoptysis

36
Q

Name an advantage of palliative radiotherapy.

A

Can be given if disease too large to encompass radically
Has a survival advantage

37
Q

What % of patients have small cell lung cancer?

A

15%

38
Q

What is the doubling time for small cell lung cancer?

A

29 days

39
Q

Describe the decline of patients with small cell lung cancer

A

Become ill more quickly due to quicker doubling time.

40
Q

What are the drugs in the combinations of drugs used to treat small cell lung cancer?

A

Cisplatin+ etoposide

41
Q

What is the treatment for small cell lung cancer if it is curative?

A

Chemo
Drug combo

42
Q

What is the response rate like for those with localised disease?

A

High (approx. 60% make full remission).

43
Q

In extensive disease, what treatment is usually given?

A

Combination chemo

44
Q

In those with localised disease, how long an they live with no treatment?

A

8 months

45
Q

In those with extensive disease, how long can they be expected to live for without treatment?

A

8 weeks

46
Q

In those with localised disease, how long can they be expected to live for with treatment?

A

16 months

47
Q

In those with extensive disease, how long can they be expected to live for with treatment?

A

8 months

48
Q

What are some of the side effects of immunchemotherapy?

A

Colitis
Pneumonitis
Dermatitis
Endocrinopathies

49
Q

Who would attend a MDT meeting?

A

Respiratory consultants
Pathologist
Radiologist
Clinical and medical oncologist
Cancer nurse specialist
Cardiothoracic surgeons

50
Q

List some of the symptoms associated with advanced lung cancer.

A

Pain-
Depression
Constipation
Breathlessness
Nausea & vomiting
Anorexia

51
Q

What are the anticipatory medications that are commonly prescribed to relieve palliative patients of distress?

A

Morphine- pain & breathlessness
Midazolam- agitation
Levomepromazine- nausea
Hyoscine butylbromide- secretions

Year 1- Respiratory (36 decks)

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