Oncology Flashcards
Types of cytotoxic agents?
ACAMTO
1. Alkylating agents
2. Cytotoxic antibiotics
3. Antimetabolites
4. Microtubule inhibitors
5. Topoisomerase inhibitors
6. Other
Alkylating agent example?
Cyclophosphamide
Cyclophosphamide MOA?
Alkylating agent - causes cross-linking in DNA
Cyclophosphamide s/e?
- Haemorrhagic cystitis
- Myelosuppression
- Transitional cell carcinoma
Cytotoxic Abx examples?
- Bleomycin
- Doxorubicin
Bleomycin MOA?
Degrades preformed DNA
Doxorubicin MOA?
Stabilizes DNA-topoisomerase II complex inhibits DNA & RNA synthesis
Bleomycin s/e?
Lung fibrosis
Doxorubicin s/e?
Cardiomyopathy
Antimetabolite examples?
- Methotrexate
- 5-FU (pyrimidine analogue)
- 6-MP (purine analogue)
- Cytarabine
Antimetabolite main s/e?
Myelosuppression
Methotrexate s/e?
- Mucositis
- Liver fibrosis
- Lung fibrosis
5-FU s/e?
- Mucositis
- Dermatitis
Cytarabine s/e?
Ataxia
Microtubule inhibitor examples?
- Vincristine, vinblastine
- Docetaxel
Vincristine s/e?
- Peripheral neuropathy (reversible)
- Paralytic ileus
Docetaxel s/e?
Neutropenia
Topoisomerase inhibitor example?
Irinotexan
Irinotecan s/e?
Myelosuppression
Cisplatin s/e?
- Ototoxicity
- Peripheral neuropathy
- Hypomagnesaemia
Hydroxyurea (hydroxycarbamide) s/e?
Myelosuppression
Which chemo causes hypomagnesaemia?
Cisplatin
Bleomycin s/e?
Lung fibrosis
Haemorrhagic cystitis chemo cause?
Cyclophosphamide
Peripheral neuropathy chemo cause?
Vincristine
Li-Fraumeni syndrome?
- AD
- Germline mutations to p53 TS gene
- High incidence of malignancies particularly sarcomas and leukaemias
- Diagnosed when: Individual develops sarcoma under 45 years, First degree relative diagnosed with any cancer below age 45 years and another family member develops malignancy under 45 years or sarcoma at any age
BRCA 1 chromosome?
17
BRCA 2 chromosome?
13
BRCA 1 & 2 breast cancer risk?
60%
What other cancers are associated with BRCA 1 and 2?
- Ovarian cancer (55% with BRCA 1 and 25% with BRCA 2)
- BRCA2 mutation associated with prostate cancer in men
Lynch syndrome (HNPCC) ?
- AD
- Colonic and endometrial cancer at young age
- 80% of affected individuals will get colonic and/or endometrial cancer
- High risk individuals ID using the Amsterdam criteria
Amsterdam criteria for Lynch syndrome?
- Three or more family members with a confirmed diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two.
- Two successive affected generations.
- One or more colon cancers diagnosed under age 50 years.
- Familial adenomatous polyposis (FAP) has been excluded.
Amsterdam criteria for Lynch syndrome?
- Three or more family members with a confirmed diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two.
- Two successive affected generations.
- One or more colon cancers diagnosed under age 50 years.
- Familial adenomatous polyposis (FAP) has been excluded.
Gardner’s syndrome?
- AD, considered a variant of FAP
- Multiple colonic polyps
- Extra colonic diseases include: skull osteoma, thyroid cancer and epidermoid cysts
- Desmoid tumours are seen in 15%
- Mutation of APC gene located on chromosome 5
- Due to colonic polyps most patients will undergo colectomy to reduce risk of colorectal cancer
Ovarian cancer marker?
Ca 125
Pancreatic cancer marker?
Ca 19-9
Breast cancer marker?
Ca 15-3
Prostate ca marker?
PSA
HCC and teratoma marker?
ADP
Colorectal cancer marker?
CEA
Melanoma, Schwannoma marker?
S100
SCLC, Gastric cancer, neuroblastoma marker?
Bombesin
Medullary thyroid carcinoma marker?
Calcitonin (as MTC arises from parafollicular cells)
Most common UK cancers?
- Breast
- Lung
- Colorectal
- Prostate
- Bladder
Most common cancers that cause deaths in UKK?
- Lung
- Colorectal
- Breast
- Prostate
- Pancreas
Neoplastic spinal cord compression features?
- Back pain, worse on lying down and coughing
- Lower limb weakness
- Sensory changes: sensory loss and numbness.
- Neurological signs depend on the level of the lesion. Lesions above L1 usually result in upper motor neuron signs in the legs and a sensory level. Lesions below L1 usually cause lower motor neuron signs in the legs and perianal numbness. Tendon reflexes tend to be increased below the level of the lesion and absent at the level of the lesion
Neoplastic spinal cord compression Ix?
Urgent Whole MRI spine within 24 hours of presentation
Neoplastic spinal cord compression Rx?
- High dose oral dexamethasone
- Urgent oncological assessment for consideration of radiotherapy or surgery
Raised bHCG and raised AFP
Non-seminomatous testicular cancer
