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Reproduction & Sexual Health > Oncology > Flashcards

Oncology Flashcards

1
Q

Name three ER positive cancers

A

Luminal A
Luminal B
Luminal C

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2
Q

Name two ER negative cancers

A

HER Overexpression

Basal like - triple negative

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3
Q

How is luminal A type of cancer treated?

A

Endocrine therapy

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4
Q

How is luminal B type of cancer treated?

A

Chemo followed by endocrine

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5
Q

How is HER2 positive cancer treated?

A

Chemo
Anti-HER2
Endocrine if ER positive

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6
Q

How is triple negative cancer treated?

A

Chemo

Immunotherapy

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7
Q

State the indications for neoadjuvant chemotherapy

A
  • downsizing tumour
  • enroll patients in clinical trials
  • locally advanced breast cancer (inflammatory, ulcerative)
  • large primary tumour compared to breast
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8
Q

State the indications for adjuvant chemotherapy

A
  • risk of relapse
  • tumour extent
  • grade
  • proliferation
  • vascular invasion
  • patient preference
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9
Q

What is the key online prognostic tools?

A

NHS PREDICT

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10
Q

What tool can be used to predict recurrence?

A

Oncotype Dx type genomic testing

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11
Q

Name the acute side effects of chemotherapy

A 
Fatigue 
Myelosuppression
Nausea/vomiting 
Alopecia 
Mucositis 
Diarrhoea 
Constipation
Renal 
Neurotoxicity 
Infertility
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12
Q

Name the late side effects of chemotherapy

A 
Cardiac 
Infertility - premature menopause
Neuropathy 
Renal impairment 
Osteoporosis 
Carcinogenesis
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13
Q

Name three anti-HER2 treatments

A
  1. Monoclonal antibodies
  2. Antibody drug conjugate
  3. Kinase inhibitor
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14
Q

Name two monoclonal antibodies

A

Transtuzumab

Pertuzumab

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15
Q

Describe antibody drug conjugates

A

Monoclonal antibody linked to chemo - antiHER2 attaches to HER2 protein signalling for the chemo drug to directly come to it

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16
Q

Name an antibody drug conjugate

A

TDM1

17
Q

Describe kinase inhibitor

A

HER2 is a kinase protein that tells the cell to grow

18
Q

Name the side effects of HER2 targeted drugs

A 
Heart disease 
Diarrhoea 
Hand-foot syndrome 
Transaminitis 
Pneumonitis/IDL
19
Q

What neoadjuvant endocrine therapy can be given?

A

Pre-menopausal - unlikely

Post-menopausal - letrozole

20
Q

What kind of drug is tamoxifen?

A

Partial ER antagonist

21
Q

What kind of drug is letrozole?

A

Aromastase inhibitor (enzyme converts hormones to oestrogen)

22
Q

Name the side effects of endocrine therapy

A 
Bone/joint pain
Hot flushes 
Fatigue 
Weight gain
Mood swings 
Hair thinning 
Loss of libido
23
Q

In post menopausal women with an ER positive tumour what endocrine treatment is given?

A

Low risk - tamoxifen for 5 years or AI

High risk - aromatase inhibitor for 10 years

24
Q

In pre menopausal women with an ER positive tumour what endocrine treatment is given?

A

Low risk - tamoxifen for 5 years

High risk - ovarian suppression, tamoxifen, exmestane

25
Q

How is triple negative cancer treated?

A

Neoadjuvant chemotherapy
High risk of brain/CNS mets or visceral mets
Clinical trials

26
Q

When is bisphosphonate recommended?

A

Post-menopausal high risk for hormone therapy

Pre-menopausal treated with ovarian suppression

27
Q

What is needed in addition to bisphosphonate?

A

Vitamin D daily

28
Q

What is the assessment guideline for metastatic disease?

A 
Minimal staging 
No routine brain imaging 
Evaluate treatment response every 2-4 months
biopsy metastatic lesion 
reassess biological markers
29
Q

What new drug can be used in metastatic disease?

A

CDK4/6 Inhibitors

30
Q

Describe CDK4/6 Inhibitors

A

Block phosphorylation of retinoblastoma - 3 different types

31
Q

What the side effects of CDK4/6 Inhibitors?

A

Neutropenia, diarrhoea, increased LFT, QTc prolongation, thromboembolic events

32
Q

What type of drugs can be used in triple negative disease?

A

Immunotherapy

33
Q

What is the aim of radiotherapy?

A

Reduce recurrence rate - 12 weeks post surgery

34
Q

State the early toxicity of radiotherapy

A

Fatigue, skin reaction, hair loss

35
Q

State the late toxicity of radiotherapy

A

Breast changes, discomfort, telangiectasia, lymphedema, heart/lung disease

Reproduction & Sexual Health (36 decks)

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