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VM753 Clin Sci IV > Oncology > Flashcards

Oncology Flashcards

1
Q

what is CR?

A

complete response
disappearance of all measurable disease

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2
Q

what is PR?

A

partial response
reduction in volume of all disease, no new lesions

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3
Q

what is SD?

A

stable disease

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4
Q

what is PD?

A

progressive disease

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5
Q

prednisone can have anti-tumor effects on which cancers?

A

lymphoma
multiple myeloma
mast cell tumor

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6
Q

prednisone can help control clinical signs in which cancers?

A

insulinoma
CNS tumor
paraneoplastic hypercalcemia

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7
Q

indications for radiation therapy?

A
  1. adjuvant
  2. neoadjuvant
  3. primary therapy
  4. palliation
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8
Q

what are some complications of biopsies?

A

hematoma
surgical site infection
exophytic tumor growth

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9
Q

limitations of FNA cytology on tumor

A

no info on structure, grade and if benign or malignant

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10
Q

limitations of needle-core on tumor

A

size of tumor that is amenable
may penetrate naive tissue/plane
risk of procedure (bleeding, air)

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11
Q

when should you do an excisional biopsy?

A

curative intent resection
high suspicion is benign
palliation

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12
Q

when should you absolutely not do an excisional biopsy

A

injection site sarcoma

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13
Q

do you cut parallel or perpendicular to tension lines?

A

parallel

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14
Q

what are these
1. aseptic technique
2. gentle tissue handling
3. hemostasis
4. preserve blood supply
5. eliminate dead space
6. accurate tissue apposition
7. min tension

A

halsted principles

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15
Q

what type of approach?
narrow, high risk for leaving microscopic disease

A

marginal

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16
Q

what type of approach?
2 cm outwards to account for active zone or microsatellites

A

wide

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17
Q

what type of approach?
tumor removal and significant amount of normal tissue around it (e.g. entire muscle)

A

radical

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18
Q

definition:
palliative vs curative/definitive vs cytoreduction

A

surgical intent

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19
Q

definition:
how much tissue is taken (marginal, wide, radical)

A

surgical dose

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20
Q

definition:
tissue plane of dissection, “cutting edge”, which is continuous with what remains in wound bed

A

surgical margin

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21
Q

are active or passive drains preferred?

A

active (closed)

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22
Q

what should never be done with reconstruction?

A

releasing incisions

23
Q

what cases with seromas are high risk?

A

LN/ventral neck
high motion areas
inguinal
pre-op radiation therapy

24
Q

what are the major determinants of metastasis?

A
  1. histotype (highly metastatic)
  2. histologic grade
  3. primary tumor size
25
Q

examples of highly metastatic tumors

A

HSA
OSA
malignant melanoma
AGASACA

26
Q

examples of tumors whose high grades have high chances of mets?

A

mast cell tumor
soft tissue sarcoma

27
Q

what is the Ewing Mechanistic Theory?

A

First site to which cancer metastasizes is the closest one in which there are small blood vessels (first capillary bed)

28
Q

what is the Paget seed and soil theory?

A

Cells are dispersed randomly but only grow in organs which provide the correct factors necessary for growth of that particular tumor

29
Q

what is the rate limiting step in metastasis?

A

survival and proliferation in new microenvironment

30
Q

why do tumors develop its own blood supply?

A

bc they should not be able to grow beyond 1 mm unless they have their own blood supply

31
Q

how do tumors develop their own blood supply - differ between the classical and vasculogenesis theory?

A

classical theory: ingrowth of endothelial cells from existing vessels
vasculogenesis theory: endothelial precursors

32
Q

treatments that might target tumor blood vessels

A
  1. block angiogenic growth factors w/ Avastin or Palladia
  2. give angiogenesis inhibitors - angiostatin, endostatin
  3. target cytotoxic drugs to growing endothelial cells
  4. metronomic chemotherapy (small amounts more frequently)
33
Q

what do you call cancer-associated alterations in bodily structure and/or function that are not directly related to the physical effects of the primary or metastatic tumor

A

paraneoplastic syndromes

34
Q

hypercalcemia of malignancy
MOA

A

PTHrp

35
Q

hypercalcemia of malignancy
associated tumor types in dogs

A

AGASACA
lymphoma
multiple myeloma

36
Q

hypercalcemia of malignancy
associated tumor types in cats

A

lymphoma
SCC

37
Q

hypercalcemia of malignancy
treatment

A

treat underling tumor!
IV or SQ fluids
furosemide
bisphosphonates (pamidronate, zoledronate)
prednisone (must have definitive diagnosis before starting)

38
Q

hypertrophic osteopathy (HO)
MOA

A

poorly understood
vagal n stimulation from thorax or humoral mechanism through increased VEGF, growth hormone and PDGF

39
Q

hypertrophic osteopathy (HO)
associated tumor types

A

primary lung tumors
osteosarcoma mets to lungs

40
Q

hypertrophic osteopathy (HO)
treatment

A

remove underlying tumor!
if secondary to mets from OSA - palliative pain management (oral analgesics), bisphosphonates (pamidronate, zoledronate), talk about euthanasia

41
Q

how does radiation therapy kill cells?

A

ionizing radiation at or near DNA, can be direct or indirect
mostly mitotic cell death
some apoptotic death

42
Q

stereotactic body radiation therapy
type of fractions?
what is required?

A

hypofractionated
requires CT, immobilization and target localization (OBI or contour)

43
Q

how does stereotactic body radiation therapy spare normal tissues?

A

by avoidance

44
Q

what is IMRT?

A

intensity modulated radiation therapy

45
Q

what does IMRT do?
fractionation?
what does it require?

A

non-uniform dose delievery
fractionated or hypofractionated
requires on board imaging

46
Q

when do acute radiation effects occur? which systems are involved?

A

within 3 months
skin, GI, hematopoietic

47
Q

when do early delayed radiation effects occur? which systems are involved?

A

2 weeks - 4 months
neurologic tissues

48
Q

when do late radiation effects occur? which systems are involved?

A

3 months - year
lung, kidney, heart, bone, liver

49
Q

should you use skin care products (aquaphor, lidocaine jelly, A/D) for the acute treatment of the skin from radiation effects?

A

no - controversial

50
Q

treatment for pneumonitis due to radiation

A

glucocorticoids
rest
O2

51
Q

toceranib can be a problem with which type of radiation

A

GI radiation

52
Q

concurrent use of what chemotherapeutics is not recommended

A

dacarbazine
lomustine
doxorubicin
cisplatin
gemcitabine
paclitaxel
toceranib

53
Q

why can concurrent antioxidants interfere with radiation cell killing

A

antioxidants prevent ROS
but ROS cause indirect killing of cancer cells

54
Q

Pentoxifylline and vitamin E can be given to help what chronic conditions to treat what

A

skin
CNS
bone
lungs

radiation fibrosis

VM753 Clin Sci IV (12 decks)

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