Oncology 4 Flashcards
When use radiation therapy in breast cancer?
5Is of radiation
lumpectomy in DCIS and Stage 1 disease Inflammatory breast cancer lymph node Axillary positive Inadequate resection - positive margins liquidate to prevent recurrence post mastectomy
If ovarian cancer - resistant to platinum based therapy what then?
After 6 months - TVS and CA125
Bevacizumab offers PS
IF Platinum resistant = Anthracycline/paclitaxel/Niraparib
IF Platinum sensitive = Continue platinum
What is protective against endometrial cancer?
OCP pills!
Which type of endometrial cancer is good and poor?
Good = endometrioid Adenocarcinoma ( estrogen dependent)
Bad = serous/clear cell ( estrogen independent)
What features in cervical cancer a/w higher chance of relapse?
corpus luteum and LN involvement
Localised cervical cancer - tx?
Mets cervical cancer - tx?
Brachytherapy + Cisplatin then after completion
-Cisplatin + Gemcitabine
Bevacizumab + Platinum + Topotecan - higher Survival
(BPT)
Acute emesis - best tx?
delayed emesis - best tx?
Anticipatory emesis - best tx?
Acute emesis - ondasetron
delayed emesis - Dexamethasone
anticipatory emesis - benzodiazepines - lorazepam
Why Ifosphamide causes encephalopathy?
Accumulation of chloracetaldehyde in CNS
Ideal tumor marker criteria?
- Highly specific for tumor type
- Reflects accurately tumor progression/regression
- Long lead-time over clinical diagnosis
- short half-life - allows serial measurements
- Test to detect should be cheap and reliable
What is Gating system in radiotherapy?
Detects motion - ie. breathing and only gives radiation when tumor is in the field
OCP in ovarian cancer?
Reduce risk of Ovarian cancer
Does benign prostatic hyperplasia has higher risk of prostate cancer?
NO
Prevention of tumor lysis?
1.Aim urine output 2ml/kg/hour
- NO URINARY ALKALINISATION
- alkaline urine reduce Ca-Po4 solubility in urine so more in serum
- Ca then bind like crazy to albumin bcoz more in serum so deposit in tissue -exacerbating the hypocalcemia
3.Drugs
Allopurinol - low risk of TLS
Febuxostat if renal dysfunction/allergic to allopurinol
Rasburicase - high risk of TLS / NO G6PD
Has G6PD - what drugs needed to be avoided?
Oxidant drugs = primaquine/chloroquine
Sulfonamides abx
Nitrofurantoin
NSAIDS
Cancer most associated with obesity?
Oesophageal adenocarcinoma - 1st
Pancreatic adenocarcinoma = 2nd
Disadvantage of MRI biopsy compared with TRUS biopsy
TRUS biopsy - picks up more low grade tumours
Therapy for Carboplatin-induced NV?
NK1 receptor antagonist - aprepitant
5HT3 antagonist - ondansetron
Dexamethasone
NSCLC treatment?
Stage 1
Stage 1 (A if <3cm) = lobectomy and surveillance -adjuvant radio and chemotherapy not recommended
Stage 2 = Platinum based chemotherapy
IDH mutation found in what tumor and causes what?
AML
ALL
Glioma
-tumorigenesis
IDH mutation found in what tumor and causes what?
AML
Glioma
-tumorigenesis
Metastatic renal cancer - progressed even with sunitinib- what treatment?
Nivolumab + Cabozantinib
Australia Cervical cancer screening new changes?
Screen age 25 - 75
Routine screening every 5 years ( 3 yrs if immunocompromised)
1st Cervical screening - 2 years from last Pap test
HPV-vaccinated women needs cervical screening as well
Leptomeningeal carcinomatosis seen in what?
Dx it - choice of screening tool?
Metastatic disease infiltrating meninges - common in Breast/Lung/Melanoma and hematological malignancy
-presents with N+V/ seizures/neurological deficits
MRI brain and spine
CSF lumbar puncture AFTER MRI if not - leptomeningeal enchancement
