Oncology Flashcards
Why is radiotherapy given as a course?
Normal tissue recovers faster than cancer tissue - giving as a course allows normal tissue time to recover
Which type of lung cancer can cause hypercalcemia and why?
Squamous cell lung cancer
Due to paraneoplastic syndrome
Releases PTH which causes hypercalcemia
What is performance status in regards to cancer treatment?
Tells how active a person is - the better the performance status then the better they will respond to certain cancer treatments
What side effects are you likely to experience when having radiotherapy for lung cancer?
Oesophagitis - occurs within 2 weeks of beginning of treatment
Dyspnoea - due to lung damage
Note that the great vessels and the heart are relatively resistant to radiotherapy
What must you always remember to prescribe and monitor when prescribing dexamethasone in cancer treatment?
PPI - as steroids can cause ulcers
Monitor BMs - as steroids can cause hyperglycaemia
What is the 1 year survival for patients diagnosed with lung cancer in the UK?
30%
Which type of lung cancer is more sensitive to chemotherapy?
Small cell lung cancer
What is letrozole?
What do you need to monitor regularly when taking it?
Aromatise inhibitor
Used in treatment of breast and endometrial cancer
Reduces oestrogen levels
Must have DEXA scans - as it can cause risk of osteoporosis
If you were in GP setting and you suspected MSCC, what would you do?
Urgent referral for MRI whole spine
Happens within 24-48 hours
Inform patient of concerns
What blood tests would you do in a patient with MSCC and why?
FBC - as bone marrow infiltration can cause bone marrow supression with anaemia and thrombocytopenia
Bone profile - to look for hypercalcemia
U&Es - especially if hypercalcemia is found
LFTs - marker for other sites of metastatic disease
Name some common bisphosphonates used in bone targeted cancer therapy?
Zoledronic acid
Denosumab - RANK ligand inhibitor
What is an important side effect of bisphosphonates and how should patients be assessed to reduce risk?
Osteonecrosis of the jaw
Patients should have a dental assessment first prior to starting to reduce risk
What does FDG mean on PET scan?
It means areas which are metabolically active and contain cancer
What are immunotherapy agents used in cancer?
They are antibodies which help to activate the human immune system to help fight off cancer cells?
Why might someone with an autoimmune condition be advised against immunotherapy in cancer?
As immunotherapy agents activate the immune system
This can worsen autoimmune conditions by activating the autoimmune pathways
How are toxicities caused by immunotherapy managed?
Corticosteroids - these lessen the immune response
What type of immunotherapy is used in some Melanomas?
BRAF inhibitors
These target a mutation in some types of melanoma
This leads to inactivation of the cancer cells
What are the common side effects seen with immunotherapy?
Skin rash
Diarrhoea
Endocrinopathy
Hepatitis
What types of HPV does the Gardasil vaccine cover against?
HPV 16 and 18 - cause 70% of cervical cancer
HPV 6 and 11 - cause genital warts
What are the side effects of radiation to the pelvis in a female?
Can cause infertility - due to loss of ovarian function
Dry vagina - leading to problems with sexual dysfunction. Patients are advised to use lubricants
Vaginal stenosis - patients are advised to use dilators
What is brachytherapy in cervical cancer?
Using a radioactive source which is inserted via an applicator into the vagina or cervix
As the radiation has a shorter range, a higher dose can be delivered with less toxicity to surrounding organs
What is cisplatin?
A platinum agent used in cancer therapy
Causes DNA crosslinking which prevents DNA repair/synthesis
What are the side effects of cisplatin?
Hearing impairment
Peripheral neuropathy
Bone marrow suppression
Renal impairment
What key information must be given to a patient when discussing a clinical trial?
Details of trial
They can withdraw from it at any time
The standard therapy available if they don’t enter the trial
Entry to trial is voluntary and refusal won’t affect their care in any way
Any other information the patient considers necessary to make in informed decision
