Oncology II Flashcards
Standard treatments
- chemotherapy
- surveillance
- surgery
- radiation
Other treatments
- bone marrow transplant
- gene therapy
- biological therapy
- alternative therapy
- hormone therapy
- clinical trials
Curative surgery
To cure
Prophylactic surgery
- to reduce risk of developing cancer
- “just in case”
Diagnostic surgery
- to biopsy
- may need to open patient “to see what’s happening”
Staging surgery
- to find out the size of the tumor and if/where it has spread
- during this surgery, the doc often removes some lymph nodes near the cancer to find out if it has spread
- these results and others often determine treatment
Palliative surgery
- used to relieve side effects caused by a tumor
- improves quality of life
Adjuvant surgery
- to keep cancer from returning
Reconstructive surgery
- to restore body’s appearance or function
- may be done at the same time as curative surgery
What is bone marrow?
- a soft, fatty substance in the cavities of bones, in which blood cells are produced
- red marrow (myeloid tissue): RBCs, platelets and most WBCs arise here
- yellow marrow: contains fat cells, produce some WBCs
Types of bone marrow transplant
- autologous: own cells
- allogenic: families cells or unrelated donor
Bone marrow biopsy
- usually done by aspiration
- from hips, pelvis, sternum or skull
Chemotherapy
In chemo, antineoplastic agents are used in an attempt to destroy tumor cells by interfering with cellular functions, including replication
Goals of chemotherapy
- cure
- control
- palliation
Adjuvant chemotherapy
Chemotherapy used after all of the known and visible cancer has been removed surgically or with radiation
Neoadjuvant chemotherapy
Chemotherapy taking place before surgical extraction of a tumor
Induction chemotherapy
The first line treatment of cancer. The goal is to cure the cancer.
Consolidation chemotherapy
Chemotherapy given once remission is achieved. The goal is to sustain remission.
Maintenance chemotherapy
Chemotherapy given in lower doses to assist in prolonging a remission.
First line chemotherapy
Chemotherapy that has, through research studies and clinical trials, been determined to have the best probability of treating a cancer.
Second line chemotherapy
Chemotherapy that is given if a disease has not responded or has reoccurred after first line chemotherapy.
Palliative chemotherapy
Chemotherapy that is given specifically to address symptom management without expecting to significantly reduce the cancer.
How can chemotherapy be given to the CSF?
- lumbar puncture (intrathecal)
- ommaya reservoir (intraventrictular)
What drug opens up the blood brain barrier?
Mannitol
Cell cycle specific drugs
Exert an effect within a certain phase of the cell cycle
Cell cycle non-specific drugs
Exert effects in all phases of the cell cycle, including the G0 resting phase
Complete response
Tumor disappears, no evidence of disease. Tumor markers WNL.
Partial response
Tumor markers decrease, tumor shrinks, still evidence of disease.
Stable disease
Cancer has neither grown nor shrunk
Disease progression
Cancer has grown, disease is advancing. Tumor markers increase.
Side effects of chemo
- Brain fog or “chemo brain“
- hair loss
- anxiety and depression
- mouth sores
- hot flashes and menopause
- weakening of the heart muscle
- lower blood cell count (platelets, RBC, WBC)
- N/V
- digestive distress
- discolored and cracked nails
- decrease urination and red urine
- sexual dysfunction
- bone loss (osteoporosis)
- poor coordination and muscle fatigue
- skin sensitivity
- edema in the hands and feet
What are lymphocytes?
- lymphocytes are one of the main types of immune cells, they are divided mainly into B and T cells
Reasons for chemotherapy resistance
- gene amplification
- cancer cells pumping the drug out of the cell as fast as it is going in (p-glycoprotein)
- cancer cells stop taking in the drugs
What is cancer surveillance?
Cancer surveillance provides a quantitative portrait of cancer and it’s determinants in a defined population.
Types of mastectomies
- partial mastectomy
- simple mastectomy
- modified radical mastectomy with lymph nodes removed
- radical mastectomy with chest muscle removed
Partial mastectomy
An operation to remove the cancer and some normal tissue around it, but not the breast itself.
Simple mastectomy
Removal of the entire breast, including the nipple, areola, and most of the overlying skin.
Modified radical mastectomy
Removal of the entire breast, including the nipple, the areola, the overlying skin, and the lining over the chest muscles. In addition, some of the axillary lymph nodes may be removed.
Radical mastectomy
Removal of the entire breast, including the nipple, the areola, the overlying skin, the lymph nodes under the arm, and the chest muscles.
Graft vs. host disease
- a condition that occurs when donor bone marrow or stem cells attack the recipient
- can occur immediately after transplant or weeks to months later
Gene therapy
- still experimental form of treatment, attempts to introduce genetic material (DNA, RNA) into living cells
- being studied in clinical trials for many types of cancer
What is radiation therapy?
The use of various forms of radiation to safely and effectively treat cancer and other diseases.
When is radiation therapy used?
- when it is determined to be the best treatment plan for an oncology patient
- sometimes radiation therapy is the only treatment a patient needs, other times it is combined with other treatments
Why are we using radiation therapy?
Because it dissolves DNA/RNA, destroys cells, hopefully destroys a tumor.
What type of radiation therapy makes a patient radioactive?
- Iodine 131
- goes to the thyroid
- patient required to be on strict isolation
Types of radiation therapy
- Standard 2D “conventional RT“
- 3-D – external RT (most common)
- internal RT
- Systemic RT
Effects of RT
- burns (aquaphor helps)
- weakness/fatigue (hits about four weeks in)
Maintenance of RT sites
- no soaps with fragrance
- no perfumes
- use lukewarm water with mild soap
- no ice on radiation burns
Biological therapy
- uses living organisms, substances derived from living organisms, or synthetic versions of such substances to treat cancer
- some types exploit the immune system’s natural ability to detect and kill cancer cells
- other types target cancer cells directly
Alternative/conventional therapy
Alternative cancer treatments that will not cure cancer, but will help patients cope with signs and symptoms caused by cancer and cancer treatments.
Alternative/conventional therapy examples
- acupuncture
- aromatherapy
- exercise
- hypnosis
- massage
What is hormone therapy?
Some cancers use hormones to grow. Hormone therapy for cancer is the use of medicines to block the effects of hormones. It does not work for all types of cancer.
Cancers that are hormone sensitive
- breast
- prostate
- ovarian
- uterine/endometrial
- kidney
What are clinical trials?
Research studies that explore whether a medical strategy, treatment or device is safe and effective for humans.
Cancer clinical trial… Phase 1
- questions are being explored
- What is the best way to get a new treatment?
Cancer clinical trial… Phase 2
- the focus is on learning whether the new treatment has an anti-cancer effect on a specific cancer
- additional info regarding the side effects of the treatment is also obtained
- only a small number of people included
Cancer clinical trial… Phase 3
- a comparison of the results of people taking a new treatment is done with the results of people taking a standard treatment
Cancer clinical trial… Phase 4
Cancer clinical trials are conducted after treatment has been approved, this provides an opportunity to learn more about the treatment such as the mechanism of action and fine points regarding toxicities.
Survivorship
The process of living with, through and beyond cancer.
