Oncology - Intro to Radiology and Chemotherapy

Question 1

what is radical treatment

Answer 1

a definitive treatment

Question 2

what is neoadjuvant treatment

Answer 2

chemo or radiotherapy to shrink a tumor for surgical excission

Question 3

What does a performance status of 0-2 mean

Answer 3

0- asymptomatic
1 - symptomatic but ambulatory
2 - symptomatic (<50% in bed)

Question 4

what does a performance status of 3-5 mean

Answer 4

3 - symptomatic >50 in bed
4 - bed bound
5 - dead

Question 5

what is included in systemic anti-cancer treatment

Answer 5

cytotoxic chemo
targeted therapy
immunotherapy
endocrine therapy

Question 6

what 2 cell division phases are targeted with cytotoxic therapy

Answer 6

M and S (mitosis and synthesis)

M-phase-specific
Disrupt mitosis
E.g. microtubule inhibitors such as Paclitaxel

S-phase specific
Disrupt DNA synthesis
E.g. anti-metabolites such as 5-Fluorouracil

Question 7

what is the normal 3 week cycle of chemotherapy

Answer 7

week 1 day 1 give chemo
week 2 - main side effects
week 3 - recovery

Question 8

what are some of the key side effects of chemotherapy

Answer 8

brain fog
anxiety depression
hair loss
mouth sores
low blood count
hot flushes
nausea/vomiting
weak heart
reduced digestion
red urine
decreased urination
sexual dysfunction
discoloured/cracked nails
peripheral blood vessel destruction
bone loss
skin sensitivity
swollen hands and feet
poor coordination
Extreme fatigue

Question 9

what is the most important side effect of cytotoxic chemotherapy

Answer 9

neutropenic sepsis
neutrophils 0-0.1

Question 10

what is the treatment for neutropenic sepsis

Answer 10

amoxicillin, metronidazole IV
given in 1 hour of arrival

ASK for allergies

Question 11

what targeted therapy is used to treat CML

Answer 11

tyrosine kinase inhibitors
Imatinib

Question 12

what monoclonal antibody can be given for HER2+ breast cancer

Answer 12

herceptin

Question 13

what chromosome is responsible for CML

Answer 13

philadelphia
chromosome 9

Question 13

Q5. Imatinib targets the tyrosine kinase enzyme BCR-ABL. Which statement is true regarding BCR-ABL?

It is present in normal cells as well as cancer cells

It is upregulated in cancer cells infected by Epstein-Barr virus (EBV)

It is produced in cancer cells affected by a specific chromosomal translocation

Answer 13

It is produced in cancer cells affected by a specific chromosomal translocation

Question 14

what immunotherapy can be given for melanoma

Answer 14

Pembrolizumab

Question 15

what are some side effects of Immune Checkpoint Inhibitors (ICIs)

Answer 15

-itisis
dermatitis, colitis, pancreatitis, arthritis, conjunctivitis, uveitis, scleritis, hepatitis, nephritis, pericarditits, vasculitits,
adrenal insufficiency, diabetes, guillian barre, myasthenia gravis, neuropathy

Question 16

what anti-oestrogen therapy can be given in ER+ breast cancer

Answer 16

tamoxifen

Question 17

what anti-androgen can be given in prostate cancer

Answer 17

Bicalutamide

Question 18

what gonadotrophin analogue can be given in prostate cancer

Answer 18

Goserelin (Zoladex)

Question 19

what is the most common side effect of endocrine therapy

Answer 19

hot flushes
(so bad people have reported feeling like they’re on fire)

Question 20

in radiology what is the X gray

Answer 20

dose of radiation

Question 21

what is the Y fractions

Answer 21

how many sessions of radiation treatment would be given
e.g. 10 session

Question 22

what are some early side effects of radiotherapy

Answer 22

fatigue, inflammation (dermatits)

onset days-weeks

Question 23

what is brachytherapy

Answer 23

inserting radioactive pellets into the prostate/cervix

Question 24

what are some late side effects of radiotherapy

Answer 24

fibrosis
necrosis
secondary cancers

months to years later
tend to be irreversible