Oncology: Medical Management Flashcards
What are the types of cancer prevention?
Primary, secondary, and tertiary prevention
What is primary cancer prevention?
Screening for and reducing modifiable risk factors
Cancer vaccines
What is secondary cancer prevention?
Screening and early detection to find cancers before they become problematic
What is tertiary cancer prevention?
Symptom management
Limiting complications
Preventing related disability
What are the different ways to diagnose cancers?
Tissue biopsy
Biological tumor markers
Molecular profiling
Scans
What are the various methods of tissue biopsy for diagnosing cancer?
Curettage
Fluid aspiration
Fine needle aspiration
Dermal punch
Endoscopy
Surgical excision
T/f: cancer can be diagnosed and removed at the same time
True
What cancer “diagnostic tool” is not really diagnostic but can show us something is abnormal if they show abnormal amounts?
Biologic tumor markers
What is molecular profiling?
Examine cancer cells for specific proteins and DNA mutation for understanding the type of cancer it is
What scans can be used to diagnose cancers?
MRI, CT, isotope scans, mammography
What is curative treatment?
Any treatment directed at trying to eradicate the cancer completely
What is palliative treatment?
Life prolonging and symptom reducing treatment that is not curative
Treatment trying to stop progression
What is neoadjuvant treatment?
Treatment before surgery such as radiation for tumor shrinking
What is adjuvant treatment?
Treatment after surgery to clean up any leftover cancer cells
What are the primary antineoplastic treatment modalities?
Surgery
Irradiation therapy
Chemotherapy
Immunotherapy
Antiangiogenic therapy
Hormonal therapy
Complementary and alternative (integrative) medicine
Is it more common to see one or multiple treatments being used to treat cancer?
Multiple (one after the other or at the same time)
How long does the cell cycle take?
19-33 days
Chemo is most effective during what phases of the cell cycle?
During S and M phases
Radiation is most effective during what phase of the cell cycle?
G2 phase
Why is treatment given in repeated doses over time?
To attempt to kill ALL cancer cells
Turnover of cells occurs every ____ days
60
Why don’t we do continuous chemotherapy?
Bc it would probably kill the pt bc of its effects in normal and abnormal tissues
What phase of the cell cycle does cancer treatment have no effect on?
G0
What are the characteristics of surgery as a cancer treatment?
It is specific, preventative, diagnostic, curative, and palliative
Why is surgery for cancer specific?
Bc it only effects the cancerous area
What are the benefits of using surgery for palliative cancer care?
Pain relief
Improve physical and physiological functioning
Relieve obstructions
T/f: surgery is often used in combo with other cancer treatment modalities
True
How does radiation treat cancer?
It destroyed cancer cell DNA by breaking DNA strand bonds
Are the effects of radiation specific or non specific?
Nonspecific but local
What tissue have a rapid cell cycle?
Hair, skin, mucosa
What tissues have a slower cell cycle?
Skin, fascia, heart, lungs
Is radiation given all at once or fractionated over session?
Fractionated
Why is radiation fractionated over many sessions?
To target all cell cycle tissues and minimize effects on healthy tissues
Is radiation given as an adjuvant or neoadjuvant treatment?
Can be either
Is radiation given as a curative or palliative treatment?
Can be either
When radiation is curative, how many sessions is typical?
20-40
When radiation is palliative, how may sessions is typical?
5-10
What are the general side effects of radiation therapy?
RADIATION INDUCED FIBROSIS
Immunosuppression
Dermatitis
Vomiting/diarrhea
FATIGUE
Avascular necrosis
Lymphedema
Radiation myelitis
What are specific side effects of radiation?
Esophagitis
Enterocolitis
Pericarditis, restrictive cardiomyopathy, CAD
Pneumonitis
Pulmonary fibrosis (chronic pneumonitis)
Nerve complications
Cystitis of the bladder
T/f: bc DNA is damaged by radiation, the s/s may be delayed
True
Is chemo specific or non specific? Local or non local?
Non specific and non local (all cells of all tissues are affected)
How does chemotherapy work?
By disrupting cell replication
Why might we use a “cocktail” of chemo agents?
To affect different stages of the cell cycle and decrease side effects
What are some administration routes for chemo?
Oral
IV
Intrathecal (lumbar puncture for CSF)
Subcutaneous
Intramuscular
What are common side effects of chemo?
Immunosuppression
Nausea and vomiting
Alopecia
Diarrhea
Mucositis
Neuropathy
Organ damage
Sterility
What cancers are stem cell/bone marrow transplants used for?
Liquid cancers (lymphoma, leukemia, multiple myelomas)
What is involved in the process of a stem cell/bone marrow transplant?
First, high dose chemo and/or whole body radiation are given to try and wipe out the bone marrow
Then there is an infusion of autologous or allogenic bone marrow/stem cells
What is a serious effect of stem cell/bone marrow transplants?
Severe immunocompromise
Why do pts receiving a bone marrow/stem cell transplant have to be admitted to the hospital?
Bc of the severe immunosuppression that results from wiping out the bone marrow first
What is an autologous bone marrow/stem cell transplant?
When the pts own bone marrow is taken out, “cleaned up” and put back into the pt
What is an allogenic bone marrow/stem cell transplant?
When donor stem cells/bone marrow are used
What is the risk with allogenic bone marrow/stem cell transplant?
Host vs donor disease
Pts receiving an allogenic bone marrow/stem cell transplant must have at least a ___ days stay at the hospital
30
What is the target of biologic/immunotherapy for cancer?
To assist pts own immune system in defending against cancer
What do monoclonal antibodies do as a biologic;/immunotherapy for cancer?
They increase the activity of T and B cells
Drugs ending in -mab are what kinds of drugs?
Monoclonal antibodies for biologic/immunotherapy for cancer
What is CAR-T (chimeric antigen receptor)?
A biologic/immunotherapy for cancer in which T cells are collected from the pt, then altered to attach to antigens specific to the pts cancer cells and returned to them
What is a frequent and serious side effect of CAR-T?
CRS (cytokine release syndrome)
Why is CAR-T a last resort cancer treatment?
Bc it have high success but also very high mortality
What is antiangiogenic therapy for cancer treatment?
A way to prevent the tumor from getting a blood supply that it needs to growth and spread
What is hormonal therapy for cancer treatment?
A treatment for hormone influenced cancers (breast, prostate) that either blocks hormone production or actions
What drug is used for hormone therapy in breast cancer treatment?
Tamoxifen
What drug is used in hormone therapy for treatment of prostate cancer?
Zoladex
What is the aim of complementary and alternative medicine in cancer treatment?
Treatment of symptoms not relived by medical treatment or for people not tolerant of other medical treatments
Aimed at managing symptoms and coping with the disease
What are examples of complementary and alternative medicine for cancer treatment?
Reiki, BodyTalk, hypnosis, Tai Chi, qi gong, yoga, meditation
