Oncology: Medical Management Flashcards by Tahlia Wasserman

What are the types of cancer prevention?

Primary, secondary, and tertiary prevention

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What is primary cancer prevention?

Screening for and reducing modifiable risk factors
Cancer vaccines

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What is secondary cancer prevention?

Screening and early detection to find cancers before they become problematic

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What is tertiary cancer prevention?

Symptom management
Limiting complications
Preventing related disability

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What are the different ways to diagnose cancers?

Tissue biopsy
Biological tumor markers
Molecular profiling
Scans

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What are the various methods of tissue biopsy for diagnosing cancer?

Curettage
Fluid aspiration
Fine needle aspiration
Dermal punch
Endoscopy
Surgical excision

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T/f: cancer can be diagnosed and removed at the same time

True

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What cancer “diagnostic tool” is not really diagnostic but can show us something is abnormal if they show abnormal amounts?

Biologic tumor markers

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What is molecular profiling?

Examine cancer cells for specific proteins and DNA mutation for understanding the type of cancer it is

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What scans can be used to diagnose cancers?

MRI, CT, isotope scans, mammography

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What is curative treatment?

Any treatment directed at trying to eradicate the cancer completely

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What is palliative treatment?

Life prolonging and symptom reducing treatment that is not curative
Treatment trying to stop progression

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What is neoadjuvant treatment?

Treatment before surgery such as radiation for tumor shrinking

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What is adjuvant treatment?

Treatment after surgery to clean up any leftover cancer cells

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What are the primary antineoplastic treatment modalities?

Surgery
Irradiation therapy
Chemotherapy
Immunotherapy
Antiangiogenic therapy
Hormonal therapy
Complementary and alternative (integrative) medicine

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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)

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How long does the cell cycle take?

19-33 days

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Chemo is most effective during what phases of the cell cycle?

During S and M phases

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Radiation is most effective during what phase of the cell cycle?

G2 phase

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Why is treatment given in repeated doses over time?

To attempt to kill ALL cancer cells

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Turnover of cells occurs every ____ days

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Why don’t we do continuous chemotherapy?

Bc it would probably kill the pt bc of its effects in normal and abnormal tissues

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What phase of the cell cycle does cancer treatment have no effect on?

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What are the characteristics of surgery as a cancer treatment?

It is specific, preventative, diagnostic, curative, and palliative

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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

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