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!Diagnostic Imaging > Oncology Tx > Flashcards

Oncology Tx Flashcards

1
Q

Local therapies

A

Sx
Radiation therapy (medicine oncologist)

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2
Q

Systemic therapies

A

Chemotherapy (cytotoxic, metronomic)
Immunotherapy (ibs and mabs)

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3
Q

Oncologic surgical principles

A

Cover ulcerated tissues
Occlude veins
Don’t handle tumor
Plan 3 ways to close
Don’t remove mass based on closure
No drains
Mohs procedure/ stains

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4
Q

Planned margins in benign tumors

A

Narrow or marginal excision (curative)

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5
Q

High grade tumors

A

2-3 cm, high recurrence (75%), follow-up procedures

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6
Q

Feline injection site sarcomas

A

5 cm margins/ 2 facial planes deep (muscle fascia)

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7
Q

Marginal excision

A

Diameter of tumor laterally
One fascial plane deep

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8
Q

Surgical doses

A

Radical (remove tumor completely), wide margins, marginal excision, cytoreductive (debulking)
Influenced by size, location, metastasis

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9
Q

What can you glean from the histopathology report?

A

Grade, margins, mitosis rate/index, vascular invasion/embolus

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10
Q

Does laser applied to the tumor bed influence recurrence?

A

No it’s not helpful

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11
Q

What are the 2 types of radiation?

A

Brachytherapy particles: travel short distances (Strotium-90, iridium-192, iodine-131)
Teletherapy: linear accelerator (rays, electrons)

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12
Q

How does radiation kill cells

A

Fractionation: split dose into multiples over time, kills cancer cells while allowing normal tissue to recover
1/3 direct damage to DNA, 2/3 indirect free radical damage

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13
Q

Why are the 4 R’s of radiation?

A

Repair, repopulation, reassortment, reoxygenation

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14
Q

Repair

A

Repair DNA damage within 6 hours (some need more)
Allows abnormal tissue to recover
Tumor cells also repair damage and proliferate

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15
Q

Repopulation

A

Proliferation surviving clomogenic tumor cells
Cancer cells become more sensitive in M and G2
2nd dose may capture radioresistant cells as they become more sensitive

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16
Q

Reoxygenation

A

O2 required to generate free radicals
As tumor cells die, expose new areas to oxygen (next dose may treat reoxygenated cancer cells)

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17
Q

Conventional RT

A

For microscopic dz
Acute side effects
Advantage: long- term dz control
Disadvantages: multiple anesthesias and long tx course

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18
Q

Palliative RT

A

For macroscopic dz
Late side effects
Advantage: short tx course, fewer anesthesias, few side effects
Disadvantage: shorter dz control, possible late side effects

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19
Q

Stereotactic RT

A

For macroscopic dz
Late side effects
Advantages: durable palliation
Disadvantages: uncertain long term outcome, possible late side effects

20
Q

Acute side effects of radiation

A

Rapidly diving cells (epithelial, GI, skin, hair follicles, BM)
Reversible
2-4w to develop and heal
Reflective of total RT dose

21
Q

Chronic effects of RT

A

Slowly dividing tissues (bone, muscle, BVs), nervous, heart, lungs)
Irreversible loss of function —> fibrosis and necrosis
6m-years to develop
Reflective of large fraction size

22
Q

How are acute side effects of RT managed?

A

Prevent self trauma
Pain management
Tea- tannic acid
Anti inflammatories/ prednisone
Silver sulfadiazine

23
Q

How are chronic side effects of RT managed?

A

Surgical removal
No tx possible

24
Q

Indications of cytotoxic chemotherapy

A

Sensitive tumor type (round cells)
Systemic dz/ already has mets
High chance of mets

25
Q

Gompertzian growth curve

A

A mathematical model that describes the growth of cancer tumors
Exponential growth: RT + chemo work best
Surgery growth curve to the left back to exponential growth

26
Q

Cell cycle specific drugs

A

Targets tumor in a specific time of cell cycle
Base analogues , folate inhibitors, tubule inhibitors

27
Q

Cell cycle non-specific

A

Targets DNA in any part of the cell cycle
Alkylators, heavy metals, abx

28
Q

What is the most common chemotherapy side effect

A

BM neutropenia
Alopecia
GI (anorexia, nausea, V/D)

29
Q

Doxorubicin

A

Anti tumor Abx
Effects: cardiac necrosis, GI upset, neutropenia, tissue necrosis with extravasation, mast cell degranulation, alopecia/ hair thinning/ skin darkening, radiation recall

30
Q

Mitoxanthrone

A

Anti tumor abx
Effects: BM suppression, GI toxicity, blue color urine

31
Q

Mechlorethamine

A

Not used in practice , spontaneous gases

32
Q

Cyclophosphamide

A

Alkylating agents, must be activated in the liver
Side effects: marrow-sparing a role in cause sterile hemorrhagic cystitis, GI, alopecia, pulmonary fibrosis

33
Q

Chlorambucil

A

Alkylating agent
Platelets affected more often with chronic use of

34
Q

CCNU

A

Severely marrow suppressive 1-3w
Liver toxicity (give denamarin too)

35
Q

Melphalan

A

Idiosyncratic effect: Pulmonary fibrosis

36
Q

DTIC/ temozolamide

A

Side effects: GI, Vesicant

37
Q

Vincristine

A

Tubule inhibitors
Marrow suppression
Peripheral neuropathy ileus, vesicant

38
Q

Vinblastine

A

Tubule inhibitors
Side effects: more marrow suppressive, less neuropathy, sub for ileus, vesicant

39
Q

Cisplatin

A

Heavy metal alkylators
Effects: renal/ diuresis, vomiting, moderate marrow suppression, splats cats

40
Q

Carboplatin

A

More marrow suppressive (cumulative)
Neurotoxic

41
Q

Rabacfosadine

A

Effects: pulmonary fibrosis after 5th dose, dermatopathy
Contrain: WHWT

42
Q

NSAIDS

A

Piroxicam, carprofen, deramax, meloxicam, previcox
Effects: GI, renal

43
Q

Prednisone

A

Side effects: panting, laxity, hepatomegaly, alopecia, thin skin, polyphagia, PU/PD

44
Q

L-asparaginase

A

Side effects: anaphylaxis (Benadryl), pancreatitis, no marrow suppression

45
Q

How to manage neutropenia patients

A

Sterile IV catheter, IV fluids
Broad spectrum abx (no baytril)
Antiematics, appetite stimulants, GI protectants
Usually recover 12-48 hrs

46
Q

How do you keep your workers safe when handling toxic agents?

A

Hood or BSC
PPE (gowns, gloves, eye/ face shields)

47
Q

How do you keep owners safe from exposure to chemotherapy agents?

A

Avoid urine and feces 48-72 hrs post chemo
Drug compounding
Piling cats
Well placed catheter

!Diagnostic Imaging (18 decks)

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