Ovarian and Bladder Cancer Flashcards
What are some important predisposing factors for epithelial ovarian Carcinoma?
Family Hx
BRCA 1/2
Your patient is over 35 years old and has epithelial ovarian carcinoma. What is a good treatment method?
Prophylactic Oophorectomy
What factor in the blood stream can be used to monitor epithelial ovarian carcinoma?
CA-125
What is the staging method for epithelial Ovarian Carcinoma?
Stage 1 = only in the ovaries
Stage 2 = Ovaries and Pelvis
Stage 3 = Ovaries, Pelvis, and lymph nodes
Stage 4 = mets to bone/lung/liver (pleural effusion)
What is the typical chemotherapeutic treatment for epithelial ovarian carcinoma?
High volume intra-peritoneal cisplatin instillation.
What is the Chemotherapeutic regimen for Stage 1&2 epithelial ovarian carcinoma?
Carbo/Cisplatin IP and Cyclophosphamide and/or doxorubicin IV
What is the chemotherapeutic regimen for Stage 3&4 epithelial Ovarian Carcinoma?
Carboplatin/cisplatin IP and Paclitaxel
What is the presenting symptom of bladder carcinoma most likely to be?
Painless hematuria
What is the treatment for Bladder carcinoma (generally speaking)?
Transurethral resection
Chemo is put in the bladder
What is the MOA of Carboplatin/Cisplatin?
Creates DNA intrastrand crosslinks
What are the adverse effects associated with Carboplatin?
Allergic rxn
Dose related myelosuppression, anemia
elevated hepatic enzymes
Elevated BUN/Cr
What are the adverse effects associated with Cisplatin?
Allergic rxn
Dose related NEPHROTOXICITY
Ototoxicity
What is the MOA of Cyclophosphamide?
cyclophosphamide alkylates DNA.
it is also a prodrug
What are the adverse effects associated with cyclophosphamide?
Hemorrhagic cystitis (mesna)
Anemia
Amenorrhea/infertility
Pulmonary fibrosis
What is the MOA of Doxorubicin?
Intercalates within DNA
Generates free radicals
inhibits Topo 2
What are the adverse effects associated with Doxorubicin?
CARDIOTOXICITY (dose limiting)
Liver disease
Extravasational necrosis
What should you give with doxorubicin to help with the cardiotoxicity?
Dexrazoxone
What is the MOA of Paclitaxel?
Paclitaxel is a microtubule stabilizer
What adverse effects are associated with paclitaxel?
Hypersensitivity
Peripheral neuropathy
Arthralgia/myalgia
What is the MOA of BCG?
Binds to urothelium and activates APCs thus inducing immune activation. lasts for months, is used post TUR.
What is the MOA of Mitomycin C?
Mono/bi - functional alkylator
What adverse effects are associated with Mitomycin C?
Pneumonitis
pancytopenia
Chemical cystitis
Dermatitis (when urine contacts skin)
What is the MOA of Thiotepa?
DNA alkylation via aziridine groups and intrastrand cross-linkage.
What adverse effects are assoicated with Thiotepa?
Pancytopenia Dysuria urine retention Chemical cystitis Renal dysfunction
