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B9W6 > PBL 2 > Flashcards

PBL 2 Flashcards

1
Q

what are some of the impacts of cancer on patients?

A 
fear of recurrence
grief - loss of old life, sex drive, fertility, independance
depression
body image difficulties
spirituality
survivor guilt
relationship changes
stress
travel
time in hospital can be lonely/boring/scary
fear/anxiety of treatment/prognosis
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2
Q

why are MDTs important in cancer care?

A

it encourages trust in the team
better communication
more holistic and patient-centred practice
events unecessary errors
avoidance of harm from errors
gives patients access to an entire team of experts

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3
Q

what are some examples of who’s in an MDT for a cancer patient?

A 
surgeon
physician
oncologist
specialist nurse
dietician
cancer information staff
clinical psychologists 
councillors
occupational therapist
radiographer
pharmacist
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4
Q

what are some treatments for cancer?

A 
chemotherapy
radiotherapy
hormone therapy
immunotherapy
stem cell transplant
surgery
targeted therapy
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5
Q

what is hormone therapy used to treat?

A

breast and prostate cancers

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6
Q

what is immunotherapy used to treat?

A

bladder, breast, cervical, colorectal. oesophageal, head and neck and leukaemia

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7
Q

what are some examples of immunotherapy?

A

monoclonal antibodies, oncolytic virus therapy, T cell therapy, cancer vaccines

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8
Q

how is chemotherapy given?

A

orally or intravenously in cycles

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9
Q

what is external beam radiation?

A

uses beams of radiation from a machine that focuses directly on the site of your tumor.

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10
Q

what is internal beam radiation?

A 
brachytherapy
uses radiation (either liquid or solid) that’s placed inside your body near where the tumor is.
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11
Q

what is systemic radiation?

A

This method involves radiation in pill or liquid form that’s either taken by mouth or injected into a vein.

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12
Q

what is concurrent therapy?

A

when chemo and radiation are given at the same time

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13
Q

when is concurrent therapy recommended?

A

if the cancer cannot be removed with surgery / Is likely to spread to other areas of your body / isn’t responding to one particular type of treatment

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14
Q

what is targeted therapy?

A

The protein or receptor is precisely targeted by the drug, so normal cells are not affected by the drugs.

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15
Q

what’s the impact of chemotherapy on the patient?

A

body image issues e.g. hair loss, skin and nail changes, scarring. loss/gain of weight, loss of body part
functional iddues e.g. infertility, earlymenopause, reduced sex drive, satigue, change in bowel/bladder works
emotional issues e.g. shock, denial, fear, sadness, avoidance, blame, guilt, anger
practical issues e.g. work travel, time in hopsital, seeing family

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16
Q

what are the main side effects of chemotherapy?

A 
fatigue
diarrhoea
nausea/vomiting
constipation
hair loss
anaemia
increased risk of infection
bruising and bleeding 
loss of appetite
mucositosis
skin and nail changes
memory and concentration issues
insomnia
loss of libido
fertility issues
17
Q

how can you attempt to avoid hair loss during chemo?

A

wearing a scalp cooking cap during the infusions to slow the blood flow to the scalp and therefore limit the amount of chemotherapy reaching the hair follicles

18
Q

what are some classes of chemotherapy drugs?

A 
alkylating agents
nitrosoureas
antimetabolites
anti-tumour antibiotics
anti-microtubule agents
topoisomerase inhibitors
mitotic inhibitors
19
Q

how do alkylating agents work

A

they bind covalently to DNA via their alkyl group whichprevents its replication.
workds in all phases of the cell cycle

20
Q

what are some examples of alkylating agents?

A

carboplatin
cisplatin
trabectadin

21
Q

what are nitrosoureas?

A

alkylating agents that can cross the blood-brain barrier so can treat brain tumours

22
Q

what are some examples of nitrosureas?

A

carmustine, lomustine

23
Q

how do antimetabolites work?

A

they act as substitites for normal building blocks for RNA/DNA which intereferes with replication
this is cell cycle dependant and only works in the S phase

24
Q

what are antimetabolites commonly used to treat?

A

leukaemias
breast cancers
ovary cancers
intestinal tract cancers

25
Q

what are some examples of anti-metabolites?

A

azacitidine
hydroxyurea
pentostatin

26
Q

how do anti-tumour antibiotics work?

A

by changing thr DNA within cancer cells to keep them from growing and multiplying e,g, anthracyclines

27
Q

what’s a major concern of anthracyclines?

A

they generate lots of free radicals which can permenantly damage the heart if given in high doses
this is why doctors set cumulative doses which are life time dose limits

28
Q

how do topoisomerase inhibitors work?

A

◦ plant alkaloids that interfere with topoisomerases which are enzymes that help separate the strands of DNA so they can be copied.

29
Q

what’s the function of topoisomerase?

A

enzymes that participate in the overwinding or underwinding of DNA.

30
Q

what’s the difference between topoisomerase 1 and 2?

A

Topoisomerase I cuts one strand in the double-stranded DNA and no ATP is required for its function. On the other hand Topoisomerase, II cuts both strands in DNA and needs ATP for its activity.

31
Q

what are topoisomerase inhibitors used to treat?

A 
leukaemia
lung cancer
ovarian cancer
GI cancer
colorectal cancer
pancreatic cancer
32
Q

what are camptothecins?

A

topoisomerase 1 inhibitors

33
Q

what are epipodophyllotoxins?

A

topoisomerase 2 inhibitors

34
Q

how do mitotic inhibitors work?

A

plant alkaloids which stop cells from dividing but can damage cells in all phases by keeping enzymes from making proteins needed for cell production.

35
Q

what are some commonly used mitotic inhibitors?

A

paclitaxel, docetaxel, vinblastine, vincristine, and vinorelbine

36
Q

what’s the usually chemotherapy drugs given for leukaemia?

A

ibrutinib or rituximab

37
Q

what are the 2 main functions of palliative care?

A

to relieve symptoms and offer respite

38
Q

what are the 3 stages of chemotherapy?

A

induction - to shrink cancer
consolidation - given once cancer remission is achieved
maintenance - given in lower doses to prolong remission for up to 2 years

B9W6 (7 decks)

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