Pink - Oncology Flashcards by Chloe Brown

What is the most common type of tumor induced post-radiation

Leukemia

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What is the most sensitive test for bone metastases

Radioactive Tc methylene-dy-pyrophosphate scan (MDPP)

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Where does neuroblastoma arise from?

Sympathetic nervous system

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What are the most common cancers in men?

Prostate
Lung
Colorectal
Bladder
NHL

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What are the most common cancers in women?

Breast
Lung
Colorectal
Uterine
NHL

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What cancers have the highest mortality?

Lung
Colorectal
Breast
Prostate
Pancreas

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What cancers have the highest mortality in men?

Lung
Prostate
Colorectal
Pancreas
NHL

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What cancers have the highest mortality in women?

Lung
Breast
Colorectal
Pancreas
Ovarian

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What is Gompertzian growth?

Rate of exponential growth that is also simultaneously, exponentially decreasing with time

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What can produce the systemic manifestations of malignant disease?

Ectopic hormones (SIADH)
Hormone-like peptides
Autoimmune phenomena
Tumor toxicity

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What are the classifications of chemotherapy drugs?

Alkylating
Antimetabolites
Antitumor antibiotics
plant alkyloids

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What are alkylating agents?

Chlorambucil
Cyclophosphamide
Ifosfamide
Melphalan
Thiotepa
Carboplatin
Cisplatin

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How do alkylating agents work?

Produce alkylation through formation of intermediates: primary mode = cross link the DNA
Cell cycle specific but phase specific
Resistance related capacity of cells to repair damage and to inactivate the drugs by conjugation with glutathione

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What are antimetabolites?

Cytarbine
Methotrexate
Mercaptopurine
Hydroxyurea
5-FU
Fludarbine

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How do antimetabolites works?

Interferes with building blocks of DNA synthesis
Major effect in S phase
Most effective when cell proliferation rapid
After a certain dose, no more cells are killed
:length of time exposed to drug is proportional to cell killing potential

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What are antitumor antibiotics?

Bleomycin
Mitomycin C
Mithramycin
Doxorubicin (Adriamycin)

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How do anti tumour antibiotics work?

Variety of mechanisms
Cell cycle non-specific
Especially useful for slow growing tumour

What are some plant alkyloids?

Vincristine
Vinblastine
Paclitaxel
Etoposide

How do plant alkyloids work?

Either topoisomerase or mitotic spindle inhibitors

What are the chemotherapeutic agents who primary dose limiting toxicity is not myelosuppresion?

Cisplatin
Bleomycin
Vincristine
Adriamycin/doxirubicin
Cyclophosphamide/Ifosfamide

What is the dose limiting toxicity of cisplatin?

Cumulative renal insufficiency
Peripheral sensory neuropathy
Tinnitus
High frequency hearing loss

What is the dose limiting toxicity of bleomycin?

Shaking
Chills
Febrile reactions
Pneumonitis

What is the dose limiting toxicity of vincristine?

Peripheral neuropathy

What is the dose limiting toxicity of doxirubicin?

Cardiomyopathy

What is the dose limiting toxicity of cyclophosphamide?

Hemorrhagic cystitis

How does radiation therapy target cancer cells?

- G2 arrest = most common - G1 and S phase delay - Cells are most sensitive during early S and mitosis when DNA are maximally uncoiled

How do the units of Gy, RAD, and J/kg relate?

Gy = 100 RAD = 1 J/kg tissue

What are sensitizers of radiation?

- Oxygen - Hypoxic cell sensitizers - DNA incorporating agents - Heat - Chemotherapeutics: hydroxyurea, 5-FU, platinum, gemcitabine

When do early reactions to radiation therapy occur?

- During or immediately following treatment | - May last for a few weeks?

What factors are important in determining early reactions to RT?

- Daily fraction size | - Time between factors

What are the acute effects of RT on normal tissue?

- Systemic: lethargy, fatigue - Skin: erythema, dry pruritus, moist desquamation, hair loss - Liver: radiation hepatitis - Oral mucous membranes: mucositis - Esophagus: esophagitis - Lung: radiation pneumonitis - Heart: acute pericarditis, myocarditis - Small bowel: cramping, diarrhea, N/V - Bladder: frequency, urgency, dysuria - Reproductive: sterility - Rectum: tenesmus - Hematopoietic: cytopenia - Nervous system: parenthesis, cerebral edema, conjunctivitis - MSK: cessation of epiphyseal growth

What are dose-limiting effects of RT?

- Necrosis - Fibrosis - Ulceration

How do late reactions from RT result?

- Vascular damage | - Accumulation of cell dropout from organ population

When do late reactions from RT occur?

- Months to years afterwards | - Often progressive

What is the most common source of bone metastases?

Lung cancer

What is the most common lung cancer histology?

Adenocarcinoma

What is the most common intracranial neoplasm?

Astrocytoma = 60%

How is astrocytoma treated?

- Debulking resection | - Radiation

What are the most common mediastinal masses?

- Neurogenic tumor - Thymoma - All cysts combined - Lymphoma - Germ cell neoplasm - Cysts taken individually

What type of tumour are most responsible for brain metastases?

- Lung (35%) - Breast (25%) - Kidney (10%) - Testes (10%) - GI (10%) - Malignant melanoma (10%)

What are the hyper vascular tumors?

CRIMP - Carcinoid - RCC - Insulinoma - Melanoma - Pheochromocytoma

What are the most common cancers?

- Lung - Breast - Colorectal - Prostate - NHL