(PM3B) Cancer Treatment Flashcards
What are the key aims of cancer treatment? List them in order of priority.
(1) Cure cancer
(2) Remission + mitigation – significant reduction in tumour size
(3) Symptomatic/ palliation – treatment of secondary complications + relief of symptoms
(4) Terminal care – improve quality of life + optimisation of symptom control
What is the likelihood of curing a systemic cancer?
Depends on the type
Leukaemias are not solid tumours – can be highly sensitive to chemotherapy drugs
What is palliation?
When cure is no longer possible
What is the average life expectancy prolongation of solid tumours using current therapy?
2-18 months
What is the average life expectancy prolongation of some leukaemias and lymphomas?
5-8 years
What is the primary treatment of tumours?
Surgery – excision of primary tumour
For which cancers is bone marrow transplantation appropriate?
Some leukaemias
What are some common treatments available for cancer therapy?
(1) Surgery
(2) Bone marrow transplantation
(3) Radiotherapy
(4) Drugs –chemotherapy/ hormone therapy/ immunotherapy
Which factors decide the appropriate treatment to use for cancer?
(1) Empirical clinical evidence
(2) Practical considerations
What are some potential reasons for choosing surgery as a treatment for cancer?
(1) Well-defined solid tumour
(2) Non-vital regions
(3) Non-mutilating results
(4) Resection/ reconstruction possible
Why may radiotherapy be selected for treatment of cancer?
(1) Diffuse but localised tumour
(2) Vital region/ organ
(3) Adjuvant therapy
(4) Palliation – reducing symptoms
What are some potential reasons for selecting chemotherapy as a treatment for cancer?
(1) Adjuvant therapy
(2) Neo-adjuvant therapy (prior to surgery)
(3) Widely disseminated/ metastasised
(4) Diffuse tumour
(5) Palliation – reducing symptoms
(6) Some primary tumours (e.g. Hodgkin’s lymphoma)
How do chemotherapeutic agents work?
Kill cells that are rapidly dividing
NOT tumour specific
affect hair follicles + gastrointestinal mucosa
What is radiotherapy?
Sending x-rays into the body
Ionisation of certain cells within the body
Why is chemotherapy used?
Most commonly used to treat advanced cancer
Trying to reduce volume of the tumour
What is a downside of chemotherapy, relating to tumour progression?
By the time a tumour is observable
Their growth has slowed
Less susceptible to chemotherapy
Why are a combination of chemotherapy drugs often given in treatment?
To achieve a high therapeutic effect
With minimal overlap of toxicity
What type of chemotherapy drugs are preferable?
(1) Drugs with known synergistic killing effects
- e.g. platinum drugs + 6-fluorouracil
(2) Combination of drugs that kill cancer at different stages of the cell cycle
Which stage of the cell cycle do microtubule inhibitors act on?
GAP 2 (G2) Phase
Which stage of the cell cycle do antimetabolites act on?
GAP 1 (G1) Phase
What are some of the side effects of cytotoxic chemotherapy?
(1) Myelosuppression – rapid falls in peripheral blood count
(2) GIT + Bladder – erosion/ ulceration
(3) Fertility – spermatogenesis is inhibited
(4) Teratogenic activity –during organogenesis
(5) Hair loss
(6) Genetic damage – heritable defects may be caused if DNA of ova/ spermatazoa are mutated
(7) Carcinogenesis – as well as curing cancer, can also cause cancer (same as radiotherapy)
(8) Nausea + vomiting – direct stimulation of the chemoreceptor trigger zone
What are some ways that side effects of chemotherapy may be managed?
(1) Anti-emetics
(2) Full blood counts
(3) Enhancement of bone marrow proliferation
(4) Forced diuresis – slight over hydration followed by a diuretic to increase urinary output
How can myelosuppresion in chemotherapy be minimised?
(1) Blood transfusions
(2) Growth factors
(3) Timing of doses
(4) Careful monitoring
(5) Isolation in sterile environment
How may nausea and vomiting as a result of chemotherapy be minimised?
Antiemetics
What is a complete response to cancer treatment?
Complete disappearance of all signs of disease
What is a partial response to cancer treatment?
More than 50% reduction
What is considered a stable disease in cancer?
Less than a 50% reduction
Less than a 25% increase
What is considered progressive cancer?
Increase of tumour size by at least 25%
