principles of oncology 2

Question 1

combination chemo

Answer 1

1964 Rosen
MOPP in Hodgkins disease
Mustine:emetic, myelosupression, carcinogenic
Oncovin (vincristine): neurpathy
Procarbazine: hepatotoxic
Prednisolone: steroid
Cyclical combination of agents with different mechanisms and non-overlapping toxicities

Question 2

neutropenia

Answer 2

Definition < 1.0 x 109/li neutrophils
Risk of sepsis related to depth and duration of neutropenia
Neutropenic sepsis :Temperature > 38C and neuts < 1.0
Immediate admission, blood cultures, iv fluids and empirical i.v. antibiotics: e.g.Cefuroxime and gentamicin

Question 3

chemo toxicities

Answer 3

General toxicities
Myelosuppresion
Nausea and vomiting
Alopecia
Mucositis
Infertility
Fatigue
Loss of appetite
Diarrhoea

Specific toxicities
Cardiac doxorubicin
Neuropathic vincristine, cisplatin, taxol
Nephrotoxic cisplatin
Urotoxic cyclophosphamide
Pulmonary bleomycin

Question 4

hormone sensitive cancers

Answer 4

Breast cancer: deprive tumour of estrogen drive
Tamoxifen; ovarian removal; aromatase inhibition
Prostate cancer: testosterone drive
Orchidectomy; LHRH agonists; anti-androgens