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Phar 509 > Principles of Oncology > Flashcards

Principles of Oncology Flashcards

1
Q

What is cancer staging

A

Determining the extent of disease BEFORE ANY DEFINITIVE TREATMENT IS INITIATED

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2
Q

What information comes from staging cancer

A

Prognosis (overall survival), treatment selection, treatment evaluation, research and education

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3
Q

T/F: Stage 4 cancer patient do not get surgery because it does not influence overall outcomes

A

True

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4
Q

What is TMN classification

A

Tumore (T1-T4), Node (N1-N4), Metastasis (M+,M-)

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5
Q

How does the number of nodes effect the prognosis

A

More nodes are involved indicating a worse prognosis

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6
Q

What are the types of hematologic malignancies

A

Leukemia, lymphomas

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7
Q

T/F: Hematologic malignancies metastasis can be dangerous because they spread all over the body

A

False: Hematologic malignancies DO NOT have a PRIMARY tumor, therefore they CANT METASTASIZE

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8
Q

What are two common scales for performance of a patient

A

ECOG scale (mostly used in US) and Karnofsky scale (mostly used in Europe)

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9
Q

What are the five parameters of the ECOG scale

A

0: Fully active, able to carry on all pre-cancer activities without restriction
1: Restricted in physically strenuous activity but ambulatory and to carry light or sedentary work
2: Ambulatory and capable of all self-care but unable to carry out work activities (up during 50% of waking hours)
3: Capable of only limited self care, confined to bed or chair ( up during 50% of waking hours)
4: Completely disabled. Cannot carry on any self-care, totally confined to bed or chair
5: Death

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10
Q

What are the goals of cancer treatment

A

Cure, prolong survival, relieve symptoms

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11
Q

When the goal of therapy is to cure what measures should be take to secure this outcome

A

Discourage dose delays, dose reductions, assist with treatment decisions regarding toxicity management

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12
Q

When the goal of thereapy is non-curative what measures should be taken

A

Likely to hold, reduce dose and discontinue therapy, assists with treatment decisions regarding therapy selection (PROLONG SURVIVAL)

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13
Q

What is induction therapy

A

High-dose, combinatoin, INTENT of INDUCING COMPLETE REMISSION when initiating a curative regiment

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14
Q

What is consolidation therapy

A

REPETITION OF THE INDUCTION REGIMEN in a patient who has ACHIEVED A COMPLETE REMISSION AFTER INDUCTION, intention is to increase cure rate or prolong remission

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15
Q

Which tissue origin is associated with consolidation

A

Hematologic malignancies

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16
Q

What is maintenance therapy

A

Chemotherapy administered after primary therapy over a specified period of time in patients with remission of their disease to prevent relapse or a primary therapy to prevent progression of disease (must illicit a response to prolong the response)

17
Q

What is adjuvant therapy

A

Short course, high dose, combination chemo in a patient with no evidence of cancer after surgery or radiotherapy, given with the INTENT of DESTROYING a low number of RESIDUAL TUMOR CELLS

18
Q

What is neo-adjuvant therapy

A

Adjuvant chemo given in the pre-operative period (applies only to SOLID TUMORS)

19
Q

What is palliative therapy

A

Chemotherapy given to control symptoms or prolong life in a patien in whom a cure is unlikely

20
Q

How is the response to anticancer therapy measured, why

A

Response Evaluation Criteria in Solid Tumors (RECIST), response after initial treatment can often predict remission and survival

21
Q

What are the outcomes of RECIST

A

Cure: Entirely free of disease with same life expectancy of cancer-free individual
Stable Disease: Tumor size neither grows nor shrinks
Progressive Disease (failure): greater than a 20% increase over small sum observed or development of new lesion while receiving treatment

22
Q

T/F: A partial response is at least a 30% decrease in the sum of diameters of target lesions

A

True

23
Q

T/F: A complete response is complete disappearance of all target lesions and no evidence of new disease for greater than one month after treatment

A

True

24
Q

What is the equation for overall response

A

Complete response PLUS partial response (doesn’t always mean an increase in survival)

25
Q

What is the most important evaluation of chemotherapy

A

Overall survival

26
Q

What is progression free survival, what does it only apply to

A

Duration of time before patient progresses onto different therapy, only applies to metastatic disease

27
Q

What is disease free survival and what does it only apply to

A

Length of time after primary threat until patient survives, only applies to patient’s that were cured

28
Q

What does a waterfall plot tell

A

If there is a response to a drug and what type of response

29
Q

What does a swimmers plot tell you

A

when they had their response and how long was the response

30
Q

What is the universal language of chemotherapy toxicity, what are the two extremes of grading

A

Common toxicity criteria grading system (CTC)/ 0 = no response while 5 = fatal toxicity due to the drug

31
Q

What toxicity grades usually continue therapy and provide supportive care, which usually modify therapy

A

Toxicity grade 1-2, toxicity grade 3-4 (reduce dose or discontinue treatment)

32
Q

Which cancer treatment guidlelines update most often

A

Nation Comprehensive Cancer Network, (NCCN)

33
Q

What are the NCCN categories

A

Category 1: Based upon high-level evidence , uniform NCCN consensus that the intervention is appropriate

Category 2a: Based upon lower-evidence, theire is uniform NCCN consensus that the intervention is appropriate

Category 2B: Based upon lower evidence, there is NCCN consensus that the intervention is appropriate

Category 2: Regardless of any level of evidence, threis major NCCN disagreement that the intervention is appropriate

Phar 509 (22 decks)

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