SG Cancer Flashcards
Clear cell renal carcinoma, grade 2 (no mets). At this time, the next step of care is to:
Repeat physical exam + scan in 4-6 months - option makes sense if discovery of tumor was incidental finding
And/or nephrectomy
What genetic disease is correlated with clear cell renal carcinoma?
VHL
What are your 3 options for a solitary renal lesion?
Nephrectomy
Cryoablation: freeze thaw cycles
Observation
CT shows metastatic renal cancer consistent with pt’s original primary tumor. Next step is:
PO sunitinib (tyrosine kinase inhibitor)
What are the 5 treatment options for advanced renal cell cancer
- Immunotherapy: IL2, IFN
- Monoclonal Abs: bevacizumab
- TK inhibitors: sunitinib, etc
- mTOR inhibitors: temsirolimus
- Nephrectomy
IL 2 toxicities
LOOKS LIKE SEPSIS (admit to MICU for dosing) Capillary leak Hypotension, tachycardia, vol depletion Arrhythmia Renal + hepatic failure Electrolyte changes AMS
What type of monoclonal Ab is bevacizumab?
VEGF inhibitor - endothelial growth factor
Bevacizumab toxicities
BLEEDING RISK b/c impaired wound healing - no surgery
- C/I w/ active hemoptysis, brain mets, on anticoag
HTN
Proteinuria
How do TK inhibitors work for renal cell carcinoma?
Inhibit proliferation and angiogenesis
TK inhibitors toxicities
FATIGUE
N/V/D
Hand-foot syndrome
HTN
Mechanism mTOR inhibitors
+ regulator of hypoxia-inducible factor dependent gene transcription
What worries you about treating bladder cancer?
High recurrance
What is the strongest risk factor for developing bladder cancer?
SMOKING
What is BCG? What does it treat?
Bacillus Calmette Guerin - live attenuated mycobacterium bovis
Treat bladder cancer
Inject into the bladder directly to trigger the immune system to fight the cancer
BCG toxicities
Cystitis, freq, huematuria
Fever, infection (systemic immune activation)
C/I in pts on statins
