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SBL > Strategies for Cancer Treatment > Flashcards

Strategies for Cancer Treatment Flashcards

1
Q

3 possible goals of cancer treatment?

A
  1. Cure
  2. Cure and prevent
  3. Palliate (relieve pain/symptoms)
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2
Q

Local cancer treatment options?

A
  • Surgery

- Radiation

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3
Q

ex. of cancers that can be cured with local treatment?

A

Sarcomas
Non-melanoma skin cancer
In situ carcinomas

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4
Q

Local cancer treatment options?

A
  • Surgery

- Radiation

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5
Q

Systemic treatment options?

A

Chemotherapy - cytotoxic, hormone, biologic

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6
Q

Adjuvant Therapy

A

Surgery -> Chemo and/or Radiation

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7
Q

With Adjuvant Therapy, what provides cytoreduction?

A

Surgery

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8
Q

Neoadjuvant Therapy

A

Chemo and/or Radiation -> Surgery -> Chemo and/or Radiation

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9
Q

With Neoadjuvant Therapy, surgery is not ______ uprfront

A

NOT as effective upfront

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10
Q

With Neoadjuvant Therapy, what provides cytoreduction?

A

Initial chemo and/or radiation

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11
Q

What will shrinking the tumor prior to surgery do with Neoadjuvant Therapy?

A

Makes the surgery more effective and safe

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12
Q

What are 3 reasons that surgery/local treatment would be contraindicated?

A
  • Metastatic disease
  • Leukemia/Lymphoma
  • Systemic therapy is so effective that surgery is unnecessary
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13
Q

3 types of Radiation Therapy?

A

External Beam Radiation
Brachytherapy
Systemic Radionucleotides

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14
Q

Linear accelerator delivering direct radiation beams to affected sites

A

External Beam Radiation Therapy

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15
Q

Very localized high dose therapy delivered continuously for a prolonged time through an implanted device

A

Brachytherapy

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16
Q

When is Brachytherapy usually used?

A

Prostate cancer

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17
Q

Describe how Systemic Radionucleotides can treat Thyroid cancer

A
  • Ingestion of radioactive Iodine
  • Iodine absorbed into blood stream and into thyroid cells
  • Radiation kills cancerous and normal thyroid cells
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18
Q

When should you use radiation therapy?

A
  • When surgery is contraindicated

- To palliate masses that are compressing structures

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19
Q

2 main types of Systemic Treatment?

A

Conventional Cytotoxic Chemotherapy

Targeted agents - hormonal/biologic

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20
Q

Why is Conventional cytotoxic chemotherapy harmful?

A

It does NOT discriminate between healthy and malignant cells

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21
Q

Describe CAR-T Therapy

A
  • T cells are manipulated ex vivo to express a binding domain for a tumor antigen
  • This includes transmembrane and intracellular domains
    = Intensifies immune attack against tumor cells
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22
Q

What is an indication for a Stem Cell Transplantation?

A

When the therapy involves ablation of bone marrow

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23
Q

Allogeneic, Syngeneic and Autologous stem cell transplant types

A 
Allogeneic = someone else
Syngeneic = identical twin
Autologous = from self
24
Q

4 screening options for ovarian cancer?

A
  • Physical exam
  • CA-125
  • Transvaginal ultrasound (TVUS)
  • Multimodal (CA-124 + TVUS)
25
Q

Are the screening options for ovarian cancer effective?

A

NOOOOO

26
Q

CA-125 is not specific for?

A

Malignant ovarian tumors

27
Q

Why is a transvaginal ultrasound not great for detecting ovarian cancer?

A

Observer dependent

28
Q

This screening option showed no improvement in mortality from ovarian cancer and had many false (+)s that lead to unneeded interventions

A

Multimodal (CA-125 + TVUS)

29
Q

High risk patients for ovarian cancer can?

A

Remove distal fallopian tubes

30
Q

What exam is such low sensitivity and specificity that it is losing relevance for prostate cancer?

A

Digital Rectal Exam

31
Q

What is the main screening option for prostate cancer?

A

Prostate Specific Antigen (PSA)

32
Q

PSA has a ______

A

High false (+) rate

33
Q

Between what ages may PSA benefit a small number of patients and past what age does it show NO benefits?

A

55-69 = may benefit a small # of patients

> 70 = NO benefits

34
Q

What 2 things have decreased the incidence of cervical cancer?

A

Screenings and HPV vaccination

35
Q

Between what ages are pap smears suggested?

A

21-65

36
Q

_____ are excellent at detecting pre-malignant and malignant cells

A

Pap smears

37
Q

Recommendations for PAP or PAP + HPV testing if results are good

A

PAP - every 3 years

PAP + HPV - every 5 years

38
Q

Only thing to look for with Endometrial cancer?

A

Women at menopause with vaginal bleeding

39
Q

Women at menopause with vaginal bleeding could indicate?

A

Endometrial cancer

40
Q

What is the Gold standard for detecting breast cancer?

A

Mammography

41
Q

Mammography guidelines change with each organization, however there is a push to wait until when to have a mammogram unless you’re high risk?

A

6th decade of life

42
Q

In resource rich settings, clinical and self breast exams are not recommended, however if you do them what should you do?

A

Do them every month

  • Look for skin changes
  • Check axilla
43
Q

Options for those that are BRCA-1/2 Positive?

A

Double mastectomy
Chemoprevention hormone medications
Increased screening

44
Q

To do BRCA-1/2 genetic testing, what types of things must be in your family history?

A
  • Multiple, young relatives affected with breast/ovarian cancer
  • Possibly a male affected
  • Personal diagnosis before age 45
45
Q

Annual stool sample tests for colon cancer?

A
  1. Guaiac-based fecal occult blood test
    - 3 stool samples; not as sensitive
  2. Fecal immunochemical test
    - single stool sample
46
Q

What is the most sensitive stool sample test for colon cancer?

A

Fecal DNA test

- higher false (+) though

47
Q

How often can you perform Fecal DNA tests?

A

Every 1-3 years

48
Q

CT colonography is performed how often?

A

Every 5 years

49
Q

What does a CT colonography require?

A

Bowel prep but NO sedation

50
Q

How often can you perform Colonoscopys?

A

Every 10 years

51
Q

What does a Colonoscopy require?

A

Bowel prep and sedation - most invasive

52
Q

What is a good thing about performing a colonoscopy?

A

You can perform a biopsy during the procedure if necessary

53
Q

What is the best prevention for lung cancer?

A

Smoking cessation

54
Q

What test can you order for lung cancer screening and how often?

A

Low-dose CT annually

55
Q

Who should get a low-dose CT annually for lung cancer screening?

A
  • Those between the ages of 50-80 with:
    • 20 year pack history
    • Actively smoke
    • Have quit in the last 15 years

SBL (48 decks)

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