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Skin Lymph Blood Exam 2 > Strategies Of Cancer Treatment And Prevention - Dr. Pence > Flashcards

Strategies Of Cancer Treatment And Prevention - Dr. Pence Flashcards

1
Q

Radiofrequency therapy

A

Small microwaves to target a cancer usually in liver lesions

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2
Q

Future of chemotherapy involves

A

Biological approach targeting a specific cell receptor and cell

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3
Q

Adjuvant therapy is what

A
  1. Cytoreduction : remove tumor

2. Then do radiation and chemo therapy

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4
Q

Neoadjunctive therapy

A

Usually for large tumors, like lung cancer
1. Chemo and radiation to reduce size
2. Surgically remove more of the tumor
3, chemo and radiation again / hormone systemic therapy

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5
Q

External Beam radiation

A

Linear accelerator delivering direct radiation beams to the affected site on the body

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6
Q

IMRT

A

Intensity Modulated Radiation Therapy : get CT image of brain and then you get a very localized picture of what to hit with radiation
Cyberknife is similar to this

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7
Q

Brachytherapy

A

Very localized high dose continuously to site
= implant radiation devices into the tissue (usually into prostate) which continually kills off the tumor cells
= so you don’t have to surgically remove anything

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8
Q

Systemic radiation

A 
Systemic radionucleotides are injected of I 131 (iodine) which the thyroid takes in readily and this Iodine is radioactive and kills the cells in the thyroid 
Pretty effective (pt should be isolated as well as all their utensils and bodily fluids)
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9
Q

Palliative care to pt with massive tumor

A

Give radiation to shrink the mass for example lung, throat, ENT, spinal cord compression, pelvic sidewall pain

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10
Q

Conventional cytotoxic chemotherapy

A

You basically kill all cells

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11
Q

Biological chemotherapy

A

Uses target agents :
H or tumor mediated (targeting the tumor cells themselves), immuno-regulatory mediated (trigger immune system to attack the tumor), AB-conjugate (give cytotoxic drug that has the Ab to attach to a specific cell type)

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12
Q

Theraputic window

A

TI = TD50 / ED50
Toxic dose over effective dose
SAFEST DRUG = high toxic dose and low effective does = longer theraputic window

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13
Q

TI of cytotoxic therapy and how to work with this

A

Low TI
Hit them with just enough and then let the normal cells recover (cancer cells take longer to recover) and then hit them again until cancer cells are no longer there

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14
Q

How to list the TX regime of a patient receiving cytotoxic chemotherapy

A 
R-CHOP
R : Rituximab 
C : Cyclophosphamide 
H : Hydroxydaunorubicin
O : Oncovin (vincristine)
P : Prednisone
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15
Q

Side effect of Rituximab (BOARDS)

A

Cytopenia , hypersensitivity

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16
Q

Side effect for Cyclophosphamide

A

Alopacia + HEMORRHAGIC CYSTITIS

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17
Q

Side effect of Hydroxydaunorubicin BOARDS

A

Cardiotoxicity ** NEED TO CHECK ECHO CARDIOGRAM BEFORE DURNG AND AFTER

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18
Q

Side effects oncovin

A

Alopecia, neuro toxic, weakness

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19
Q

Prednisone side effects

A

Increased appetite, insomnia, anxiety , HTN, hyperglycemia

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20
Q

Cycle of giving chemotherapy (R-CHOP)

A 
21 days (5 days of chemo + 16 days of recovery) for 6 cycles 
****cytopenia usually happens day 8 or 9 , neutropenic fever
21
Q

Immune checkpoint inhibitors

A

PD-1 and CTLA on tumor cells (inhibits T-cells from killing tumor cells) , so you add inhibitor of this marker and then it cant signal anything to t-cells and get killed

22
Q

CAR-T therapy

A
  1. Take T-cells and expose them to retrovirus
  2. T-cells make CARs or receptors on surface that signal to kill the tumor cells
    80% get Cytokine storm (only approved for ALL at this time) (TX cytokine storm with IL-6 inhibitor Tusalibsomab)
23
Q

Allogenic stem cell transplant

A

From another person (G vs H can happen)

BM transplant is important for patients who are undergoing chemotherapy

24
Q

Synergetic

A

Transplant from identical twin

25
Q

Autologous

A

From yourself (risk of cancer coming back)

26
Q

how I need to stay up to date on therapies no recommendations

A

USPSTF (US preventative service task force)*

ACS (American cancer society)

27
Q

Which grades do I use a specific therapy to a patient

A

Grade A : high benefits over risks
Grade B : recommended still, moderate benefic over risks
Grade C : based on patient and need to be discussed the risks and benefits
We dont do any grade D or I

28
Q

Ovarian Cancer general facts about this

A

5th leading cause of women death (14,000 per year)

95% over age 45yo (20% not at early stage) - not good screening

29
Q

Screening for over ovarian cancer

How good are they

A
  1. Physical exam (not good)
  2. CA-125 : not good since not all cancer cells emit this
  3. Transvaginal US (TVUS) : not good and very hard to see early
  4. Multimodal (CA-125, TVUS) : NOT GOOD (10% false +)
30
Q

Who should have more screening and heightened awareness of pelvic pain as a sign of ovarian cancer

A

Pt with BRCA or Lynch syndrome (high risk, Family history)

31
Q

Prostate cancer general facts

A

25% of men get this
80yo median time of death from this (2.5% chance)
Most men die from something else

32
Q

Screening for prostate cancer and how good is it

A
  1. PSA (Prostate Specific Ag) : HIGH FALSE+ 60% not good, can show + if inflammation or benign processes
  2. DRE (Digital rectal exam) : 50% sensitivity only so not good
33
Q

PSA is what grade

A

GradeC : need to talk to pt and if over 55yo-69yo and for high risk and good reasons only
GradeD : if pt is over 70yo

34
Q

Cervical Cancer facts

A

Has decreased a lot due to screening

35
Q

Cervical cancer screening

A
  1. Pap smear
  2. HPV Testing
  3. Co-Testing (PAP and HPV)
36
Q

Pap smear should be done when and how

A

At age 21yo start and every 3 years
Stop at age 65yo (grade D)
If you have the HPV test + over 30yo (every 5 years)
GRADE A

37
Q

Tx if Pap smear shows cervical cancer

A

Local excision

Cryoblation (before any spread)

38
Q

Endometrial cancer screening is what

A

Council post-menopausal women that bleeding of any kind is not normal report any vaginal bleeding

39
Q

Breast cancer facts

A

2nd cause of cancer death behind lung cancer

40
Q

Breast Cancer screening and how good are they

A

Self breast exam
Clinical breast exam
Mammography : gold standard
ALL ARE GOOD however the first 2 are lower grade

41
Q

Mammogram should be done when and grade

A

50yo-74yo
To eliminate false +
GRADE B

42
Q

Self breast exam

A 
Check axilla 
Look for skin changes
Avoid during or right before period 
Start at early age 1 time a month 
Top and bottom, semi-circle, circular motions of pads of fingers
43
Q

BRCA-1 and BRCA-2 genetic testing guidelines

A

If there is family history of this you should screen for this

44
Q

BRCA + TX brief overview

A

Prophylactic surgery (remove breasts)
Bilateral salpingo-oophorectomy
E lowering chemotherapy

45
Q

Colon Cancer facts

A

3rd eading cause of death most common in 65yo-74yo

10% before 50yo

46
Q

Colon cancer screening and how good are they

A
  1. Guaiac-based fecal blood test
  2. Fecal immunochemical test
  3. Fecal DNA
  4. CT Colonography
  5. Colonoscopy : GOLD STANDARD
47
Q

Colonoscopy

A

Age 50yo-75yo
GRADE A
45yo-49yo GRADE B

48
Q

Lung cancer

A

200,00 people a year get this
150,000 deaths per year
Prevent this form smoking

49
Q

Lung cancer screening

A

Low-Dose CT scan annually
- for people who actively smoke + 20 pack-year smoking
- for people who smoked and quit less then 15yo ago
GRADE B

Skin Lymph Blood Exam 2 (9 decks)

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