Therapeutic options Flashcards

1
Q

what are cancer prevention options? (4)

A
  1. diet
  2. screening
  3. genetics
  4. medication
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2
Q

what are cancer treatment options? (3)

A
  1. surgery
  2. radiotherapy
  3. systemic therapy
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3
Q

what 2 diet choices have links with what cancers?

A
  1. red meat consumption; associated with colorectal (bowel) cancer
  2. saturated fat intake; associated with breast cancer
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4
Q

what is the current advice on diet which affect hormonal balance in the body? (3)

A
  • 5 a day
  • at least 30 mins of exercise a day
  • avoid obesity
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5
Q

what are the 3 main screening options?

A
  1. cervical cancer: smear tests
  2. CRC: faecal occult blood test
  3. breast cancer: mammography
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6
Q

what are the more controversial screening tests which aren’t available readily?

A
  1. prostate cancer (PSA blood test)

2. lung cancer ( MR/CT scanning and breath test)

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7
Q

what are 2 of the most common genetically inherited cancers?

A
  1. breast cancers (BRCA1 and BRCA2)

2. CRC (colorectal cancer) and FAP (familial adenomatous polyposis coli)

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8
Q

what 3 measures can be taken for people who have the autosomal dominant CRC or FAP conditions?

A
  1. screen families for APC mutations
  2. regular colonoscopy
  3. offer panprotocolectomy when adenomas found
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9
Q

what are some of the more controversial cancers which use chemo-prevention

A
  1. oesophageal cancer
  2. breast cancer
  3. lung cancer
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10
Q

what are 4 types of local/ regional treatment for cancer?

A
  1. surgery
  2. radiotherapy
  3. ablation (freezing, radi-frequency, etc)
  4. isolated limb perfusion
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11
Q

what are 4 types of systemic treatment for cancer?

A
  1. hormonal therapy
  2. chemotherapy
  3. immunotherapy
  4. whole body irradiation
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12
Q

what 2 factors does cancer staging depend on?

A
  1. where is cancer

2. what kind of cancer

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13
Q

How can the location if the cancer be detected? (2)

A
  1. examination/ palpation

2. use of radiology/ imaging (CT, MRI, USS, PET etc)

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14
Q

how can the kind/ type of cancer be detected?

A

through pathology/cytology

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15
Q

what does surgery mean in terms of how much cancer is cleared?

A

Surgery needs anatomical clearance (ALL of cancer is taken out)

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16
Q

what can radiotherapy allow doctors to do? (3)

A
  1. needs anatomical coverage
  2. can treat inoperable lesions
  3. can make surgery become possible
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17
Q

What are the 5Rs of radiobiology?

A
  1. radiosensitivity (of tumour)
  2. repair
  3. re-population (growth)
  4. re-oxygenation
  5. re-assortment
18
Q

does radiotherapy provide more or less oxygen to the tumour?

A

More oxygen

19
Q

in what cell cycle phase will most cell be in?

20
Q

what does re-assortment mean in terms of cells in radiography?

A

when cells have dividing chromosomes, it makes them more sensitive to radiation

21
Q

What are the 3 main reasons why radiotherapy is given?

A
  1. to cure cancer (e.g.~40% of head/neck, cervix/uterus, skin and lymphoma cancers)
  2. to combine with chemotherapy (e.g. anal, rectal, oesophageal cancers)
  3. important in palliation (pain relief, bleeding, swollen limbs)
22
Q

why is systemic treatment both good and bad?

A
  • good and beneficial for widespread

- bad as can result in widespread toxicity

23
Q

what is the main treatment method to palliate patients? (easing pain)

A

chemotherapy

24
Q

In the therapeutic index curves used by oncologists, how do they want to keep the curves on the graph?

A

As far away from each other as possible

25
What does no overlap in the therapeutic index curve mean?
it means everyone is being cured and no one is hurt or suffering from side effects (drug is 100% beneficial)
26
what are the 4 indications for the use of cytotoxic drugs?
1. curative 2. palliative 3. adjuvant (even if patholgoy tells us otherwise, the risk of growth population is reduced) 4. neoadjuvant (people treated before surgery)
27
what 2 cancers have the best outcomes for chemotherapy?
testicular cancer and lymphomas
28
chemotherapy can be used in combination with radiotherapy to produce good results in what cancer?
anal cancer
29
what is adjuvant chemotherapy?
- increasing amount of chemotherapy use - follows surgery (e.g. colon or breast) - improves survival (the aim)
30
what are the 2 decisions which need to be considered in adjuvant chemotherapy?
1. toxicity vs benefit | 2. cost vs benefit
31
what is palliative chemotherapy?
- aims to alleviate pain/relieve symptoms (e.g. lung, breast, CRC) - accounts for 50% of chemotherapy use - sometimes used when surgery would do more harm to patient
32
what 2 genes does colorectal cancer have (tumour biomarkers)?
1. KRAS 2. BRAF (interact together)
33
what is neoadjuvant chemotherapy?
- more recent use of chemotherapy - PREcedes surgery or radiotherapy - aims to increase survival and reduce morbidity - often used for breast and oesophagus cancers
34
what is hormone therapy
specific and targeted therapy for specific cancers
35
which 2 cancers often used hormone therapy?
breast (tamoxifen) and prostate (LHRH antagonists)
36
Synthesis of specific antibodies can be created if they don't exist naturally, for which conditions?
1. cancers 2. rheumatology (arthritis) 3. colitis
37
what are the 3 specific immune therapies?
1. monoclonal antibodies 2. programmed cell death pathway (uses immune system to attack foreign cancer cells) 3. chemeric antigen receptor (CAR) T cells (artificial T cell receptors using retroviral vectors to give a specific cell killing function against cancer cells)
38
what is the main problem with new treatment methods of using T cells to detect cancers?
markers on T cells can unmask other antigens in other body sites
39
what are designer therapies targeting in cells?
Intracellular growth control points
40
Improvements in what 4 areas will lead to better therapeutic options?
1. surgical techniques 2. radiotherapy 3. systemic treatment 4. immunotherapies