Therapeutic Options

Question 1

What food is bowel cancer associated with?

Answer 1

Red meat

Question 2

Prevention - genetics

Answer 2

Autosomal dominant
Screen families for APC mutations
Regular colonoscopy
Offer panprotocolectomy when adenomas found

Question 3

Panprotocolectomy

Answer 3

Take out all of large bowel and rectum
Permanent stoma
At 30
Prevents cancer

Question 4

Chemo prevention

Answer 4

Oesophageal cancer - china and Iran
Supplement diet with anti-oxidants

Breast cancer - prophylactic tamoxifen

Lung cancer - anti-oxidants

Question 5

Local/ regional treatments

Answer 5

Surgery
Radiotherapy
Ablation (freezing, radio frequency)
Limb perfusion

Question 6

Systemic treatments

Answer 6

Hormonal therapy
Chemotherapy
Immunotherapy
Whole body irradiation

Question 7

Stromal environment

Answer 7

Areas in which tumour sits

Question 8

What can radiotherapy do?

Answer 8

Can treat inoperable lesions

Can make surgery become possible

Question 9

5 r’s of radiobiology

Answer 9

Radiosensitivity
Repair
Re-population
Re-oxygenation
Re-assortment

Question 10

What % of cancers can be cured by radiotherapy?

Answer 10

40%

Question 11

Radiotherapy % chemotherapy combination

Answer 11

Anal cancer, rectal cancer, oesophageal cancer

Question 12

Palliation

Answer 12

Making disease less severe without removing cause

Question 13

Cytotoxic drugs

Answer 13

Curative
Palliative
Adjuvant - preventing in future
Neoadjuvant - treatment before surgery to shrink problem.

Question 14

Immune therapies

Answer 14

Innate - macrophages/ NK cells
Monoclonal antibodies
Programmed cell-death pathway
CAR T-cell therapy

Question 15

CAR T-cells (chimeric antigen receptor)

Answer 15

Artificial T-cell receptors, targeting specific cancer cells

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