Therapeutic options

Question 1

What are the two therapeutic routes for cancer?

Answer 1

Prevention

Treatment

Question 2

What are the main types of prevention therapies?

Answer 2

Education about environment/behaviour/diet

Screening

Genetics (looking for pre-disposed patients)

Medication/vaccination

Question 3

Describe the purpose of staging, in cancer therapy.

Answer 3

To find out where a cancer is, and what kind of cancer it is

Question 4

What is chemo-prevention?

Answer 4

Chemoprevention is the use of chemotherapy to lower the risk or prevent cancer in healthy people

It is preventative, and can be used for treatment of high risk patients, or patients who have had previous cancers

Question 5

For what specific cancers, is chemo-prevention used for?

Answer 5

Oesophageal cancer: supplemented diet of anti-oxidants

Breast cancer:
tamoxifen for high risk patients

Also given to patients who have had H&N or lung cancer

Question 6

What are the types of local/regional treatment?

Answer 6

Surgery
Radiotherapy

Ablation
Isolated limb perfusion

Question 7

Why is radiotherapy used for treatment instead of surgery?

Answer 7

For treatment of inoperable lesions

Can sometimes make surgery possible

Treated area can maintain function and appearance. This can sometimes make surgery un-suitable.

Question 8

Describe how a cell’s progress through the cell cycle affects how easily they can be damaged by radiation

Answer 8

Cells in mitosis (dividing) are most sensitive to DNA damaging agents

Cells are most resistant during late S phase

Question 9

Describe the different uses of radiotherapy

Answer 9

Curative - by itself

Curative - in combination with chemo-therapy

Palliative treatment

Question 10

What are the different types of systemic treatment?

Answer 10

Immunotherapy

Chemotherapy

Hormonal therapy

Targeted treatment

Whole body irradiation (only in bone marrow transplants - BMT)

Question 11

Give an example of hormonal therapy

Answer 11

Tamoxifen to treat ER +ve breast cancer

Question 12

Describe what targeted treatment is, and give an example of when it is used

Answer 12

Used to target tumour mutations

EGFR mutations and TKI agents

Question 13

Cytotoxic drugs are used in therapy, and can be given for 4 reasons.

What are these?

(4 types of cytotoxic drug treatments)

Answer 13

Curative

Palliative

Adjuvant

Neoadjuvant

Question 14

What does adjuvant therapy mean?

Answer 14

Cytotoxic drugs given after treatment to suppress secondary tumour formation

Question 15

What does neoadjuvant therapy mean?

Answer 15

Administration of cytotoxic drug before main treatment (surgery etc)

Question 16

What are the different types of immunotherapy?

Answer 16

Monoclonal antibody treatment

Innate immunotherapy - macrophages/NK cell administration

Adaptive immunotherapy (innate + adaptive sometimes used together)

Programmed cell death pathway (PD-1)

Chimeric antigen receptor (CAR) T cells

Question 17

What is PD-1 immunotherapy?

Answer 17

Treatment route

Uses patient’s immune system to attack ‘foreign’ cancer cells

Basically stops the cancer cells from being recognised as ‘self’

Question 18

How does CAR T cell therapy work?

Answer 18

Patients T cells (blood) taken and CAR gene inserted - giving them artificial receptors for the cancer cells

T cell culture grown and injected into patient

T cells attack cancer cells

Question 19

What is PD-1 immunotherapy commonly used to treat?

Answer 19

Melanoma

Lung cancer