Therapeutic Options Flashcards

1
Q

How can cancer be prevented or treated?

A
  • Prevented: diet, screening, genetics, stop people smoking, medication
  • Treatment: surgery, radiotherapy, systemic therapy
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2
Q

What do the studies on diet say?

A
  • inconsistent
  • lots of confounding factors
  • CRC probably a link with red meat consumption
  • Breast cancer probably link with saturated fat intake
  • physical activity decreases risk
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3
Q

What screening is available?

A
  • smear tests for cervical cancer
  • faecal occult blood for CRC
  • mammography for breast cancer
  • PSA blood test fro prostate cancer
  • MR/CT scanning or breath test for lung cancer
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4
Q

What can be offered to families with histories of CRC and FAP?

A
  • they are autosomal dominant conditions
  • screen families for APC mutations
  • regular colonoscopy
  • offer panprotocolectomy when adenomas found
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5
Q

What controversial chemo-preventions are there?

A
  • primary oesophageal cancer= supplement diet with anti-oxidants
  • primary breast cancer= prophylactic tamoxifen
  • secondary previous H&N or lung cancers= give anti-oxidant supplements
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6
Q

What are local/regional treatment options?

A
  • surgery
  • radiotherapy
  • ablation
  • isolated limb perfusion
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7
Q

What are the systemic treatment options?

A
  • hormonal therapy
  • chemotherapy
  • immunotherapy
  • whole body irradiation
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8
Q

How is cancer staged?

A
  • where it is according to examination and use of radiology

- what kind of cancer according to pathology/cytology

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9
Q

What does surgery require?

A

anatomical clearance

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10
Q

What does radiotherapy require?

A

-anatomical coverage

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11
Q

What are the 5 Rs of radiology?

A
  • radio sensitivity
  • repair
  • re-population
  • re-oxygenation
  • re-assortment
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12
Q

What role does radiotherapy play in cancer treatment?

A
  • of cancers cured 40% are cured by radiotherapy
  • can be combined with chemotherapy
  • important role in palliation
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13
Q

Why would cytotoxic drugs be used?

A
  • curative
  • palliative
  • adjuvant
  • neoadjuvant
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14
Q

Describe adjuvant chemotherapy.

A
  • accounts for an increasing amount of chemotherapy use
  • aim is to improve survival
  • follows surgery
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15
Q

Describe palliative chemotherapy.

A
  • accounts for about 50% of chemotherapy use
  • main aim is to relieve symptoms
  • may improve survival
  • needs careful assessment
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16
Q

Describe neoadjuvant chemotherapy.

A
  • more recent use of chemotherapy
  • aims to either improve survival or reduce morbidity
  • precedes surgery or radiotherapy
17
Q

When does hormone therapy prove beneficial?

A
  • Breast cancer= ER=ve and tamoxifen

- Prostate cancer= LHRH antagonists

18
Q

What immune therapies are there?

A

SPECIFIC
-monoclonal antibodies: (rituximab and B cell NHL: +/- radioactivity) (trastuzumab and response in HER2 +ve breast and gastric cancer)
-programmed cell death pathway PD-1 (uses immune system to attack foreign cancer cells)
-chimeric antigen receptor CAR T-cells (artificial T-cell receptors, using retroviral vectors to give an specific cell killing function directed against cancer cells)
NON-SPECIFIC