Therapeutic Options Flashcards
What do therapeutic options for cancer involve?
Both prevention and treatment
What are prevention options for cancer?
Environment/behaviour changes
Diet
Screening
Genetics
Medication/vaccination
What are treatment options for cancer?
Surgery
Radiotherapy
Systematic therapy
Immunotherapy
What is immunotherapy?
Type of cancer treatment that boosts the body’s natural defences to fight cancer
What does evidence suggest colorectal cancer is increased with the consumption off?
Red meat
What does evidence suggest breast cancer is increased with the consumption of?
Saturated fat
What is the current advice for diet?
Eat 5 or more portions of fruit and vegetables per day
Avoid obesity
Regular exercise (30 mins a day)
What are the 2 classes of screening, in terms of societies optionions?
High quality research evidence
More controversial
What are examples of high quality research evidence screening?
Cervical cancer (smear test)
Colorectal cancer (blood in faeces)
Breast cancer (mammography)
What are examples of controversial screening?
Prostate cancer (PSA blood test)
Lung cancer (MR/CT screening)
What are examples of hereditary genes that increase cancer risk?
FAP increase colorectal cancer
BRCA1 and BRCA2 increasing breast cancer
What is a very controversial form of prevention?
Chemo-prevention
What is chemoprevention useful for?
Primary such as oesphagael cancer and breast cancer
Secondary such as head and neck or lung cancer
What is a common kind of chemo-prevention that is not believed to be of much use?
Anti-oxidants
What kind of cancer is heavily linked with lung cancer, meaning if you have one you are likely to have the other?
Head and neck cancer
What are the 2 general kinds of treatment?
Local or regional
Systematic
What are examples of local or regional treatments?
Surgery
Radiotherapy
Ablation (radiowaves or freezing)
Isolated limb perfusion (chemotherapy directly to the limb)
What is ablation?
Radio waves or freezing
What is isolated limb perfusion?
Chemotherapy directly to the limb
What are kinds of systematic treatments?
Hormonal therapy
Chemotherapy
Immunotherapy
Whole body irradiation
What can staging tell us?
Where is the cancer
What kind of cancer
What is used to tell us where a cancer is?
Examination
Imaging
What is used to tell us the kind of cancer?
Pathology
What does surgery need?
Anatomical clearance (complete removal of the tumour)
What is anatomical clearance?
Complete removal of the tumour
What can radiotherapy do?
Treat inoperable lesions
Make surgery more possible
Maintain function or appearance
What does radiotherapy need, just like surgery?
Complete anatomical coverage
What are the 5 R’s of radiobiology?
Radio sensitivity (some tumours are not sensitive to treatment)
Repair (no breaks does not allow the tumour to grow so improves survival)
Re-population
Re-oxygenation (oxygen makes cells more sensitive to treatment)
Re-assortment (tumours are least sensitive during the DNA replication stage of the cell cycle
When are tumours least sensitive to radiotherapy?
During the DNA replication stage of the cell cycle
Why is re-oxygenation important for radiotherapy?
Oxygen makes cells more sensitive to treatment
What is pallation?
Care that makes you feel better even though it can’t sure you, used for terminally ill patients
What is radiotherapy used for in pallation?
Pain
Bleeding
Swollen limbs
What is systematic treatment used for?
Widespread disease
What is a possible side effect of systematic treatment?
Widespread toxicity, the dose required to get the desired effect (kill the tumour) has unavoidable side effects due to being high
What does hormone treatment have the potential to be?
Very specific
What does cytotoxic mean?
Toxic to living cells
What are cytotoxic drugs used for?
Curative
Pallative
Adjuvant (has surgery but at risk of reoccurence)
Neoadjuvant (treatment before surgery to shrink the tumour)
What is adjuvant in terms of the use of cytotoxic drugs?
Has surgery but is at risk or reoccurance
What is neoadjuvant in terms of the use of cytotoxic drugs?
Treatment before surgery to shrink the tumour
What are specific therapies based on?
Molecular science
What do specific therapies target?
Intracellular growth control points
What is an example of a specific therapy we can create?
Artificial antibodies that cannot exist in nature, such as ones that are bifunctional and can bring cells together
What are examples of immune therapies?
Nonspecific/innate
Specific
Monoclonal antibodies
Programmed cell death pathway (PD-1)
Chimeric antigen receptor (CAR) cells
What do programmed cell death pathways (PD-1) use?
Immune cells to attack cancer cells
What is chimeric antigen receptor (CAR) T cells?
Artifical T cell receptors to give a specific cell killing function directly againt cancer cells (stops cancer cells hiding from the immune system)
What stops cancer cells hiding from the immune system?
Chimeric antigen receptor (CAR) T cells
What does immunotherapy need to be?
Precise as the immune cells will keep diving and will always be present, and the wrong receptor is used they will attack healthy tissue
What will happen if the wrong receptor is used in immunotherapy?
The immune cells could attack healthy tissue
How can cancer cells hide from the immune system?
Due to being self cells (antigen binds to self-cell receptor on T cell)
How do CAR T cells prevent cancer from binding to self-receptors and hiding from the immune system?
Bind to cancer cells antigen with the forign receptor and destroy them
What does CAR T cells being successful depend on?
Mutation burden of cancer
Immunogenicity of neoantigens
What is clinical research important for?
Determining what treatments are effective for who and making them even better
Why don’t all people with the same condition respond to the same treatment?
Due to unique factors such as genetics and what bacteria normally live in your gut
