Therapeutic Options: Cancer Flashcards
What type of therapeutic options are there
Prevention
Treatment
Name some prevention therapeutic options
Environment / Behaviour change Diet Screening Genetics Medication / vaccination
Name some treatment therapeutic options
Surgery
Radiotherapy
Systemic therapy
Immunotherapy
Name a diet risk factor of colorectal cancer
Red meat consumption
Name a diet risk factor of breast cancer
Link with saturated fat intake
Name a diet risk which decreases a persons chance of obtaining cancer
Physical activity
What is the current dietary adivce
Eat 5 or more portions of fruits and vegetables/day
Avoid obesity
Take regular exercise (30 minutes/day)
What type of screening is available for cervical cancer
Smear tests
What type of screening is available for colorectal cancer
Faecal occult blood
What type of screening is available for breast cancer
Mammography
What type of screening is available for prostate cancer
PSA blood test
although more controversial
What type of screening is available for lung cancer
MR/CT scanning
Breath test
(although more controversial)
Describe the features of CRC and familial adenomatous polyposis coli (FAP)
Autosomal dominant
Screen families for APC mutations
Regular colonoscopy
Offer panprotocolectomy when are adenomas found
What is a controversial primary oesophageal cancer chemo-prevention method
Supplement diet with anti-oxidants
What is a controversial primary breast cancer chemo-prevention method
Known at risk women can be given prophylactic tamoxifen
What type of local or regional treatment is avaliable
Surgery
Radiotherapy
Ablation (freezing, radio-frequency, etc)
Isolated limb perfusion
What type of systemic treatment is available
Hormonal therapy
Chemotherapy
Immunotherapy
Whole body irradiation (for BMT)
How can where the cancer is be identified
Through examination
Radiology/imaging (e.g. CT, MRI, USS, PET etc.)
How can the type of cancer be identified
Through pathology and cytology
What does surgery require
Anatomical clearance
What does radiotherapy require
Anatomical coverage
What are the benefits of radiotherapy
Can treat inoperable lesions
Can make surgery become possible
Can maintain function and/or appearance
What are the 5 R’s of radiobiology
Radiosensitivity Repair Re-population Re-oxygenation Re-assortment
Describe the features of radiotherapy
About 40% of cancers are cured by radiotherapy (e,g, head and neck, cervix, uterus, skin and lymphoma)
Can be combined with chemotherapy (e.g. anal cancer, rectal cancer, oesophageal cancer)
Important role in palliation (e.g. pain, bleeding, swollen limbs)
State an advantage and disadvantage of systemic treatments
Beneficial for widespread disease
Can result in widespread toxicity
What are the indications for the use of cytotoxic drugs
‘Curative’
Palliative
Adjuvant
‘Neoadjuvant’
What are designer therapies
‘Specific’ therapies based on molecular science
What kind of immune therapies are there
Non-specific/innate
Specific
What kind of therapy uses monoclonal antibodies
Rituximab
What does the programmed cell death pathway type of immune therapy do
Uses immune system to attack ‘foreign’ cancer cells
What does the chimeric antigen receptor (CAR) T-cells type of immune therapy do
Artificial T-cell receptors using retroviral vectors to give a specific cell killing function directed against cancer cells
What can be used as a checkpoint blockade
PD-1
PDL-1 antagonists
Where are checkpoint blockades currently in use
Melanoma
Lung cancer
What does the success of checkpoint blockades depend on
’Mutation burden’ of cancer
Immunogenicity of ‘neoantigens’
Describe the process of chimeric antigen receptor (CAR) T-cell therapy
T cell collection
T cell transfection
T cell adoptive transfer
Patient monitoring
