Therapeutic Options in Cancer 2 Flashcards
What is CRC (colorectal cancer) linked to in terms of diet?
Red meat consumption
What is breast cancer linked to in terms of diet?
Saturated fat intake
What is the current advice for diet?
5 or more portions of fruit or veg per day
Avoid obesity
Regular exercise every day (30 minutes)
How do we screen for Cervical cancer, CRC and breast cancer?
Smear tests
Faecal occult blood the most commonly used test- 16% reduction in CRC mortality
Mammography
How do we screen for prostate cancer?
PSA blood test
How do we screen for lung cancer?
MR / CT scanning
Breath test
How do we protect families with a history of CRC & familial adenomatous polyposis coli (FAP)?
Screen families for APC mutations
- regular colonoscopy
- offer panprotocolectomy when adenomas found
What is recommended for those with high risk of oesophageal cancer?
Supplement diet with anti-oxidants
What is recommended for those with high risk of breast cancer?
Prophylactic tamoxifen
What are the therapeutic ‘treatment options’?
Local or regional treatment
- surgery
- radiotherapy
- ablation (freezing, radio-frequency, etc)
- isolated limb perfusion
- Systemic treatment
- hormonal therapy
- chemotherapy
- immunotherapy
- whole body irradiation (for BMT)
What are the principles of staging?
Looking WHERE it is and examining it using radiological techniques (CT , MRI, USS, PET etc)
Determining WHAT kind of cancer it is using pathology / cytology
To determine Classification, risk factors etc
Genomics likely to play a role in the future
What are the advantages of radiotherapy?
Can treat inoperable lesions (– treat things you can’t remove)
Can make surgery become possible
Can maintain function and or appearance
Important role in palliation - improving someones symptoms
What are the 5 R’s of radiobiology?
- Radiosensitivity
- Repair
- Re-population
- Re-oxygenation
- Re-assortment
Define radiosensitivity
How sensitive the tumour is to the treatment
What is the principle of re-oxygenation?
Having oxygen present makes the treatment more effective.
What is the purpose of medical treatment of cancer?
Beneficial for widespread disease3% of cancers are cured by chemotherapy
Palliation in 50% of cancers
HOWEVER - can result in widespread toxicity
What are the indications for cytotoxic drugs?
Curative
Palliative
Adjuvant (applied after initial treatment for cancer, especially to suppress secondary tumour formation.)
Neoadjuvant (aims to reduce the size or extent of the cancer before using radical treatment intervention, thus making procedures easier and more likely to succeed)
What is the aim of adjuvant chemotherapy?
To improve survival following surgery
What are the factors you need to consider before giving someone an adjuvant?
Toxicity vs benefit ‘cost’ vs benefit
What is the purpose of palliative chemotherapy?
50% of chemo use
Relieves symptoms and may improve survival
What is the aim of neoadjuvant chemotherapy?
To improve survival
To reduce morbidity
PRECEDES SURGERY
What can hormone therapy be used for?
Specific or targeted therapy
Used in breast cancer and prostate cancer
What can antibodies be used for?
Irritable bowel disease
Cancer Arthritis
What is the purpose of the programmed cell death pathway?
Uses the immune system to attack the foreign cancer cells
What is the purpose of CAR T-cells?
Chimeric antigen receptor T-cells
T cells are removed and modified so they express receptors specific to the patients particular cancer
Transfer of coding sequence os facilitated by retroviruses
What is the purpose of monoclonal antibodies?
Treats cancer
