therapeutic options in cancer Flashcards
therapeutic options can be …
preventative or treatments
prevention
environment/behaviour diet screening genetics medication/vaccination
treatment
surgery
radiotherapy
systemic therapy
immunotherapy
diet
inconsistent evidence and lots of confounding factors
CRC: probably linked with red meat consumption
breast cancer: probably a link with saturated fat intake
physical activity decreases risk
also a benefit for reducing CVD
environment
○ Smoking in public places
○ Minimal alcohol pricing
○ Water and air quality: electric cars, renewable energy
○ Vaccination: HPV/Hep B
○ Opportunities via school: physical activity, school meals
○ Income and housing policies
For medical profession: importance of public health specialists and GPs
screening
high quality research evidence available
Age of screening varies with cancers
cervical cancer screening
regular smear tests (should become rarer due to introduction of HPV vaccine in young girls(13y/o))
CRC cancer screening
faecal occult blood the most commonly used test
16% reduction in CRC mortality
breast cancer screening
mammography
problems with screening
sometimes gives false reassurance to patients, investigations also come with risk which needs to be considered
Population that take part in screening tend to be healthier and wealthier (i.e. people who don’t turn up tend to be more at risk and this can lead to health inequalities)
genetics
- More targeted than screening
- High quality research evidence available
○ CRC and FAP (familial adenomatous polyposis coli)
○ Breast cancer and BRCA1/2:
CRC and FAP (familial adenomatous polyposis coli)
§ autosomal dominant
§ screen families for APC mutations
§ regular colonoscopy
§ offer panprotocolectomy when adenomas found - remove colon and rectum to prevent cancer as one of the polyps is almost guaranteed to become cancerous
breast cancer and BRCA1/2
§ These genes increase risk of breast cancer
§ also important in therapeutic area
Chemo-prevention
- More controversial - give people medication to prevent them getting cancer
limited effectiveness - Primary: oesophageal cancer
- Primary: breast cancer
- Secondary: previous H&N or lung cancers
chemo - prevention: oesophageal cancer
○ High rates in parts of China and Iran
○ Thought to be related to diet (particularly in Iran)
○ Supplement diet with anti-oxidants - didn’t make a lot of difference
chemo-prevention: breast cancer
○ Known at risk women
○ Prophylactic tamoxifen - tamoxifen has side effects which need to be considered