Theraputic Options

Question 1

What is CRC (colorectal cancer) linked to in terms of diet?

Answer 1

Red meat consumption

Question 2

What is
breast cancer linked to in terms of diet?

Answer 2

Saturated fat intake

Question 3

How do we screen for Cervical cancer, CRC and breast cancer?

Answer 3

Smear tests

Faecal occult blood the most commonly used test
- 16% reduction in CRC mortality

Mammography

Question 4

How do we screen for prostate cancer?

Answer 4

PSA blood test

Question 5

How do we screen for lung cancer?

Answer 5

MR / CT scanning

Breath test

Question 6

How do we protect families with a history of CRC & familial adenomatous polyposis coli (FAP)?

Answer 6

Screen families for APC mutations
- regular colonoscopy
- offer panprotocolectomy when adenomas found

Question 7

What is recommended for those with high risk of oesophageal cancer?

Answer 7

Supplement diet with anti-oxidants

Question 8

What is recommended for those with high risk of breast cancer?

Answer 8

Prophylactic tamoxifen

Question 9

What are the therapeutic ‘treatment options’?

Answer 9

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)

Question 10

What are the principles of staging?

Answer 10

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

Question 11

What are the advantages of radiotherapy?

Answer 11

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

Question 12

What are the 5 R’s of radiobiology?

Answer 12

Radiosensitivity
Repair
Re-population
Re-oxygenation
Re-assortment

Question 13

Define radiosensitivity

Answer 13

How sensitive the tumour is to the treatment

Question 14

What is the principle of re-oxygenation?

Answer 14

Having oxygen present makes the treatment more effective.

Question 15

What is the purpose of medical treatment of cancer?

Answer 15

Beneficial for widespread disease

3% of cancers are cured by chemotherapy
Palliation in 50% of cancers

HOWEVER - can result in widespread toxicity

Question 16

What are the indications for cytotoxic drugs?

Answer 16

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)

Question 17

What is the aim of adjuvant chemotherapy?

Answer 17

To improve survival following surgery

Question 18

What are the factors you need to consider before giving someone an adjuvant?

Answer 18

Toxicity vs benefit
‘cost’ vs benefit

Question 19

What is the purpose of palliative chemotherapy?

Answer 19

50% of chemo use

Relieves symptoms and may improve survival

Question 20

What is the aim of neoadjuvant chemotherapy?

Answer 20

To improve survival
To reduce morbidity

PRECEDES SURGERY

Question 21

What can hormone therapy be used for?

Answer 21

Specific or targeted therapy

Used in breast cancer and prostate cancer

Question 22

What can antibodies be used for?

Answer 22

Irritable bowel disease
Cancer
Arthritis

Question 23

What is the purpose of the programmed cell death pathway?

Answer 23

Uses the immune system to attack the foreign cancer cells

Question 24

What is the purpose of CAR T-cells?

Answer 24

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

Question 25

What is the purpose of monoclonal antibodies?

Answer 25

Treats cancer