Treatment Flashcards
What are Weinberg’s hallmarks of cancer
Sustaining proliferative signalling Evading growth suppressors Activating invasion and metastasis enabling replicative immortality Inducing angiogenesis Resisting cell death
What is brachytherapy
Delivery of a local radiotherapy using small physical objects inserted in the target organ instead of an external beam
What is radical treatment
Curative intent - aims to eradicate the tumour often at the expense of treatment related side effects
What is palliative treatment
Non-curative, aims to improve symptoms/QoL and prolong life but not at the expense of significant side effects
What is adjuvant therapy
After surgery aimed at reducing the risk of reccurence
What is neo-adjuvant therapy
Before surgery, usually to shrink a tumour before surgical removal
What is overall survival
Time alove
What is disease free survival
Time without any symptoms/signs of cancer
What is progression free survival
Time living with cancer that is not getting worse
What is local control
Time without recurrence or progression at a specific tumour site
What are some chemotherapy options
Alkylating agents Platinum salts Anti-metabolites Taxanes Anthracyclines Topoisomerase inhibitor
What do alkylating agents do
Attach an alkyl group to DNA
What do platinum salts do
DNA cross-linking
What do anti-metabolites do
Interfere with DNA/RNA growth
What do taxanes do
They are mitotic inhibitors
What do anthracyclines do
Interfere with enzymes for DNA coying
What does a topoisomerase inhibitor do
Prevents DNA strands from unwinding
What are some (well known) side-effects of chemotherapy
General malaise and fatigue
Alopecia
GI- diarrhoea, nausea, mucositis (mouth ulcers) and altered taste
Haem - neutropenia (low neutrophils), thrombocytopenia (low platelets) and anaemia
What are the other side-effects of chemotherapy
Peripheral neuropathy
renal/liver impairment
Nail changes
Fertility changes / menopause
How does radiation kill cnacer
The wavelength causes a double strand break in the DNA - preventing division and causing cell death
What are the acute symptoms of radiotherapy (weeks)
Fatigue
Erythema/desquamation
Head and Neck -Mucositis, pain odynophagia (painful swallowing)
Pelvis - diarrhoea, cystitis
Thorax/Abdomen - oesophagitis, nausea/vomiting
What are some late symptoms of radiotherapy (months-years)
Skin fibrosis/ulceration Dysphagia Bowel dysfunction Incontinence Bladder instability Pneumonitis (Cough, dyspnoea) Menopause Infertility Secondary cancer
How is radiotherapy prescribed
In Grays (Gy) as a unit of absorbed dose divided into fractions delivered Mon-Fri.
How does radical and palliative radiotherapy compare in delivery
Radical is usually done over 25-30 fractions (4-6w) and often combined with chemotherapy
Palliative radiotherapy is at much lower doses
