Treatment of Cancer Flashcards
What is the primary goal of targeted therapy in cancer treatment?
To selectively attack cancer cells based on specific molecular changes, minimizing damage to normal cells.
How do small molecule inhibitors differ from monoclonal antibodies?
Small molecules penetrate the cell membrane and block intracellular signaling, while monoclonal antibodies target extracellular receptors.
What is the role of immunotherapy in cancer treatment?
It boosts the immune system’s ability to recognize and kill cancer cells.
How does Pembrolizumab work as an immunotherapy drug?
It blocks PD-1, preventing cancer cells from evading immune attack.
What is the function of ipilimumab in immunotherapy?
It blocks CTLA-4, enhancing T-cell activation against cancer cells.
What is an Antibody-Drug Conjugate (ADC)?
A combination of an antibody and chemotherapy drug that delivers treatment directly to cancer cells.
What is an example of an ADC?
Trastuzumab-Deruxtecan (T-DXd), which delivers chemotherapy directly to HER2-positive cancer cells.
What is the purpose of a liquid biopsy?
It detects cancer DNA in the blood, providing a non-invasive way to monitor mutations and treatment response.
What is a driver mutation in cancer?
A genetic mutation that actively contributes to cancer progression
What was the significance of the Philadelphia chromosome in CML?
It was the first discovered genetic mutation linked to cancer, leading to targeted therapy development (Imatinib/Gleevec).
What is a major cause of drug resistance in lung cancer patients?
The overexpression of the KRAS gene.
How do tyrosine kinase inhibitors (TKIs) work in cancer treatment?
They block kinase phosphorylation, preventing cancer cell proliferation.
How does cancer promote neovascularization?
By releasing growth factors like VEGF, which stimulate new blood vessel formation.
How do anti-angiogenic therapies work?
They block VEGF and related pathways to prevent tumor blood vessel growth.
What are common side effects of targeted cancer therapies?
Hair loss, nausea, neuropathy, liver toxicity, and blood cell count suppression.
What specific side effect led to stopping T-DXd?
Pneumonitis, characterized by lung inflammation and breathing difficulties.
What side effects are associated with anti-angiogenic therapies?
Stomatitis, mucositis, and hand-foot syndrome.
What is adenocarcinoma?
A malignancy of glandular tissue.
What type of cancer arises from supporting structures like fibrous tissue, muscles, or bones?
Sarcoma.
What is a malignancy of neuroendocrine cells called?
Neuroendocrine cancer, such as small cell cancer.
What type of cancer originates in the bone marrow?
Myeloma.
What is leukaemia?
A malignancy of blood cells.
What imaging is used for breast cancer staging?
CT scan of the chest, abdomen, and pelvis.
What does T2N1M0 indicate in breast cancer staging?
Tumor size 2-5 cm (T2), lymph node involvement (N1), and no distant metastasis (M0) – Stage IIB.
What are the main oncology specialties involved in cancer treatment in the UK?
- Surgical Oncologist
- Medical Oncologist
- Clinical or Radiation Oncologist
- Palliative Medicine and Physicians
What is the purpose of a multidisciplinary team (MDT) meeting in cancer care?
To determine the best treatment approach, such as surgery, chemotherapy, or radiotherapy.
What are the main goals of chemotherapy?
To cure cancer when possible or to provide palliative care when a cure is not possible.
What are the different routes of chemotherapy administration?
Intravenous, oral, subcutaneous, or intramuscular.
How is chemotherapy given?
In treatment sessions called cycles, usually every 3 weeks but sometimes weekly, 2-weekly, 4-weekly, or 6-weekly.
What is neoadjuvant chemotherapy?
Chemotherapy given before surgery to shrink the tumor.
What is adjuvant chemotherapy?
Chemotherapy given after surgery to reduce the risk of cancer recurrence.
What is palliative chemotherapy?
Chemotherapy used to control symptoms and extend survival when a cure is not possible.
What chemotherapy drugs were used in the patient’s treatment?
Epirubicin + Cyclophosphamide for 4 cycles (every 3 weeks, total 12 weeks).
Docetaxel for 4 cycles.
What supportive medications are given alongside chemotherapy?
Dexamethasone and ondansetron to prevent nausea and vomiting.
What are common side effects of chemotherapy?
- Nausea and vomiting (first 2-3 days)
- Soreness of mouth (mucositis, 2nd week)
- Hair loss (alopecia)
- Neutropenic sepsis (low neutrophils, increased infection risk)
- Diarrhoea (colitis or typhlitis)
- Skin rash
- Peripheral neuropathy (accumulating with each cycle)
What is the purpose of post-chemotherapy radiotherapy?
To destroy any remaining cancer cells and reduce recurrence risk.
What are common side effects of radiotherapy?
Skin redness and pain
Fatigue
Nausea and vomiting
What are additional site-specific side effects of radiotherapy?
- Diarrhoea (radiation colitis)
- Painful urination (radiation cystitis)
- Swallowing problems (radiation oesophagitis)
- Cough and breathing difficulty (radiation pneumonitis)
What medication can be prescribed after radiotherapy?
Tamoxifen for 10 years.
How does Tamoxifen work?
It blocks oestrogen receptors, preventing cancer cells from using oestrogen to grow.
What are common side effects of Tamoxifen?
Hot flushes
Night sweats
Weight gain
Joint pain
Endometrial cancer risk
Deep vein thrombosis
What long-term effects can occur after chemotherapy?
- Chemotherapy-induced second cancer (rare)
- Infertility
- Persistent numbness (neuropathy)
- Heart damage (cardiomyopathy)
What chemotherapy drugs are associated with specific long-term side effects?
- Cisplatin – Hearing loss (irreversible), kidney damage
- Cytarabine – Conjunctivitis (reversible)
- Bleomycin – Lung toxicity (pneumonitis)
- Vincristine – Peripheral neuropathy
- Paclitaxel – Infusion reactions
- Irinotecan – Severe diarrhoea
What are the four main mechanisms of chemotherapy?
- DNA damage – Alkylating agents prevent DNA separation.
- Topoisomerase inhibition – Prevents DNA unwinding for replication.
- Mitosis disruption – Prevents cancer cell division.
- Metabolic interference – Disrupts cancer cell metabolism.
How does radiotherapy kill cancer cells?
By generating free radicals that damage DNA strands.
What are other uses of radiotherapy besides primary cancer treatment?
Palliative care (pain relief)
Brain metastases treatment
Spinal cord compression
Bleeding control
Airway obstruction management
How has breast cancer survival improved over time?
- In the 1970s, 40% of women survived beyond 10 years.
- By the 2010s, almost 78.4% survived beyond 10 years.
How does social deprivation affect breast cancer survival?
- 88.4% survival in the least deprived group.
- 82.1% survival in the most deprived group.
