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Disease processes > Treatment of cancer > Flashcards

Treatment of cancer Flashcards

1
Q

Radiotherpay can be…

A

Direct

Indirect

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2
Q

Indirect radiotherpay forms

A

Super oxide free radicals

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3
Q

Aim of radiotherapy =

A

damage DNA/double-strand break –> apoptosis

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4
Q

Radiotherapy is usually delivered via a

A

Linear accelerator

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5
Q

Types of particle radiation =

A

Photon
Electron
Proton

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6
Q

Photon therapy advantages =

A

Skin sparing

Beam uniformity

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7
Q

Gray =

A

A unit of absorbed radiation equal to the dose of 1 joule of energy absorbed per 1 kg of matter (1 J/Kg)

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8
Q

SABR =

A

Stereotactic ablative radiotherapy

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9
Q

Stereotactic ablative radiotherapy

A

Specialised way of delivering radiotherapy. Uses small, very precisely targeted treatments. Minimises damage to surrounding tissue.

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10
Q

Brachytherapy =

A

Internal radiotherapy

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11
Q

Conditions needed for brachytherapy =

A
  • Accessible, well-demarkated tumour w/o high risk of regional lymph node metastasis
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12
Q

2 types of complications of radiotherapy:

A
  1. Acute tissue reactions

2. Late tissue reactions

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13
Q

Acute tissue reactions usually occur =

A

In the middle of a long radiotherapy schedual

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14
Q

Acute toxicity in radiotherapy =

A

2nd week = mucosal reactions (e.g. mucositis)

5th week = skin reactions

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15
Q

Mucositis =

A

An intensity-limiting side effect for aggressive schedules. May mean patient can’t feed themselves during rounds

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16
Q

Late toxicity tends to be

A

Permanent

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17
Q

Late toxicity in radiotherapy occurs in cells with:

A

Low turnover (fibroblasts, neurons)

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18
Q

Late toxicity develops within

A

Months - years

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19
Q

Most common late side effect of radiotherapy

A

Xerostomia

20
Q

Xerostomia

A

Dry mouth

21
Q

Ex of late toxicity reactions to radiotherapy:

A
  • Xerostomia
  • Dental caries
  • Fibrosis
  • Soft-tissue necrosis
  • Nerve tissue damage
  • Ocular: catarcts, optic neuropathy, retinopathy
  • otological
  • CNS
22
Q

At what weight do tumour cells become clinically apparent?

A

1g

23
Q

Log-kill hypothesis of chemotherapy =

A

For a given dose of chemo in a given tumour, only a fraction of tumour is killed. Therefore, several courses is needed.

24
Q

Chemotherapy works in cells that’re…

A

Cycling

25
Q

Chemo works more rapidly on

A

Proliferating areas

26
Q

Ex of proliferating areas:

A
  • Hair
  • Skin
  • GI mucosa
  • Bone marrow
27
Q

Uses of chemotherapy:

A
  • Curative
  • Adjuvant
  • Neoadjuvant
  • Palliative
28
Q

Curative chemo:

A

Chemo is main treatment

29
Q

Adjuntive chemo:

A

Used to mop up cancer cells after treatment

30
Q

Neoadjuvant chemo:

A

Given before surgery

31
Q

Palliative chemo:

A

Improve QOL

32
Q

2 types of chemo toxicity:

A
  1. Acute: due to effects on normal proliferating cells

2. Chronic: end organ damage

33
Q

Common acute side effects of chemo:

A
  • Bone marrow: decrease WBC, RBC, platelet
  • Alopecia
  • Stomatitis, mucositis, nausea, vomiting
  • Extraversion
34
Q

Extraversion =

A

Leakage of IV drugs into surrounding tissues.

35
Q

Drug resistance can be:

A

Primary or secondary

36
Q

Primary drug resistance:

A

Tumour grows from start/never responds to chemo

37
Q

Secondary drug resistance:

A

Intital response to chemo, tumor then grows again

38
Q

MDR-1 gene is involved in:

A

Drug reflux

39
Q

Drugs that reverse MDR

A

Verapamil
Guanidine
Cyclosporine

40
Q

Ex of alkylating agents:

A

Nitrogen mustard gases

41
Q

Alkylating agents MoA

A

Add alkyl group to guainine. Covalent bond/cross link - arrest cell cycle

42
Q

Ex of antimetabolite

A

Methotrexate

43
Q

Methotrexate disrupts

A

Folate metabolism (DHFR)

44
Q

Cisplatin has a similar effect to

A

Alkylating agents

45
Q

Tyrosine kinases are involved in…

A

Growth factor replication signal transduction

Disease processes (21 decks)

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