Week 05 - Breast and Prostate Cancer

Question 1

Two step process of cancers….

Answer 1

1. Development/initiation

2. Progression/proliferation

Question 2

Cancer is influenced by two main factors… explain them..

Answer 2

• Exogenous factors (environmental, e.a. pollution)

- Endogenous factors (physiological, eg insulin resistance, obesity, weak immune).

Question 3

Cancerous tumour vs benign?

Answer 3

Cancerous tumour can metastasis (unlike benign) which means it can move (via circulation) as it continues to grow = can develop second tumours/spread.
Malignant - moves/spreads

Question 4

How much of the risk factor of cancer is due to genetics?

Answer 4

Quite little (6-8%)

Question 5

Avoidable risk factors: Environmental and lifestyle (6)

Answer 5

• Lack of physical activity
• Poor diet
• Being overweight/obese
• Drinking alcohol
• Radiation to the chest
• Combined hormone replacement therapy (HRT)
  
  • prescribed for menopause, oestrogen enhancing for bone density

Question 6

Study analysing mice with exercise vs chemotherapy found what???

Answer 6

• Half the mice performed exercise (running with wheels)
• Exercise + chemo did best = smallest tumour
• Exercise suppressed tumour to similar extend just chemo did

Question 7

What is the exercise prescription for cancer patients?

Answer 7

General exercise guidelines (150-300 mins moderate or 75-150 mins of vigorous) EXCEPT must consider additional factors like:

• bone moss
• lymphedema
• peripheral neuropathy
• Ostomy
• sun safety, symptoms, older adults

Question 8

What does the COSA 2018 Position statement say about exercise and cancer?

Answer 8

Exercise should be a standard practice for cancer patients (as per recommended guidelines AND 2-3 RT sessions)

Question 9

Stage 0 of breast cancer refers to …?

Answer 9

pre-invasive/non-invasive

Question 10

Treatments for Breast Cancer

Answer 10

• Surgery
• Chemotherapy
• Radiotherapy
• Immunotherapy
• Hormonal Therapy (Taxofifen/Aromatase inhibitors)

Question 11

Modified Radical Mastectomy…?

Answer 11

Non removing pec muscle, but full breast tissue

Question 12

Lumpectomy is…?

Answer 12

Just removing lump/tumour, not whole breast

Question 13

Explain chemotherapy

Answer 13

• Systemic treatment; injection of cytotoxic agents to kill cells
• Usually used in those with probability of metastases
• Kills all cells: normal cells believed to recover faster than cancerous cells

Question 14

What are acute side effects of chemo?

Answer 14

•Fatigue, nausea, anaemia, hair loss, neuropathy, pain, “chemo brain”, psychological effects (depression, anxiety, etc.)

Question 15

What are chronic side effects of chemo?

Answer 15

• Fatigue, cardiomyopathy, pulmonary fibrosis, neuropathy, bone loss, leukaemia, menopause, weight change, “chemo brain”, psychological effects
• Organs at risk: heart, lungs, brain/nerves

Question 16

Radiotherapy is…

Answer 16

• Localising treatment
• Ionising radiation to the site
• Targets and destroys DNA

Question 17

Immunotherapy is…

Answer 17

• Systemic
• Stimulates the immune system (i.e. NK T-cells) to attack malignant cells
• Usually oral or IV administered

Question 18

Hormonal Therapy types…

Answer 18

• Tamoxifen
  
  • Estrogen receptors blocker
  • May be prescribed in breast cancer patients with oestrogen tumours
• Aromatase inhibitors
  
  • Block oestrogen production

Question 19

Hormonal therapy (aromatase inhibitors, tamoxifen) side effects?

Answer 19

• heart attack, angina
• bone loss
• joint pain
• mood swings
• blood clots
• stroke
• cataracts
• endometrial cancer

Question 20

What is the consensus around lymphedema and upper body exercise?

Answer 20

In 2001 National Lymphedema Network rejected upper body exercise for lymphedema, in 2011 updated to encourage UB training (as per evidence)
- Lower risk of lymphedema with exercise in breast cancer

Question 21

Treatments for Prostate Cancer

Answer 21

• No intervention
• Surgery: prostatectomy
• Radiotherapy
• Hormonal Therapy: Androgen deprivation therapy (ADT)

Question 22

Side Effects of ADT:

Answer 22

• Bone wasting
• Muscle wasting
• Fatigue
• Breast development
• Hot flushes
• Low libido
• Fat gain
• Insulin resistance
• CVD
• Dementia/alzheimers disease
• Depression

Question 23

Evidence shows what muscle mass with exercise vs non exercise prostate cancer groups?

Answer 23

Muscle mass declined LESS in exercise group