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Pharmacology - Year 2 AC > Week 12 - Radiotherapy > Flashcards

Week 12 - Radiotherapy Flashcards

1
Q

What gives an atom stability?

A

The protons = electrons

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2
Q

What is ionising radiation?

A

Radiation consisting of particles, X-rays or gamma rays with sufficient energy to cause ionisation in the medium through which it passes

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3
Q

What is ionisation?

A

The process by which an atom or a molecule acquires a negative or positive charge by gaining or losing electrons to form ions, often in conjugation with other chemical changes

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4
Q

Which atoms emit radioactive decay?

A

Atoms of natural radioactive substances with unstable nuclei

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5
Q

Name some ionising radiation

A
  • electromagnetic waves (X-rays or gamma rays)
  • alpha or á particles (short range - more damaging)
  • beta or b particles

Many radioactive substances emit all three

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6
Q

What is radiotherapy?

A

The treatment of disease by ionising radiation

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7
Q

What is an advantage of radiation?

A

Targeted to damage cancer cells - healthy cells can recover

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8
Q

How does ionising radiation have an effect on tissues/cells?

A
  • can penetrate tissues and alter the nuclear material (I.e. DNA)
  • disrupting cell growth and reproduction
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9
Q

What effect does radiation have on human cells when it damages them and how?

A

-damages cells - causes apoptosis

  • when a high energy ray hits a molecule, it can cause it to break up
  • this can form free radicals which can cause further damage to the inside of the cell
  • leads to apoptosis
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10
Q

Which radiations are more likely to cause tissue or cell damage and why?

A
  • alpha and gamma radiation

- more likely to cause tissue or cell damage because they are more effective at producing ionisation

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11
Q

Which are the preferred radiations to treat malignancies and why?

A

Alpha and gamma

-more likely to cause tissue or cell damage because are more effective at producing ionisation

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12
Q

When may radiotherapy be used?

A
  • treat cancer as a stand alone treatment
  • shrink tumour before surgery
  • reduce cancer returning after surgery
  • control symptoms or reduce pain if cancer is no longer treatable
  • reduce growth of cells - Graves’ disease
  • palliative radiotherapy
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13
Q

Give examples of the malignancies specifically confined to one area that radiotherapy aims to treat

A 
Brain 
Skin
Prostate
Breast
Uterus
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14
Q

What are the types of radio therapy?

A

Internal and external

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15
Q

What is external radiotherapy?

A
  • supplied from outside the body

- local exposure-targeting specific cells

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16
Q

What is internal radiotherapy?

A
  • utilising radioactive implants placed inside the body

- local exposure-targeting specific cells

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17
Q

What is each exposure of radiotherapy classed as?

A

A fraction

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18
Q

How is external radiotherapy given?

A
  • usually given over several days or weeks
  • mon-fri with weekend off
  • mark target area - need to lie in certain position
  • motionless
  • 5 mins per fraction
  • painless procedure
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19
Q

How does a radiotherapy machine work?

A

A metal element is heated to produce electrons. These accelerate in an electric field towards a piece of tungsten metal, which then emits high-energy X-rays when they hit it

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20
Q

What is conformal radiotherapy? (CRT)

A

Use of metal blocks to direct the beam of ionising radiation
-3D CRT

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21
Q

What is an advantage of conformal radiotherapy (CRT)?

A

-more closely targets the shape of the tumour

22
Q

What is conformal radiotherapy (CRT) routinely used for?

A

Prostate cancer

23
Q

What is internal radiotherapy also known as?

A

Brachytherapy

24
Q

How is internal radiotherapy given?

A

-may be given once or only a few times
-usually involves short stay in hospital
-radioactive wires (a few days)
or
- radioactive seeds (radioactive gold or iodine a permanent - small amounts of ionising radiation placed in tumour - degrade over time) put in to affected area
-IV or in liquid form
-may have to limit contact with people

25
Q

What may be limited when having internal radiotherapy treatment?

A

Contact with people

26
Q

What is radioactivity measured with?

A

A Geiger counter

27
Q

What radiation is most likely to be used for radioactive pellets and why?

A

Alpha radiation

-shorter range and more powerful

28
Q

What is given when treating someone wit. internal radiotherapy using IV or liquid form?

A
  • strontium 89
  • samarium 153 (some bone cancers)
  • iodine 131 (thyroid gland)
  • radium 223 (secondary bone cancer- trials)

-may also be used to relieve blockages of the oesophagus

29
Q

What do the side effects of radiotherapy depend on?

A
  • dependant on area being treated
  • dose of radiation
  • physical well being at the time of treatment
30
Q

When can side effects appear?

A
  • during treatment

- weeks/months after treatment

31
Q

Why are side effects caused by radiotherapy?

A
  • most people experience some side effects

- caused by damage to healthy cells - may take time to recover

32
Q

What are the side effects of radiotherapy?

A
  • tiredness
  • N&V
  • sore skin
  • muscle and joint pain
  • fertility
33
Q

Why can radiotherapy cause tiredness as a side effect?

A
  • physical exertion of going for treatment everyday
  • anaemia - destruction of erythrocytes
  • less o2 carrying capacity

-extreme cases - transfusion

  • bone marrow affected - pelvis, abdo, prostate
  • diarrhoea
34
Q

Why can radiotherapy cause N&V as a side effect?

A
  • GI tract, brain (depends on area of body receiving treatment)
  • loss of appetite
35
Q

What can be done to control N&V as a side effect of radiotherapy?

A
  • alter diet
  • prescribe anti-emetics (e.g. domperidone)
  • dexamethasone, 5HT antagonists, anti-histamines
36
Q

Why might sore skin be caused as a side effect of radiation?

A
  • local reaction to the radiation
  • sore and red - avoid irritants

-temporary hair loss in area

37
Q

Why might muscle and joint pain be caused as a side effect of radiation in radiotherapy?

A
  • treatment may cause muscle stiffness in affected area
  • swelling of joints

-light exercise/physiotherapy

38
Q

Why may fertility be affected as a side effect of radiotherapy?

A
  • loss of libido (tiredness)
  • pelvic area - may effect ovarian function in women - induce an early menopause causing infertility
  • prostate - impotence/infertility
39
Q

What are the risks of radiotherapy?

A

-increased dose - increases slight risk to normal cells and could cause cancer

40
Q

Why might the thyroid gland need radiotherapy?

A
  • Graves’ disease (swelling of the neck and protrusion of the eyes resulting from an overactive thyroid gland)
  • reduce activity of thyroid gland by destroying cells
  • less T3/T4 release
41
Q

What 2 treatments appear to be the future of radiotherapy?

A

Hyperfractioned radiotherapy

Hypofractioned radiotherapy

42
Q

What is hyperfractioned radiotherapy?

A
  • increasing frequency of fractions - more than one a day
  • e.g. Continuous hyperfractioned accelerated radiotherapy
  • treatment given over 12 days rather than 4/6 weeks
  • total dose the same
  • requires hospital stay
  • only available in a few centres
43
Q

What is Hypofractioned radiotherapy?

A
  • increase dose of radiotherapy per fraction - lower the frequency of fractions
  • overall = reduction in the total amount of radiotherapy received
  • need to assess reduction in side effects and reduction in risk of recurrence of the cancer
44
Q

What is stereotactic radiotherapy?

A
  • novel treatment used to treat small round tumours usually found in the head
  • treatment delivered from many different points in the head
  • external frame used to keep head in place
45
Q

What may be treated by stereotactic radiotherapy?

A
  • used to treat a number of benign conditions
  • pituitary adenomas
  • acoustic neuromas
  • growths at the base of the skull (meningiomas)

-secondary brain tumours or gliomas

46
Q

What is another type of stereotactic radiotherapy?

A

Radiosurgery

47
Q

What is Radiosurgery?

A
  • patients receive one single large dose of radiation
  • IMRT - intensity-modulated radiation therapy
  • IGRT - image-guided radiation therapy
48
Q

Why might Radiosurgery be used?

A

If patients can’t undergo surgery

49
Q

Why isn’t Radiosurgery not suitable for medium or large tumours?

A

Because there needs to be a consistency of exposure

50
Q

What may radiosurgery cause?

A

Damage to nerves

51
Q

What are atoms made up of?

A

Protons
Neutrons
Electrons

Pharmacology - Year 2 AC (14 decks)

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