Wk 2 Cancer

Question 1

What is Stage 1 cancer?

Answer 1

cancer confined to organ or origin

Question 2

What is Stage 2 cancer?

Answer 2

cancer that is locally invasive

Question 3

What is Stage 3 cancer?

Answer 3

cancer that has spread to regional structures such as lymph nodes

Question 4

What is Stage 4 cancer?

Answer 4

cancer that has metastasised to distant sites

Question 5

Adjuvant chemotherapy

Answer 5

use of chemotherapy AFTER local treatment (e.g. radiotherapy or surgical removal of primary tumour). Useful when minimal cancer remaining but at high risk for metastasis –> by preventing growth of tiny sites of metastasis deposits that are not clinically detectable (reduce chances of recurrence)

Question 6

Neoadjuvant chemotherapy?

Answer 6

(AKA primary chemotherapy). Use of chemotherapy BEFORE definitive local control surgery or irradiation to decrease initial tumour size (makes local treatment such as surgery less invasive)

Question 7

Sophia received chemotherapy to decrease the size of the tumour, followed by its surgical removal. The type of chemotherapy she received is categorized as:

Answer 7

Neoadjuvant chemotherapy

Question 8

Sophia, a 28-year-old female has been diagnosed with cervical cancer. Upon examination, her cancer was found to have spread to her lymph nodes, but not to distant sites (i.e. other organs). What is the stage of her cancer?

Answer 8

Stage 3

Question 9

What are side effects of chemotherapy?

Answer 9

nausea, vomiting, alopecia, fatigue, anorexia/appetite suppression, weight loss/cachexia, peptic ulcers, oral ulcers, malabsorption, diarrhoea, bone marrow suppression, skin erythema & skin breakdown, decreased fertility and premature menopause

Question 10

Explain how chemotherapy leads to side effects by relating to its mechanism of action

Answer 10

Chemotherapy attacks rapidly dividing cells and is non-discriminatory with the cells it destroys therefore it destroys healthy rapidly dividing cells such as blood cells and oral cells

Question 11

Explain why several agents are used in chemotherapy regimens

Answer 11

ensures max. number of cancer cells are destroyed rather than only cells in 1 particular cell cycle phase if only 1 agent is used. Reduces drug resistance ass. w/ using 1 drug. Also allows for more destruction and lesser side effects

Question 12

The rationale for cycle-based chemotherapy

Answer 12

• Most effective against actively dividing cells
• healthy cells can recover w/in weels unlike cancerous cells
• there is a lag time while body repairs and recovers itself in order to develop normal numbers of healthy cells again –> this occurs after each dose of chemo
• Cycle-based chemotherapy is used to allow time in between treatments for healthy cells destroyed by chemo to recover and regenerate to baseline levels.

Question 13

The dosage of chemotherapeutic agents is directly proportional to the degree of destruction of the cancerous cells. Explain why we do not administer high-dose chemotherapy to eradicate cancer at a single dose?

Answer 13

Although very high doses are more effective in destroying cancer cells, a large number of healthy cells are also destroyed and therefore these doses are too high to be tolerated.

Question 14

Explain the consequence of administering a sub-therapeutic dose of chemotherapy

Answer 14

Decreasing the chance of successful eradication of malignant cells

Question 15

How does monoclonal antibody therapy work, and why does it not lead to side effects such as pancytopenia alopecia, oral ulcers and diarrhoea?

Answer 15

Monoclonal antibodies: drugs that consist of antibodies that are produced to bind to specific antigens on the surface of cancerous cells, thereby leading to their destruction. e.g. rituximab binds to antigens on B lymphocytes in B cell lymphomas

Question 16

Febrile neutropenia - signs, urgency & treatment

Answer 16

• temperature of 38.0°C or greater
• neutrophil count of less than 1.0 x 109 cells/L
• Considered oncologic emergency –> neutropenic pt. lacks immunity to fight off infection so can deteriorate quickly
• Broad-spectrum antibiotics should be administered within 30 minutes (source of infection is unknown at first)

Question 17

Why may cancer patients continue to receive chemo when their cancer is incurable?

Answer 17

Chemotherapy can still be administered for non- curative purposes (also referred to as ‘palliative intent’) to control cancer growth to manage symptoms such as pain, often with lower than the curative dose to minimize chemotherapy side effects

Question 18

Chemotherapy

Answer 18

Non-selective cytotoxic drugs that target vital cellular or metabolic processes critical to both malignant and normal cell growth and replication

Question 19

Tamoxifen

Answer 19

Hormone therapy for breast cancer treatment (aims cancer death by inhibiting or stopping the hormone production)

Question 20

Rituximab

Answer 20

Monoclonal antibodies (drugs which consist of antibodies that are produced to bind to specific antigens on the surface of cancerous cells, thereby leading to their destruction)

Question 21

Brachytherapy

Answer 21

treating with internally implanted radioactive seeds

Question 22

Allopurinol

Answer 22

prophylaxis for tumour lysis syndrome. Reduces uric acid level.

Question 23

What are proto-oncogenes and oncogenes?

Answer 23

proto-oncogenes: Genes that code for proteins in a cell to help regulate normal cell growth. When mutated –> oncogenes
oncogenes:
- genes that promote the development of cancer
- Change in DNA sequence of a proto-oncogene –> leads to mutation = oncogene
→ unregulated cell proliferation and differentiation → cancer