Therapeutic options Flashcards

1
Q

what are cancer prevention options? (4)

A
  1. diet
  2. screening
  3. genetics
  4. medication
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2
Q

what are cancer treatment options? (3)

A
  1. surgery
  2. radiotherapy
  3. systemic therapy
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3
Q

what 2 diet choices have links with what cancers?

A
  1. red meat consumption; associated with colorectal (bowel) cancer
  2. saturated fat intake; associated with breast cancer
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4
Q

what is the current advice on diet which affect hormonal balance in the body? (3)

A
  • 5 a day
  • at least 30 mins of exercise a day
  • avoid obesity
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5
Q

what are the 3 main screening options?

A
  1. cervical cancer: smear tests
  2. CRC: faecal occult blood test
  3. breast cancer: mammography
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6
Q

what are the more controversial screening tests which aren’t available readily?

A
  1. prostate cancer (PSA blood test)

2. lung cancer ( MR/CT scanning and breath test)

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7
Q

what are 2 of the most common genetically inherited cancers?

A
  1. breast cancers (BRCA1 and BRCA2)

2. CRC (colorectal cancer) and FAP (familial adenomatous polyposis coli)

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8
Q

what 3 measures can be taken for people who have the autosomal dominant CRC or FAP conditions?

A
  1. screen families for APC mutations
  2. regular colonoscopy
  3. offer panprotocolectomy when adenomas found
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9
Q

what are some of the more controversial cancers which use chemo-prevention

A
  1. oesophageal cancer
  2. breast cancer
  3. lung cancer
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10
Q

what are 4 types of local/ regional treatment for cancer?

A
  1. surgery
  2. radiotherapy
  3. ablation (freezing, radi-frequency, etc)
  4. isolated limb perfusion
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11
Q

what are 4 types of systemic treatment for cancer?

A
  1. hormonal therapy
  2. chemotherapy
  3. immunotherapy
  4. whole body irradiation
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12
Q

what 2 factors does cancer staging depend on?

A
  1. where is cancer

2. what kind of cancer

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13
Q

How can the location if the cancer be detected? (2)

A
  1. examination/ palpation

2. use of radiology/ imaging (CT, MRI, USS, PET etc)

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14
Q

how can the kind/ type of cancer be detected?

A

through pathology/cytology

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15
Q

what does surgery mean in terms of how much cancer is cleared?

A

Surgery needs anatomical clearance (ALL of cancer is taken out)

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16
Q

what can radiotherapy allow doctors to do? (3)

A
  1. needs anatomical coverage
  2. can treat inoperable lesions
  3. can make surgery become possible
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17
Q

What are the 5Rs of radiobiology?

A
  1. radiosensitivity (of tumour)
  2. repair
  3. re-population (growth)
  4. re-oxygenation
  5. re-assortment
18
Q

does radiotherapy provide more or less oxygen to the tumour?

A

More oxygen

19
Q

in what cell cycle phase will most cell be in?

A

G1 phase

20
Q

what does re-assortment mean in terms of cells in radiography?

A

when cells have dividing chromosomes, it makes them more sensitive to radiation

21
Q

What are the 3 main reasons why radiotherapy is given?

A
  1. to cure cancer (e.g.~40% of head/neck, cervix/uterus, skin and lymphoma cancers)
  2. to combine with chemotherapy (e.g. anal, rectal, oesophageal cancers)
  3. important in palliation (pain relief, bleeding, swollen limbs)
22
Q

why is systemic treatment both good and bad?

A
  • good and beneficial for widespread

- bad as can result in widespread toxicity

23
Q

what is the main treatment method to palliate patients? (easing pain)

A

chemotherapy

24
Q

In the therapeutic index curves used by oncologists, how do they want to keep the curves on the graph?

A

As far away from each other as possible

25
Q

What does no overlap in the therapeutic index curve mean?

A

it means everyone is being cured and no one is hurt or suffering from side effects (drug is 100% beneficial)

26
Q

what are the 4 indications for the use of cytotoxic drugs?

A
  1. curative
  2. palliative
  3. adjuvant (even if patholgoy tells us otherwise, the risk of growth population is reduced)
  4. neoadjuvant (people treated before surgery)
27
Q

what 2 cancers have the best outcomes for chemotherapy?

A

testicular cancer and lymphomas

28
Q

chemotherapy can be used in combination with radiotherapy to produce good results in what cancer?

A

anal cancer

29
Q

what is adjuvant chemotherapy?

A
  • increasing amount of chemotherapy use
  • follows surgery (e.g. colon or breast)
  • improves survival (the aim)
30
Q

what are the 2 decisions which need to be considered in adjuvant chemotherapy?

A
  1. toxicity vs benefit

2. cost vs benefit

31
Q

what is palliative chemotherapy?

A
  • aims to alleviate pain/relieve symptoms (e.g. lung, breast, CRC)
  • accounts for 50% of chemotherapy use
  • sometimes used when surgery would do more harm to patient
32
Q

what 2 genes does colorectal cancer have (tumour biomarkers)?

A
  1. KRAS
  2. BRAF
    (interact together)
33
Q

what is neoadjuvant chemotherapy?

A
  • more recent use of chemotherapy
  • PREcedes surgery or radiotherapy
  • aims to increase survival and reduce morbidity
  • often used for breast and oesophagus cancers
34
Q

what is hormone therapy

A

specific and targeted therapy for specific cancers

35
Q

which 2 cancers often used hormone therapy?

A

breast (tamoxifen) and prostate (LHRH antagonists)

36
Q

Synthesis of specific antibodies can be created if they don’t exist naturally, for which conditions?

A
  1. cancers
  2. rheumatology (arthritis)
  3. colitis
37
Q

what are the 3 specific immune therapies?

A
  1. monoclonal antibodies
  2. programmed cell death pathway (uses immune system to attack foreign cancer cells)
  3. chemeric antigen receptor (CAR) T cells (artificial T cell receptors using retroviral vectors to give a specific cell killing function against cancer cells)
38
Q

what is the main problem with new treatment methods of using T cells to detect cancers?

A

markers on T cells can unmask other antigens in other body sites

39
Q

what are designer therapies targeting in cells?

A

Intracellular growth control points

40
Q

Improvements in what 4 areas will lead to better therapeutic options?

A
  1. surgical techniques
  2. radiotherapy
  3. systemic treatment
  4. immunotherapies