Cancer 3- Principles of Cancer TX Flashcards

Aoife

1
Q

Principles of Cancer Tx

Tx if cancer localised (2)

A
  1. Surgical removal
  2. Tx with drug or radiation tx to kill residual cancer
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2
Q

Principles of Cancer Tx

What would an ideal cancer tx be

A

One that removed all the cancer cells without affecting normal cells

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3
Q

Principles of Cancer Tx

What are txs based upon (2)

A
  1. Killing cancer cells
  2. Preventing further growth of tumour
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4
Q

Principles of Cancer Tx

What is the best approach

A

Surgical removal of a tumour mass

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5
Q

Principles of Cancer Tx

Limitations of surgical removal as a tx

A
  1. Cancers of blood (leukaemias) not amenable to surgeries
  2. Same true for cancers that have metastasised to inaccessible sites like bone and brain
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6
Q

Principles of Cancer Tx

What tx is widely used in addition/alternatively to surgery

A

Drug tx

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7
Q

Principles of Cancer Tx

What is the cytostatic effect

A

The prevention of cell proliferation

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8
Q

Principles of Cancer Tx

What is the cytotoxic effect

A

The killing of cancer cells

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9
Q

Principles of Cancer Tx

What does chemo having a broad cell specificity mean

A

It effects all cell processes such as DNA synthesis and cell proliferation common to all cells

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10
Q

Principles of Cancer Tx

What is the disadvantage of chemo having broad cell specificity

A

Side effects ensue.
Fast growing cells targeted -> hair and taste loss

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11
Q

Principles of Cancer Tx

What cancers (2) are hormone txs used to treat and why

A
  1. Prostate
  2. Breast
    Hormone txs effect the growth of cells in these cancers
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12
Q

Principles of Cancer Tx

Explain the principle of radiotherapy being used

A

DNA can be irreversably damaged by ionizing radiation such as X rays which are used in radiotherapy tx along w surgery

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12
Q

Principles of Cancer Tx

What will cytotoxic drugs do

A

Potentially cure the patient

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12
Q

Principles of Cancer Tx

What will cytostatic drugs do

A

Prevent growth but not eliminate the cancer

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13
Q

Principles of Cancer Tx

How would the future tx of angiogenic drugs do?

A

They would prevent angiogenesis and therefore prevent metastatic growth

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14
Q

Principles of Cancer Tx

What are some prognostic factors

A

Prognostic factors to assess prognosis:
1. Tumour size
2. Tumour spread
3. Tumour markers in the tissue or blood associated with the tumour

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15
Q

Principles of Cancer Tx

Remission

A

Decline in cancer size as a result of tx

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16
Q

Principles of Cancer Tx

Relapse

A

Reappearance of a cancer

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17
Q

Principles of Cancer Tx

Screening programmes for early detection exist for? (3)

A
  1. Cervical
  2. Breast
  3. Colon
18
Q

Principles of Cancer Tx

Preventing cancer cells from generating can be achieved with what and e.g:

A

With vaccinations. E.g: cervical cancer vaccine, against Human Papilloma Virus

19
Q

Definition of a response

Complete response

A

Cancer disappears completely

20
Q

Definition of a response

Partial response

A

Partially removed, some remains

21
Q

Definition of a response

No change

A

Remains static

22
Q

Definition of a response

Progressive disease

A

Continues to grow

23
Q

Patient Criteria: Stage and Grade

the 2 criteria in defining cancer

A
  1. Tumour size & degree of spread -> STAGE of disease
  2. Cellular characteristics of the cancer -> GRADE of disease
24
Q

Patient Criteria: Stage and Grade

Advanced stage cancer description

A

One that is large and has invaded its surrounding tissues or organs and metastised to other parts of the body

25
Q

Patient Criteria: Stage and Grade

3 criteria cancer staging is based on

A

TNM system:
1. Tumour size
2. Spread to lymph nodes
3. Metastasis to distant sites

26
Q

Patient Criteria: Stage and Grade

What does a low grade tumour have in comparison to a high grade tumour

A
  • A low grade tumour has histological resemblance to the tissue of origin
  • A high grade tumour has undergone so many changes that it only marginally resembles tissue of origin
27
Q

Patient Criteria: Stage and Grade

Criteria for grading (3)

A
  1. Number of mitoses
  2. Irregularities in nuclear shape
  3. Relative architectural resemblance to normal tissue
28
Q

How does early detection affect prognosis

A

Time equates with increased cullular changes towards aggressiveness so the earlier it can be detected, the fewer changes it has undergone and the greater chance of it responding well to tx

29
Q

Surgery

How can surgical removal result in a cure

A

If all the cancer cells are removed it can result in a cure

30
Q

Surgery

What are the 2 tx options after surgery and why are they more successful after surgery

A

To kill the remaining cancer cells:
1. Drug therapy
2. Ionising radiation therapy
These are more likely to be successful due to the debulking effect of cell removal

31
Q

Radiotherapy

How does radiation kill cancer cells

A

Radiation such as xrays damage DNA and kill cancer cells

32
Q

Drug tx

Chemotherapy definition

A

The term given to drugs whose actions are largely based on blocking cell proliferation

33
Q

Drug tx

What type of cells is chemo most effective against

A

Rapidly dividing cells

34
Q

Drug tx

Efficacy of chemo depends on (2)

A
  1. Conc of drug reaching tumour
  2. Duration of this exposue
35
Q

Drug tx

How can the side effects of chemo be managed

A

By using combinations of drugs with different toxicities

36
Q

Drug tx

What is primary chemo

A

First line tx for local disease

37
Q

Drug tx

What is adjuvant chemo used for

A

It is the agent used in addition to other treatments (surgery) to kill remaining cancer cells. (adjuvant chemo used post mastectomy)

38
Q

Drug tx

What do chemo patients have a tenfold increased risk of

A

Leukaemia

39
Q

Chemotherapy

what can chemotherapeutic agents be categorised into (3)

A
  1. Whether they alkylate DNA (alkylating agents - transfer an alkyl group from one molecule to another)
  2. Antagonise metabolites needed for DNA synthesis (antimetabolites)
  3. Others are natural products from plants and fungi
40
Q

Chemo side effects

What are some of the side effects of chemo and why

A
  1. Anaemia, Thrombocytopenia, Neutropenia as normal haemopoietic cells in bone marrow particularly sensitive to chemo
  2. Patient more prone to infection due to destruction of immune cells
  3. Hair loss as hair follicles are rapidly dividing cells
  4. Nausea & vomiting -> treat w anti emetic drugs
41
Q

Hormone tx

Principle of hormone tx

A

A tx that uses medicines to block/lower amount of hormones in the body to slow down/stop the growth of cancer

42
Q

Hormone tx

Explain how specific properties of cells are exploited with hormone tx

A
  • Steroid hormones are required for the growth of prostate and breast cancer
  • Responsive cells must have specific receptors for the steroid hormone and as most cells in the body dont have these receptors, they are unaffected by the hormone therapy used
  • Hormone tx prevents excess steroid synthesis and blocks their effects at the target cell via the receptor machinary
43
Q

Hormone tx

Examples of the hormone txs used for 1. breast 2. prostate cancer

A
  1. Tamoxifen to treat breast cancer
  2. Anti androgens therapy to treat prostate cancer
44
Q

New forms of tx

4 new forms of tx

A
  1. Angiogenesis: txs prevent new blood vessel formation in cancers
  2. Immunotherapy: mechanisms that use the immune system to facilitate the attack and lyse of tumour cells
  3. Tyrosine Kinase Inhibitors: Tx attempts to intefere w enzymes and proteins involved in cell signalling pathways that control cell proliferation
  4. Gene therapy
45
Q

8 methods of general support therapy

A
  1. Blood product support -> red cells for anaemia, platelet transfusion for thrombocytopenia
  2. Haemostatic support -> Vit K or fresh frozen plasma
  3. Antiemetic therapy -> nausea & vomiting side effects of chemo
  4. Nutritional support -> loss of appetite can cause atrophy, tongue cells affected by chemo, can be prescribed high calorific supplement if can eat orally
  5. Reproductive issues -> egg retrieval or sperm collection
  6. Psychological support
  7. Pain support
  8. Tx for infections