cancer management Adam's txtbook

Question 1

what is an immunomodulator?

Answer 1

a general term referring to any drug/therapy that affects body defences. there are 2 basic types

1. immunostimulants
2. immunosuppressants

Question 2

what is an immunostimulants?

Answer 2

drugs that increase the ability of the immune system to fight infection and disease
-used to treat pts with cancer and hepatitis

Question 3

what are immunosuppressants?

Answer 3

drugs that diminish the ability of the immune system to fight infection and disease

• used to prevent transplant rejection and to dampen hyperactive immune responses
  ex. exacerbations of lupus, rheumatoid arthritis (RA), cancer etc.

Question 4

what are interferons (IFNs)

Answer 4

cytokines secreted by lymphocytes and macrophages that have been infected with a virus

• when secreted they attach to uninfected cells and signal them to secrete antiviral proteins
• interferons slow the spread of viral infections and enhance the activity of existing leukocytes
• increases phagocytosis and enhances the cytotoxic activity of T cells

Question 5

what are interleukins (ILs)

Answer 5

• another class of cytokines synthesized by lymphocytes, monocytes, and macrophages
• there are 30 differs ILs- only a few are available as meds
• they stimulate T-cell function, stimulation of B-cells and plasma cells production, and promotion of inflammation

ex. interleukin 2 derived from helper T lymphocytes cause proliferation of T lymphocytes and activated B lymphocytes

Question 6

how do cells in the body have the ability to regulate its growth (proliferation)

Answer 6

by turning specific genes on and off

Question 7

what are growth suppressor genes

Answer 7

responsible for slowing the duplication rate and can completely shut down replication, as in the case of muscle cells and most neurons. if these suppressor genes becomes damaged/ mutated and stops slowing down the cell growth the cells undergo abnormal proliferation

Question 8

metastasis means

Answer 8

travel of cancer cells from their original site to distant tissue

Question 9

telomeres

Answer 9

serve to protect the vital sequences of DNA from being destroyed
-every time a cell divides, it loses a small amount of DNA at the end of each chromosome. these regions of “extra” repetitive DNA are called telomeres
-telomerase can lengthen the DNA chains and allow continued replication
cancer cells-n as soon as they become mutated produce telomerase contributing to a progression in cancer

Question 10

normal cells are able to undergo mitosis how many times before the cell loses the protective telomeres?

Answer 10

50-60 times

Question 11

angiogenesis and cancer cells

Answer 11

cancer cells have the ability to control angiogenesis and establish their own blood supply, which brings nutrients to the cells but also provides an “escape route” during metastasis

Question 12

what are carcinogens

Answer 12

-agents that cause cancer- such as environmental factors that have been found to cause cancers –> tobacco smoke, asbestos, and benzene

Question 13

can viruses cause cancer?

Answer 13

yes, examples –> herpes simplex type 1 and type 2, Epstein-Barr Virus, humanpapilloma virus (HPV) , cytomegalovirus, and human-T lymphotrophic viruses
-recommended that females between 9-26years be given the HPV vaccine to prevent cervical cancer caused by HPV

Question 14

damage to the tumour suppressor gene is known as the _ ?

Answer 14

p53- associated w/ breast, lung, brain, colon, and bone cancer

Question 15

what are the 7 signs of cancer

Answer 15

1. change in bowel or bladder habits
2. a sore that does not heal
3. unusual bleeding or discharge
4. thickening or lump in the breast or elsewhere
5. indigestion or difficulty swallowing
6. obvious change in wart or mole i.e, bleeding
7. nagging cough or hoarseness
   “CAUTION”

Question 16

what are the 3 general roles of chemotherapy?

Answer 16

cure, control and palliation –> means to alleviate symptoms rather than cure the disease

Question 17

what does debulking mean?

Answer 17

when only a portion of the tumour is removed

Question 18

can you do surgery on tumours of blood cells?

Answer 18

no

Question 19

radiation treatment

Answer 19

frequently prescribed post-op to kill cancer cells that may remain following an operation
-can be given as palliation for inoperable cancers to shrink the size of a tumour that may be pressing on vital organs and to relieve pain, difficulty breathing, or difficulty swallowing

Question 20

what is adjuvant chemotherapy?

Answer 20

administration of antineoplastic drugs after surgery or radiation therapy
purpose of this to to rid the body of any cancerous cells that were not removed during the surgery or to treat any micro metastases that may be developing

Question 21

what is neoadjuvant chemotherapy

Answer 21

administration of antineplastic drugs before surgery or radiation therapy with the goal of shrinking a large tumour to a more manageable size. this may also be done if the tumour has invaded vital tissues around it, such as brain tumours
-shrinking the tumour pre-op results in less surgical invasion when removing the tumour

Question 22

what is staging

Answer 22

the process of determining where the cancer is located and the extent of its invasion
staging helps develop the right treatment to use
stage I is assigned to cancers that are least invasive and have the best prognosis
-stage IV is assigned to the cancer that is the most aggressive and has the poorest prognosis

Question 23

what is grading

Answer 23

a process that examines potential cancer cells under a microscope and compares their appearance to normal parent cells
-grade 1 (G1) has the best prognosis and well differentiated
G4 cells are grossly abnormal and clearly different from normal cells - have the worst prognosis

Question 24

when should we administer antiemetics?

Answer 24

they work best when given continuously rather than pre and should be given 30-60 minutes before the initiation of chemotherapy to effectively counteract nausea

Question 25

what is cachexia?

Answer 25

clients w/ cancer experience a general wasting of muscle and other tissues known as cachexia

• cachexia may be caused by toxic effects from the cancer itself or from its treatment
• symptoms from chemo such as anorexia, mucositis, nausea, and vomiting may contribute to cachexia
• chronic pain, depression, and fatigue are also contributors