Cancer Treatments
Surgery Radiotherapy Chemotherapy - Neo-adjuvant - Adjuvant - Palliative
Immunotherapy
Drugs given in malignancies
Chemotherapy
Why is chemotherapy given in intervals
To allow bone marrow recover
Bone Marrow is also targeted as they are also rapidly dividing
Effect of Multiple courses of chemotherapy on normal cells and tumour cells
Targets of Chemotherapy
DNA Synthesis
Folate antagonists
Interfere with synthesis of purines & pyrimidines - (methotrexate)
Antimetabolites
How to treat side effects of folate antagonists
High dose folic acid is given to patients afterwards to prevent side effects and replenish folic acid reservoirs
False substrate approach of chemotherapy
5-Fluoruracil
Pyrimidine Analogues
Inhibit thmidylate synthase, incorporated into DNA as false metabolites lead to DNA damage
Antimetabolite
**Chemotherapy
Alkylating Agents
Cyclophosphamide
Cause chemical cross linking of DNA, preventing DNA replication (I think)
**Chemotherapy
Platinum compounds
Cisplatin
Inhibition of DNA synthesis by cross-linking Guanine (G) residues
Revolutionised treatment of testicular cancer
- *Chemotherapy
- *Think Giratina (G) from Pokemon Platinum
Anthracycline antibiotics
Doxorubicin
Interfere with nucleotide synthesis by intercalating between DNA strands, inhibiting topoisomerase (involved in uncoiling and supercoiling) and generating free radicals
Topoisomerase Inhibitors
Etoposide
Inhibition of topoisomerase II prevents ligation of DNA, leading to breaks in DNA strand
**Chemotherapy
Microtubule inhibitors
Vinca Alkaloids block the formation of the mitotic spindle
Taxanes stabilise spindle fibres and stop them from doing their job
**Chemotherapy
Side effects of anticancer chemotherapy
Inhibiting all fast growing cells (GI epithelia, hair loss)
Myelosuppression (bone marrow)
- Neutropaenia/Neutropaenic sepsis
- Anaemia
- Decreased platelet counts
Nausea (especially Pt compounds)
Infertility
Cardiotoxicity
How to overcome reduced white counts as a side effect of chemotherapy
Colony-Stimulating Factors
Antibiotics & Antifungals
Maintain good oral hygeine
Palliative Care of Cancer
Pain Relief Strong Opioids - Morphine/Heroine Syringe Drivers Hospice Care
