Oncology - Background Flashcards by Hannah Lapos

Counseling on skin protection

Seek shade
Wear a shrit
Use broad-spectrum sunscreen (>30 SPF) and reapply Q2H
Wear a hat
Wear sunglasses

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What are the warning signs of melanoma

Asymmetry
Border is irregular
Color not consistent
Diameter lager than 6mm
Evolving

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Breast screening guidelines

Females
45-54 YO: QY
≥55 YO: Q2Y or QY

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Cervical screening recommendations

Females
25-65 YO:
- Pap smear Q3Y
- HPV DNA test Q5Y
- Pap + HPV DNA Q5Y

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Colorectal screening recommendations

Male and female
≥45YO:
Stool-besed tests: FIT and fecal occult blood test QY
- stool DNA test Q3Y

Visual exam:
- Colonoscopy Q10Y
- CT colonography Q5Y
- Sigmoidoscopy Q5Y

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Lung screening recommendations

Males and females ≥50 YO:
CT scan of chest if pt smokes 20 pack/year and still smokes or quit within 5 years

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Prostate screening recommendations

If the patient chooses to be tested:
- PSA +/- digital rectal exam

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What are the warning signs of cancer

Change in bowel or bladder habits
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

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How do you diagnose cancer

Biopsy
Imaging
Biomarker

TNM staging:
- Tumar size and location
- Node involvement
- Metastasis

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What is a carcinoma

Forms from the epithelial cells that line internal and external surfaces of the body

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What is leukemia

Cancer in bone marrow effecting leukocytes

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What is lymphoma

Cancer affecting lymphatic system

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What is multiple myeloma

Arises from plasma cells of the bone marrow

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What is sarcoma

Develops in connective or supportive tissue

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What is neoadjuvant therapy

Used before surgery to shrink the tumor and make resection more likely

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What is adjuvant therapy?

Additional cancer treatment given after primary treatment to eradicate residual disease and recurrence

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What is complete response

Complete remission: the cancer can’t be detected

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Progressive disese

The cancer has grown or is worsening

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Stable disease

The cancer is not improving or worsening

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Chemo that targets the M-phase

Taxanes: Pacitaxel, Docetaxal
Vinca alkaloids: Vincristine, Vinblastine

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Chemo that targets G2 phase

Etoposide
Bleomycin

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Chemo that targets G1 phase

Pegaspargase

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Chemo that targets S phase

Antimetabolites: MTX, pemetrexed, 5-FU, capecitabine

Topoisomerase I inhibitors: Irinotecan, topotecan

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Chemo that is not dependent on the phase of the cell cycle?

Alkylating agents: Cyclophosphamide, ifosfamide

Anthracycline: Doxorubicin, daunorubicin

Platinum compounds: Cisplatin, carboplatin, oxaliplatin

AAP

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How to calculate BSA

Root of [(Ht in cm) x (Wt in kg)]/3600

Alkylating agents

Cyclophosphamide Ifosfamide Busulfan Carmustine

Safety concerns of cyclophosphamide

Hemorrhagic cystitis → toxic acrolein - Hematuria, dysuria

Prevention of cyclophosphamide and ifosfamide toxicity

Mesna

Safety concern of busulfan

Pulmonary toxicityq

Safety concern of carmustine

Pulmonary toxicity Neurotoxicity → seizures

Prevention of neurotoxicity in carmustine

Antiseizure med

Prevention of pulmonary toxicity in busulfan

Symptomatic care

Safety concerns of platinum agents and how to mitigate

Hypersensitivity: supportive care Nephrotoxicty: Hydration, amifostine (Ethyol), Cisplatin ≤100 mg/m^2 per dose Ototoxcity Peripheral neuropathy Oxaliplatin: acute neuropathy exacerbated by cold → avoid cold

Anthrocycline

Doxorubicin Mitoxantrone Danrubicin Idarubicin Epirubicin

Safety concerns of Doxorubicin and how to mitigate

Cardiotoxicity → Lifetime cumulative dose of 450-550 mg/m^2, dexrazoxane if ≥300 Red dicoloration

ADR of mitoxantrone

Blue discoloration

Topoisomerase I inhibtors

Irinotecan Topotecan

Irinotecan

Camptosar

Safety concerns with irinotecan and how to mitigate

Acute diarrhea: atropine Delayed diarrhea (>24hr of infusion): loperamide

Pyrimadine Analog Antimetabolite

5-FU Capcetabine Gamcitabine

Safety concerns with Pyrimadine Analog

Hand-foot syndrome DPD defiiecny → toxicity Mucositis ↑ INR Diarrhea

Tx for hand-foor syndomre

Emollients Cold compress Reduce pressure and friction

Tx for mucositis

Oral hygiene Ice chips Bland wash Nystatin, Clotrimazole Magic mouthwash, Viscous lidocaine 2%

Reversal for Pyrimadine Analog

Uridine triacetate

Reversal for platins

Amifostine

Reversal of doxorubicin cardiotoxcity

Dexrazonane

Folate Antimetabolite

Methotrexate Pemetrexed

Safety concerns for MTX and how to mitigate

GI toxicity → mucositis treatment, leucovorin rescue Nephrotoxicity (≥500mg/m^2): - Prevention: leucovorin rescue, hydration with IV sodium bicarb (alkalize urine), avoid nephrotoxic drugs - Tx: glucarpidase (Voraxaze) antidote

Taxanes

Pacitaxel Docetaxel

Administration of taxanes

Non-PVC with 0.22 micron filter

ADR of taxanes and how to mitigate it

Peripheral neuropathy Hypersensitivity → premeditate with steroid, benadryl, H2RA Docetaxel: fluid retention → diuretics or premeditate with steroid

Vinca alkaloids

Vincristine Vinblastine

Vinca ADR and ways to mitigate

Peripheral neuropathy → limit singe vincristine doses to 2 mg Autonomic neuropathy (constipation) Paralysis and death if given intrathecally → Prepare in small bags (piggyback) Vincristine: CNS roxicity Vinblastine: bone marrow suppression

Topoisomerase II inhibitrs

Etoposide

ADR of etoposide and prevention

Infusion-related hypotension → infuse over 30-60 min

ADR of Bleomycin and how to mitigate

Pulmonary toxicity → lifetime dose 400 units Hypersensitivity

ADR of Pegasparigase

Pegylated → less allergic reaction and frequent dosing

ADR of immunomodulators

Severe birth defects Thrombosis

Immunomodulators

-lidomide

ADR of proteasome inhibitors

Herpes reactivation → acyclovir, valacyclovir

ADR of arsenic

QTc prolngation

Chemo that causes neurotoxicity

Carmustine

Cisplatin ADR

Ototoxcity, emetogenicity, nephrotoxicity, pheripheral neuropathy, hypersensitivity

Mucositis Chemo

MTX → leukovorin 5-FU, capcetabine

Pulmonary toxicity chemo

Bleomycin: 400 units Carmustine Bisulfan

Chemo that causes cardiotoxcity

Doxorubicin: 450-550 lifetime, ≥300 initiate dexarozamine Daurubicin

Chemo that cause hemorrhagic cystitis

Cyclophosphamide Ifosfamide Mesna is antidote

Peripheral neuropathy chemo

Platin, Vinca, Taxane Oxaliplatin: avoid cold Vincristine: 2 mg dose only

Bone marrow suppression chemo

Most except bleomycin, pegaspargase, vincrisitne

Oncology - Background Flashcards

(69 cards)