Oncology Blue Book - Part 1 Flashcards
(77 cards)
1
Q
No. of ppl will be diagnosed with cancer?
A
1 in 3
2
Q
No. of ppl will die of cancer in our generation
A
1 in 4
3
Q
What are the Big 4 cancers
A
Breast, Lung, Prostate and GI tract
4
Q
what cancer does cigarette smoke cause
A
lung cancer
5
Q
Epstein Barr Virus cause what cancer
A
Burkitt’s lymphoma
6
Q
What cancer is caused by a germline deletion of one allele of a gene and so mutation of the remaining allele –> carcinogenesis
A
neurofibromatosis, adenomatous polyposis coli and familiy breast cancer (BRCA 1 & 2)
7
Q
which cancer leads to the discovery of p53
A
Li-Fraumeni syndrome
8
Q
how does cigarette smoke cause cancer
A
causes specific mutation in the p53 tumour suppressor gene
9
Q
where us aromatic amines commonly found
A
industrial dye
10
Q
what do aromatic amines cause?
A
bladder cancer
11
Q
where can you find benzene in
A
dye
12
Q
what does benzene cause?
A
leukaemia
13
Q
what does wood dust cause?
A
nasal adenocarcinoma
14
Q
where can you find vinyl chloride
A
aerosol spray
15
Q
what does vinyl chloride cause?
A
angiosarcoma
16
Q
how does radiation cause cancer?
A
causes DNA damages anc accunumation of mutations in tumor-suppressor genes and oncogenes
17
Q
what cancer does radiation causes
A
skin cancer
18
Q
how does low fibre diet cause cancer
A
low fiber diet causes increase in transit time of food in the colon and so greater amount of carcinogens are absorbed this way
19
Q
what does low fibre diet cause
A
colorectal carcinoma
20
Q
what does smoke food cause
A
gastric carcnioma
21
Q
what is topoisomerase
A
Topoisomerase = enzyme control changes in DNA Backbone by catalyzing the breaking & rejoining of phosphodiester backbone of DNA
22
Q
an example of topoisomerase inhibitor
A
anti-cancer agent
23
Q
what can topoisomerase cause
A
acute leukaemia
24
Q
what cancer can human papillomavirus cause
A
cervical cancer
anal cancer
25
how can Human papillomavirus cause cancer
E6 protein by HPV16 binds to inactivate the p53 protein --> dysregulation of cell cycle and apoptotic pathways + malignant transformation of epithelial cells
26
what cancer can Epstein Barr Virus cause
non-Hodgkin's Lymphoma
27
what can HBV cause
hepatocellular cancer
28
what cancer can retrovirus
HTLV1 (Human T-cell Leukaemia Virus Type 1)- T-cell lymphoma
29
What cancer can H. pylori cause
MALT - mucosal-associated lymphoid tissue tumours
30
How can infection/drug that causes weakening of the immune system cause cancer
immune system important in tumour survillance
| weak immune system --> weak survillance and so cancer
31
what are some presenting symptoms of lump changes in cancer patient
breast lumps
change in moles
node, nodules and musclo-skeletal lumps
32
what are some presenting symptoms of bleeding in cancer patient
rectal bleeding
haemoptysis
haematuria
post-menopausal/irregular menstrual bleeding
33
what are some presenting symptoms of pain in the cancer patient
chest pain
abdo pain
headache
oftne unexplainable
34
what are some presenting symptoms of change in function in cancer patient
```
change in bowel habit, new cough
dyspnoea
weight loss
fever
acute confusional state
```
35
what is the purpose of staging
prognosis and appropriate choice of treatment
36
what does higher staging means to a patient
more extensive the treatment has to be and probable systemic blood-norne metastases --> mets
37
what is the general mechanism of action of chemotherapy
most agents targets DNA either directly or indirectly
toxic towards actively proliferating cells
38
what is neoadjuvant chemotherapy
pre-operative treatment of an operable tumour before definitive surgery and also treat occult micro mets
aim to inc cure rate
39
what is primary chemotherapy
initial chemo for a tumour that is inoperable or of uncertain operability
however reduction in tumour bulk in a pre-defined manner may make surgery with curative intent feasible
aim to inc cure rates
40
what is adjuvant chemo
use of chemo following a complete macroscopic clearance at surgery to treat occult microscopic mets
aim to inc cure rate
41
what is palliative chemo
aim to alleviate symptoms and prolong life in some cases in patient who can not be cured
42
what is curative chemo
aim to cure cancer even if mets at presentation with modern chemo
example incl germ cells, Hodgkin's disease, Non-Hodgkin's Lymphona and childhood cancer
this justify the use of intensive chemo
43
what is prophylactic chemo
hormonal treatments given before malignancy appears
example incl tamoxifen for in-situ breast cancer
44
how is chemo usually given
as a combination of chemo medication
45
why a combination of chemo drugs are given instead of only one
because multiple drugs can give synergism effect and may kill more cancer cells in a single cycle
also reduce the chance of medication resistance tumour cells to develop as different meds wrok in different sites of the cancer cells
46
why is chemo given in cyles?
to allow normal cells to recover from the toxicity of treatment
47
what cells are most commonly affected by the chemo
haematopoietic and gut lining --> myelosuppresion (low blood count)
48
what is the usual effectiveness of a cycle of chemo drugs
roughly 6 months
49
what justified the use of 'high dose' chemo
ehen long term survival or cure possible
50
advantage of using drugs orally
to free patient from lengthy hospital visit or invasive procedure
51
which chemo is available in oral form
cyclophosphamide
etoposide
tamoxifen
capecitabine
52
how is systemic chemo given
usually bolus injection, short infusion
| sometimes longer infusion via central line (PICC, central line or tunneled under the skin)
53
which cancer warren a intra-vesical infusion of chemo
bladder cancer - by directly injecting chemo into the bladder, lower systemic absorption and higher local concentration = higher cure rate and less SE
54
which cancer warren a intra-peritoneal infuision of chemo
Ovarian cancer - by injecting directly into the peritoneal cavity, chemo can stop trans-coelomical spread (spread within a cavity) of ovarian cancer
55
which cancer warren an intra-arterial injection of chemo
Liver mets (direct injection in to hepatic artery) - this method of chemo injection only works for cancer which has a well-defined arterial supply.
56
what is the commonly used way to calcuate the dose of a chemo drug
bodt surface area using the DuBois and DuBois formula
57
which chemo drug has its dosage calculate using renal function
carboplatin
58
which chemo drug has its dosage calculate using body weight
monocolonal antibody trastuzumab
59
what is the first consideration when considering the start of chemo
SE vs potential benefit
60
how can SE of chemo be divided into
```
immediate = relevant to all patient
late = only concern those with long survival rate
```
61
what are some examples of immediate side effects of chemo
Haemotology -
myelosuppresion
```
GI -
N+V
oral mucositis
diarrhoea
colitis
small bowel mu=coasal inflammation
constipation
```
alopecia
```
Neuro -
peripheral neuropathy
autonomic neuropathy
central neuropathy
ototoxicity
```
nephrotoxicity
bladder toxicity
cardiac -
acute arrhythmia
coronary artey spasm
cardiac ischaemia
```
skin and soft tissue -
extravasation
palmar-plantar erythema
photosensitivity
pigmentation
```
allergic reaction
lethargy
myalgia and arthralgia
62
how severe leucopenia is considered to be at risk of infection
neutrophil of 0.5x10 9 is considered at risk of infection but 1x10 9 is considered to be safe
63
what is nadir
it is the lowest point of neutropenia induced by chemotherapy (10-14 days post chemo)
64
how long does it take for the haematopoietic cells recover
3-4 wks
65
which chemo drugs commonly cause neuropathy
cisplatin
taxanes eg docetaxel
vinca alkaloids - cytotoxic
66
which chemo drug can cause CNS toxicity
isfamide-induced encephalopathy
| 5-Fu cerebellar toxicity
67
which chemo drug can cause ototoxicity
cisplatin --> permanent
68
which chemo drug can cause nephrotoxicity
cisplatin, ifosfamide
69
which chemo drug can cause bladder toxicity
cyclophosphamide, ifosfamide
70
which chemo drug can cause acute arrhythmia
Doxorubicin and paclitaxel
71
whch chemo drug can cause coronary artery spasm
5-FU --> can further induce cardiac ischaemia
72
which chemo drug can cause palmar plantar erythema
5-FU, capecitabine
| targeted agents eg sunitinib, erlotinib
73
which chemo drug can cause photosenitivity
5-FU
74
which chemo drug can cause pigmentation
bleomycin
75
which chemo drug has high frequency of allergic reaction
paclitaxel and docetaxel
76
what are some late side effects of chemo
```
secondary malignancies
fertility
pulmonary fibrosis/pneumonitis
acute conduction defects
psychological and social
```
77
what can female cancer patient do to perserve her fertility
store fertilised ova
| cryopreservation of sections of ovary
