SG Cancer Flashcards Preview

P&T Block 5 Renal > SG Cancer > Flashcards

Flashcards in SG Cancer Deck (17)
1

Clear cell renal carcinoma, grade 2 (no mets). At this time, the next step of care is to:

Repeat physical exam + scan in 4-6 months - option makes sense if discovery of tumor was incidental finding
And/or nephrectomy

2

What genetic disease is correlated with clear cell renal carcinoma?

VHL

3

What are your 3 options for a solitary renal lesion?

Nephrectomy
Cryoablation: freeze thaw cycles
Observation

4

CT shows metastatic renal cancer consistent with pt's original primary tumor. Next step is:

PO sunitinib (tyrosine kinase inhibitor)

5

What are the 5 treatment options for advanced renal cell cancer

1. Immunotherapy: IL2, IFN
2. Monoclonal Abs: bevacizumab
3. TK inhibitors: sunitinib, etc
4. mTOR inhibitors: temsirolimus
4. Nephrectomy

6

IL 2 toxicities

LOOKS LIKE SEPSIS (admit to MICU for dosing)
Capillary leak
Hypotension, tachycardia, vol depletion
Arrhythmia
Renal + hepatic failure
Electrolyte changes
AMS

7

What type of monoclonal Ab is bevacizumab?

VEGF inhibitor - endothelial growth factor

8

Bevacizumab toxicities

BLEEDING RISK b/c impaired wound healing - no surgery
- C/I w/ active hemoptysis, brain mets, on anticoag
HTN
Proteinuria

9

How do TK inhibitors work for renal cell carcinoma?

Inhibit proliferation and angiogenesis

10

TK inhibitors toxicities

FATIGUE
N/V/D
Hand-foot syndrome
HTN

11

Mechanism mTOR inhibitors

+ regulator of hypoxia-inducible factor dependent gene transcription

12

What worries you about treating bladder cancer?

High recurrance

13

What is the strongest risk factor for developing bladder cancer?

SMOKING

14

What is BCG? What does it treat?

Bacillus Calmette Guerin - live attenuated mycobacterium bovis
Treat bladder cancer
Inject into the bladder directly to trigger the immune system to fight the cancer

15

BCG toxicities

Cystitis, freq, huematuria
Fever, infection (systemic immune activation)
C/I in pts on statins

16

When can't you use BCG?

Muscle invasive disease - no longer localized disease even if it is still only in the bladder

17

Ideal pt for chemo-radiation

1st debulked tumor
T2 transitional cell carcinoma
No obstruction/hydronephrosis
Tolerate follow up appts