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Principles of Disease 16 > Therapeutic options in Cancer > Flashcards

Flashcards in Therapeutic options in Cancer Deck (20)
1

Describe modalities of therapy currently available

Prevention:
• Diet
• Reduced environmental factors e.g. smoking
• Screening
• Genetics
• Medication

Treatment:
• Surgery
• Radiotherapy
• Systemic therapy - chemotherapy, immunotherapy

2

How is diet linked to colorectal cancer?

Linked to red meat consumption

3

How is diet linked to breast cancer?

Linked to saturated fat intake

4

Describe some currently available cancer screening schemes

• Cervical cancer: smear tests, HPV injections
• CRC: faecal occult blood
• Breast cancer: mammography

More controversial, is it of benefit to patient:
• Prostate cancer: PSA blood test (reliable?)
• Lung cancer: MR / CT scanning, breath test

5

Describe some chemoprevention commonly used

Primary: oesophageal cancer
- High rates in parts of China
- Supplement diet with anti-oxidants, not much difference

Primary: breast cancer
- Known at risk women
- Prophylactic tamoxifen, benefit vs. harm (side effects) e.g. increases risk of endometrial cancer

Secondary: previous H&N or lung cancers
- Give anti-oxidant supplements
- No benefit

6

Describe some mechanisms of local cancer treatment

- Surgery
- Radiotherapy
- Ablation (freezing, radio-frequency, etc.)
- Isolated limb perfusion

7

Describe some methods of systemic treatment

- Hormonal therapy
- Chemotherapy
- Immunotherapy
- Whole body irradiation (for bone marrow transplant)

8

What are the 5 Rs of radiobiology?

• Radiosensitivity – How sensitive is it to radiotherapy?
• Repair – allows repair of normal cells, not necessarily cancer
• Re-population – allows repopulation of normal cells, while ideally not allowing tumour growth
• Re- oxygenation – hypoxic cells resistant to radiation, splitting the dose into fractions raises the possibility of the closed vessel being open the next time around, and therefore allowing the tumour cells to be killed.
• Re-assortment – allows targeting of cells in different stages of cell cycle during different treatments

9

What is total mesolectal excision?

Total mesorectal excision is a standard technique for treatment of colorectal cancer. A significant length of the bowel around the tumour is removed, and the removed lymph system scrutinised for cancerous activity (see lymphadenectomy). It is possible to rejoin the two ends of the colon; however, most patients require a temporary ileostomy pouch. Local treatment.

10

What is prostate brachytherapy?

Localised treatment where tiny radioactive particles the size of a grain of rice are implanted directly into the site of the tumour. These particles are known as ‘seeds’, and they can be inserted linked together as strands, or individually. Because the seeds are inserted or implanted directly into, or very close to, the tumour, they deliver high doses of radiation to the tumour without affecting the normal healthy tissues.

11

Where in the cell cycle are cancer cells not susceptible to radiotherapy?

G1 quite unsusceptible, and no effect in G0 (no treatment kills senescent cells)

12

Define the therapeutic index

Represents the difference between the lowest therapeutic concentration and the concentrationt that causes toxicity in patients

13

What is a neoadjuvant?

‘Neoadjuvant’ – chemotherapy given beforehand e.g. increase success of surgery/radiation

14

What are some important biomarkers for metastatic CRC?

• Kras status
• Braf status

15

Give some examples of hormone therapy for cancer treatment

• Breast cancer: ER+ve & tamoxifen
• Prostate cancer: LHRH antagonists

16

What is Rituximab used for?

B cell NHL

17

What drug is used to treat B cell NHL?

Rituximab

18

What is Trastuzumab used for?

HER2 +ve breast and gastric cancer

19

What is HER2 +ve breast and gastric cancer treated with?

Trastuzumab

20

What is ZD1839 (‘Iressa’) used for?

EGFR inhibitor for lung cancer