Theraputic Options Flashcards

1
Q

What is CRC (colorectal cancer) linked to in terms of diet?

A

Red meat consumption

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2
Q

What is
breast cancer linked to in terms of diet?

A

Saturated fat intake

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3
Q

What is the current advice for diet?

A

5 or more portions of fruit or veg per day

Avoid obesity

Regular exercise every day (30 minutes)

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4
Q

How do we screen for Cervical cancer, CRC and breast cancer?

A

Smear tests

Faecal occult blood the most commonly used test
- 16% reduction in CRC mortality

Mammography

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5
Q

How do we screen for prostate cancer?

A

PSA blood test

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6
Q

How do we screen for lung cancer?

A

MR / CT scanning

Breath test

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7
Q

How do we protect families with a history of CRC & familial adenomatous polyposis coli (FAP)?

A

Screen families for APC mutations
- regular colonoscopy
- offer panprotocolectomy when adenomas found

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8
Q

What is recommended for those with high risk of oesophageal cancer?

A

Supplement diet with anti-oxidants

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9
Q

What is recommended for those with high risk of breast cancer?

A

Prophylactic tamoxifen

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10
Q

What are the therapeutic ‘treatment options’?

A

Local or regional treatment
- surgery
- radiotherapy
- ablation (freezing, radio-frequency, etc)
- isolated limb perfusion

Systemic treatment
- hormonal therapy
- chemotherapy
- immunotherapy
- whole body irradiation (for BMT)

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11
Q

What are the principles of staging?

A

Looking WHERE it is and examining it using radiological techniques (CT , MRI, USS, PET etc)

Determining WHAT kind of cancer it is using pathology / cytology

To determine Classification, risk factors etc
Genomics likely to play a role in the future

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12
Q

What are the advantages of radiotherapy?

A

Can treat inoperable lesions (– treat things you can’t remove)

Can make surgery become possible

Can maintain function and or appearance

Important role in palliation - improving someones symptoms

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13
Q

What are the 5 R’s of radiobiology?

A

Radiosensitivity
Repair
Re-population
Re-oxygenation
Re-assortment

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14
Q

Define radiosensitivity

A

How sensitive the tumour is to the treatment

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15
Q

What is the principle of re-oxygenation?

A

Having oxygen present makes the treatment more effective.

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16
Q

What is the purpose of medical treatment of cancer?

A

Beneficial for widespread disease

3% of cancers are cured by chemotherapy
Palliation in 50% of cancers

HOWEVER - can result in widespread toxicity

17
Q

What are the indications for cytotoxic drugs?

A

Curative
Palliative

Adjuvant (applied after initial treatment for cancer, especially to suppress secondary tumour formation.)

Neoadjuvant (aims to reduce the size or extent of the cancer before using radical treatment intervention, thus making procedures easier and more likely to succeed)

18
Q

What is the aim of adjuvant chemotherapy?

A

To improve survival following surgery

19
Q

What are the factors you need to consider before giving someone an adjuvant?

A

Toxicity vs benefit
‘cost’ vs benefit

20
Q

What is the purpose of palliative chemotherapy?

A

50% of chemo use

Relieves symptoms and may improve survival

21
Q

What is the aim of neoadjuvant chemotherapy?

A

To improve survival
To reduce morbidity

PRECEDES SURGERY

22
Q

What can hormone therapy be used for?

A

Specific or targeted therapy

Used in breast cancer and prostate cancer

23
Q

What can antibodies be used for?

A

Irritable bowel disease
Cancer
Arthritis

24
Q

What is the purpose of the programmed cell death pathway?

A

Uses the immune system to attack the foreign cancer cells

25
Q

What is the purpose of CAR T-cells?

A

Chimeric antigen receptor T-cells

T cells are removed and modified so they express receptors specific to the patients particular cancer

Transfer of coding sequence os facilitated by retroviruses

26
Q

What is the purpose of monoclonal antibodies?

A

Treats cancer