Treatment of Cancer

Question 1

What is the primary goal of targeted therapy in cancer treatment?

Answer 1

To selectively attack cancer cells based on specific molecular changes, minimizing damage to normal cells.

Question 2

How do small molecule inhibitors differ from monoclonal antibodies?

Answer 2

Small molecules penetrate the cell membrane and block intracellular signaling, while monoclonal antibodies target extracellular receptors.

Question 3

What is the role of immunotherapy in cancer treatment?

Answer 3

It boosts the immune system’s ability to recognize and kill cancer cells.

Question 4

How does Pembrolizumab work as an immunotherapy drug?

Answer 4

It blocks PD-1, preventing cancer cells from evading immune attack.

Question 5

What is the function of ipilimumab in immunotherapy?

Answer 5

It blocks CTLA-4, enhancing T-cell activation against cancer cells.

Question 6

What is an Antibody-Drug Conjugate (ADC)?

Answer 6

A combination of an antibody and chemotherapy drug that delivers treatment directly to cancer cells.

Question 7

What is an example of an ADC?

Answer 7

Trastuzumab-Deruxtecan (T-DXd), which delivers chemotherapy directly to HER2-positive cancer cells.

Question 8

What is the purpose of a liquid biopsy?

Answer 8

It detects cancer DNA in the blood, providing a non-invasive way to monitor mutations and treatment response.

Question 9

What is a driver mutation in cancer?

Answer 9

A genetic mutation that actively contributes to cancer progression

Question 10

What was the significance of the Philadelphia chromosome in CML?

Answer 10

It was the first discovered genetic mutation linked to cancer, leading to targeted therapy development (Imatinib/Gleevec).

Question 11

What is a major cause of drug resistance in lung cancer patients?

Answer 11

The overexpression of the KRAS gene.

Question 12

How do tyrosine kinase inhibitors (TKIs) work in cancer treatment?

Answer 12

They block kinase phosphorylation, preventing cancer cell proliferation.

Question 13

How does cancer promote neovascularization?

Answer 13

By releasing growth factors like VEGF, which stimulate new blood vessel formation.

Question 14

How do anti-angiogenic therapies work?

Answer 14

They block VEGF and related pathways to prevent tumor blood vessel growth.

Question 15

What are common side effects of targeted cancer therapies?

Answer 15

Hair loss, nausea, neuropathy, liver toxicity, and blood cell count suppression.

Question 16

What specific side effect led to stopping T-DXd?

Answer 16

Pneumonitis, characterized by lung inflammation and breathing difficulties.

Question 17

What side effects are associated with anti-angiogenic therapies?

Answer 17

Stomatitis, mucositis, and hand-foot syndrome.

Question 18

What is adenocarcinoma?

Answer 18

A malignancy of glandular tissue.

Question 19

What type of cancer arises from supporting structures like fibrous tissue, muscles, or bones?

Answer 19

Sarcoma.

Question 20

What is a malignancy of neuroendocrine cells called?

Answer 20

Neuroendocrine cancer, such as small cell cancer.

Question 21

What type of cancer originates in the bone marrow?

Answer 21

Myeloma.

Question 22

What is leukaemia?

Answer 22

A malignancy of blood cells.

Question 23

What imaging is used for breast cancer staging?

Answer 23

CT scan of the chest, abdomen, and pelvis.

Question 24

What does T2N1M0 indicate in breast cancer staging?

Answer 24

Tumor size 2-5 cm (T2), lymph node involvement (N1), and no distant metastasis (M0) – Stage IIB.

Question 25

What are the main oncology specialties involved in cancer treatment in the UK?

Answer 25

1. Surgical Oncologist 2. Medical Oncologist 3. Clinical or Radiation Oncologist 4. Palliative Medicine and Physicians

Question 26

What is the purpose of a multidisciplinary team (MDT) meeting in cancer care?

Answer 26

To determine the best treatment approach, such as surgery, chemotherapy, or radiotherapy.

Question 27

What are the main goals of chemotherapy?

Answer 27

To cure cancer when possible or to provide palliative care when a cure is not possible.

Question 28

What are the different routes of chemotherapy administration?

Answer 28

Intravenous, oral, subcutaneous, or intramuscular.

Question 29

How is chemotherapy given?

Answer 29

In treatment sessions called cycles, usually every 3 weeks but sometimes weekly, 2-weekly, 4-weekly, or 6-weekly.

Question 30

What is neoadjuvant chemotherapy?

Answer 30

Chemotherapy given before surgery to shrink the tumor.

Question 31

What is adjuvant chemotherapy?

Answer 31

Chemotherapy given after surgery to reduce the risk of cancer recurrence.

Question 32

What is palliative chemotherapy?

Answer 32

Chemotherapy used to control symptoms and extend survival when a cure is not possible.

Question 33

What chemotherapy drugs were used in the patient’s treatment?

Answer 33

Epirubicin + Cyclophosphamide for 4 cycles (every 3 weeks, total 12 weeks). Docetaxel for 4 cycles.

Question 34

What supportive medications are given alongside chemotherapy?

Answer 34

Dexamethasone and ondansetron to prevent nausea and vomiting.

Question 35

What are common side effects of chemotherapy?

Answer 35

- Nausea and vomiting (first 2-3 days) - Soreness of mouth (mucositis, 2nd week) - Hair loss (alopecia) - Neutropenic sepsis (low neutrophils, increased infection risk) - Diarrhoea (colitis or typhlitis) - Skin rash - Peripheral neuropathy (accumulating with each cycle)

Question 36

What is the purpose of post-chemotherapy radiotherapy?

Answer 36

To destroy any remaining cancer cells and reduce recurrence risk.

Question 37

What are common side effects of radiotherapy?

Answer 37

Skin redness and pain Fatigue Nausea and vomiting

Question 38

What are additional site-specific side effects of radiotherapy?

Answer 38

- Diarrhoea (radiation colitis) - Painful urination (radiation cystitis) - Swallowing problems (radiation oesophagitis) - Cough and breathing difficulty (radiation pneumonitis)

Question 39

What medication can be prescribed after radiotherapy?

Answer 39

Tamoxifen for 10 years.

Question 40

How does Tamoxifen work?

Answer 40

It blocks oestrogen receptors, preventing cancer cells from using oestrogen to grow.

Question 41

What are common side effects of Tamoxifen?

Answer 41

Hot flushes Night sweats Weight gain Joint pain Endometrial cancer risk Deep vein thrombosis

Question 42

What long-term effects can occur after chemotherapy?

Answer 42

- Chemotherapy-induced second cancer (rare) - Infertility - Persistent numbness (neuropathy) - Heart damage (cardiomyopathy)

Question 43

What chemotherapy drugs are associated with specific long-term side effects?

Answer 43

- Cisplatin – Hearing loss (irreversible), kidney damage - Cytarabine – Conjunctivitis (reversible) - Bleomycin – Lung toxicity (pneumonitis) - Vincristine – Peripheral neuropathy - Paclitaxel – Infusion reactions - Irinotecan – Severe diarrhoea

Question 44

What are the four main mechanisms of chemotherapy?

Answer 44

1. DNA damage – Alkylating agents prevent DNA separation. 2. Topoisomerase inhibition – Prevents DNA unwinding for replication. 3. Mitosis disruption – Prevents cancer cell division. 4. Metabolic interference – Disrupts cancer cell metabolism.

Question 45

How does radiotherapy kill cancer cells?

Answer 45

By generating free radicals that damage DNA strands.

Question 46

What are other uses of radiotherapy besides primary cancer treatment?

Answer 46

Palliative care (pain relief) Brain metastases treatment Spinal cord compression Bleeding control Airway obstruction management

Question 47

How has breast cancer survival improved over time?

Answer 47

- In the 1970s, 40% of women survived beyond 10 years. - By the 2010s, almost 78.4% survived beyond 10 years.

Question 48

How does social deprivation affect breast cancer survival?

Answer 48

- 88.4% survival in the least deprived group. - 82.1% survival in the most deprived group.