Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oncology > Treatment of Cancer: Surgery, Chemo, & Radiation > Flashcards

Treatment of Cancer: Surgery, Chemo, & Radiation Flashcards

1
Q

4 Phases of the Cell Cycle

G1

S

G2

M

A

G1: RNA and protein synthesis, cell growth, DNA repair

S: DNA completely replicated

G2: Additional RNA synthesis, protein & specialized DNA

M: Mitosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Resting Phase

Growth Fraction

A

Resting Phase: Cells don’t engage in synthesis activities

Growth Fraction: Cell proportion of a tumor that are actively involved in division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Chemotherapy

A

MOA: Cell-cycle specific and nonspecific

Specific: Kills @ specific cycle phase

Nonspecific: Kills in all phases

-Alkylating agents, antitumor antibiotics, cisplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Alkylating Agent

A

One of 1st discovered

Directly damage DNA - work on all phases (nonspecific)

Blood cancer, HL, MM, sarcoma, lung/breast/ovary cancer

Class toxicities: N/V, myelosuppression, alopecia

May cause leukemia from long-term bone marrow damage

-risk is dose-dependent w/ highest risk 5-10 yrs out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Alkylating Agent Classes

A

Nitrogen Mustards: Cyclophosphamide, Ifosfamide

-Hemorrhagic cystitis from metabolic products - increase fluids

Platinum analogs: Carboplatin, Oxaliplatin, Cisplatin

  • Nephrotoxic, neurotoxic, ototoxic
  • Give w/ amifostine to prevent these
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Antimetabolites

A

MOA: Interfere w/ DNA & RNA growth - substitute for normal aa

Damage occurs during S phase while chromosome is copied

Primary toxicities: Myelosuppression, N/V, mucositis, dermatologic

-rash, pruritus, injection site reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antimetabolite Classes

A

Purine analogs - Mercaptopurine

Pyrimidine analogs - Fluorouracil, Gemcitabine

Folate Antagonists - Methotrexate (MTX, Trexal)

  • SE: Toxicity effects rapid turnover cells (BM, mucosa)
  • Get damage to liver and kidneys, decreased renal clearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MTX - drugs that reduce excretion

A

ASA

NSAIDS

Amiodarone

Omeprazole

PCN

Phenytoin

Sulfa compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drug given w/ MTX to reverse toxic effect

Drug given w/ Cisplatin to prevent toxic effects

A

Methotrexate - Leucovorin to reduce folic acid

-reverse toxic effects and prevent death

Cisplatin - IV Amifostine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mitotic Inhibitors

A

AKA Anti-tumor antibiotics

MOA: Alter DNA - works in all phases of cell but mostly M

  • Stops mitosis in M phase
  • Inhibits enzymes and damages DNA in all phases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mitotic Inhibitor Classes

A

Epothilones - Ixabepilone

Taxanes - Paclitaxel

Vinca Alkaloids - Vincristine

  • Interfere w/ M phase
  • SE: Neuropathy - distal to proximal; also get constipation (most common SE)

Anthracyclines - Daunorubicin, Doxorubicin

-SE: Cardiotoxicity causing systolic CHF - get MUGA scans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Topoisomerase Inhibitors

A

MOA: separate DNA strands so they can be copied during S phase

Topoisomerase I Inhibitors: Topotecan

Topoisomerase II Inhibitors: Etoposide (VP-16)

Increase risk of secondary cancers (AML) as early as 2-3 years after treatment

General Toxicities: Myelosuppression, alopecia, GI toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Miscellaneous drugs

A

Mitomycin - C

Mitoxantrone (acts as topoisomerase II)

Actinomycin - D

Bleomycin

-SE: interphalangeal joint edema, hardened skin on palms and soles, anaphylactic/serum sickness-like reaction, pulmonary fibrosis

Get hypotensive reaction - severe/fatal after 1st dose in 1% patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Targeted Chemo Therapies

A

Specifically attack cancer cell

Mutant genes or too many copies make them targets

Main treatment or to prevent recurrence

Imatinib (Gleevec)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Differentiating Agents

A

Cause cancer cells to mature into normal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hormone Therapy

A

Sex hormones - slow growth of genital cancers by changing triggering hormone production

-Anti-estrogens (tamoxifen) - Commonly causes blood clots

Aromatase inhibitor (Anastrozole)

Progestin/Estrogen

Anti-androgens (Bicalutamide)

Gonadotropin-releasing hormone (GnRH) - Leuprolide

17
Q

Immunotherapy

A

Active: Stimulates body’s own immune system to fight

Passive: Use immune system components created outside body

  • Synthetic monoclonal Abs tag cancer cells for destruction
  • “checkpoint inhibitors” which eliminate cancer cell immune override

Rituximab (Rituxan), BCG

18
Q

Adjuvant

Neoadjuvant

Induction

Maintenance

A

Adjuvant: set course given to patients with no evidence dx after surgery or radiation

Neoadjuvant: Aim to eradicate micrometastatic dx or reduce inoperable dx

Induction: combo chemo given in high dose to cause remission

Maintenance: Long-term, low-dose regimen given in remission

-inhibits growth of remaining CA cells

19
Q

Skin Toxicity

A

Erythema

Dry desquamation

Moist desquamation

Hyperpigmentation

Late: Hypopigmentation, Telangiectasis, fibrosis

20
Q

Brain Radiation Toxicity

A

Acute: Fatigue, hair loss, skin erythema, desquamation

Late: Cognitive dysfunction, edema, necrosis

21
Q

Head/Neck Radiation Toxicity

A

Acute: Mucositis, Taste dysfunction, Pain, Xerostomia

Late: Permanent Xerostomia, soft tissue fibrosis, osteoradionecrosis of mandible, dysphagia, pharyngeal stricture

22
Q

Breast Radiation Toxicity

A

Acute - common and temporary

-Dry desquamation, fatigue, skin redness

Late - uncommon and permenant

-Fibrosis, cosmetic failure, hyperpigmentation

23
Q

Lung Radiation Toxicity

A

Acute: skin reaction, fatigue, esophagitis (anesthetics/analgesics), cough, radiation pneumonitis

Late: Radiation pneumonitis, esophageal stricture, brachial plexopathy, pulmonary fibrosis

24
Q

Esophageal Radiation Toxicity

A

Acute: Esophagitis, modest skin tan, fatigue, wt. loss, D/N/V

Late: esophageal stricutre/stenosis (60%), perforation, hepatobiliary

25
Q

Abdominal Radiation Toxicity

A

Stomach, pancreas, hepatobiliary

Acute: Dyspepsia, anorexia, nausea, fatigue

Late: bowel obstruction, worsen DM secondary to pancreatic function, liver/kidney - possible renal failure/HTN

26
Q

Pelvic Radiation Toxicity

A

Acute: Diarrhea, rectal irritation, urinary sx - nocturia, retention, fatigue

Late: Persistent urinary sx, bowel changes, erectile dysfunction

27
Q

Anal Radiation Toxicity

A

Acute: Skin rxn, leukopenia, thrombocytopenia, proctitis, diarrhea, cysts

Late: Chronic diarrhea, rectal urgency, sterility, impotence, vaginal dryness/fibrosis, decreased testosterone

28
Q

GYN Radiation Toxicity

A

Cystitis, proctitis, fistula, vaginal ulceration/stenosis/necrosis, skin rxn

29
Q

Systemic Side effects of radiation

A

Fatigue is the only one

All other SE are limited to irradiated tissue

Oncology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions