Back Pain After Cancer Treatment Flashcards

1
Q

Treatment of metastatic breast cancer

A

Symptomatic and palliative

Options: endocrine therapy, chemotherapy, HER2 targeted therapy (pertuzumab/trastuzumab), bone therapy (zolendronic/denosumab - RANK ligand inhibitor)

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2
Q

How does endocrine therapy work?

A

Prevents tumour cells being stimulated to divide by circulating oestrogen

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3
Q

Drug classes used in hormone therapy

A

Selective oestrogen receptor modulator (SERM) - Tamoxifen

Fulvestrant (SERM) - post-menopausal women (not first line)

Aromatase inhibitors (Letrozole) - prevent conversion of androgens into oestrogen (only effective in post-menopausal women)

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4
Q

When is chemotherapy offered for metastatic breast cancer?

A

HER2 negative
Oestrogen receptor negative

Gemcitabine is used first line

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5
Q

Treatment of HER2 receptor positive metastatic breast cancer

A

Pertuzumab (prevents dimerisation of HER2 with other receptors)
Trastuzumab (prevents HER2 stimulation by growth factors)
Chemotherapy - Docetaxel

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6
Q

Precautions with Trastuzumab and Pertuzumab

A

Can affect cardiac function
Patient need assessment of LVEF prior to starting the drugs and @ regular intervals

Measured by echocardiogram or Multi-gated acquisition scan

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7
Q

Side effects of Denosumab

A

Hypocalcaemia - blood test before and soon after starting treatment, patients are given calcium supplements

Osteonecrosis - patients need dental check up before starting treatment

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8
Q

Percentage of breast cancer ER positive

A

80%

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9
Q

Percentage of breast cancer HER2 positive

A

15%

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10
Q

Another name for Trastuzumab

A

Herceptin

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11
Q

What is epirubicin?

A

Chemotherapy drug (anthracycline) used to treat breast cancer

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12
Q

What is bicalutamide?

A

Anti-androgen used in prostate cancer

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13
Q

Treatment options in MSCC

A

Neurosurgical decompression

Radiotherapy - helps with pain. Used as a mono therapy or alongside surgery

Vertebroplasty (khyphoplasty) - injection of cement into collapsed vertebrae can help control pain

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