Breast and Prostate cancer Flashcards Preview

PT3 Oncology > Breast and Prostate cancer > Flashcards

Flashcards in Breast and Prostate cancer Deck (64):
1

breast cancer rate

1 in 8 women

2

2 most common types of breast cancer

lobular carcinoma
ductal carcinoma

3

risk factors for breast cancer

-past history
-BRCA mutation
-age
-age of menarche
-age of first live birth
-1st degree relatives with breast cancer
-previous breast biopsy w/ atypical hyperplasia
-race/ethnicity

4

most common mutation in breast cancer

BRCA1 or BRCA2

5

when to do breast MRI

-when 2D or 3D screens were unclear or radiologist needs more info
-usually for high risk patients >20%

6

breast cancer diagnosis steps

-positive mammogram or breast exam
-diagnostic bilateral mammogram
-biopsy of tissue
-determine lymph node involvement

7

what has to be done before treatment can start

biopsy so you know what receptors are involved

8

most common place for metastasis to hit

lungs

9

approach for treating in-situ lobular carcinoma

-Counsel on risk reduction strategies
+surgery
+anti-hormonal therapy for 5 years

10

approach for treating in-situ ductal carcinoma

-surgery and/or radiation
+lumpectomy with whole breast radiation
+total mastectomy and tamoxifen or aromatase x5 years

11

approach for treating invasive carcinoma

-clinical staging
-lymph node status determination during surgery/biopsy
-search for metastasis with MRI, PET scan, bone scan

12

curable stages of breast cancer

stage 1 and 2

13

potentially curable stage of breast cancer

stage 3

14

not curable stage of breast cancer

stage 4 (metastasis)

15

treatment techniques for stages 1-3 of breast cancer

-debulking
-systemic treatment

16

debulking treatments in breast cancer

sugery
radiation

17

systemic treatments in breast cancer

antineoplastics
anti-hormonals

18

general treatment regimen for ER/PR + and HER2 +

endocrine and targeted therapy

19

general treatment regimen for ER/PR - and HER2 +

targeted therapy

20

general treatment regimen for ER/PR + and HER2 -

endocrine therapy

21

general treatment regimen for ER/PR - and HER2 -

chemotherapy only

22

HER2 features

-epidermal growth factor receptor
-overexpressed in ~30% of breast cancer
-worse prognosis

23

two drugs that target HER2

trastuzumab
pertuzumab

24

regimens for HER2 positive

dose dense AC THP
TCHP

25

dose dence AC THP regimen (including cycles and length)

-doxorubicin + cyclophosphamide on day one
-pegfilgrastim on day 2
14 day cycle, for 4 cycles
THEN
-Pertuzumab + trastuzumab + paclitaxel
21 day cycle, for 4 cycles
THEN
trastuzumab q3wk for one year

26

ddAC+T regimen (including cycles and length)

-doxorubicin + cyclophosphamide on day one
-pegfilgrastim on day 2
14 day cycle, for 4 cycles
THEN
-paclitaxel
21 day cycle, for 4 cycles

27

regimen for HER2 negative

ddAC+T

28

ddAC+T monitoring areas

-cardiac (baseline EF)
-bone marrow effects
-hepatic
-neurologic
-infusion reactions

29

doxorubicin side effects

-red urine
-nausea (acute and delayed)
-low wbc count
-sun sensitivity

30

paclitaxel side effects

-low wbc
-neuropathy
-skin changes
-infusion reactions

31

cyclophosphamide side effects

-low wbc
-mouth sores
-diarrhea

32

endocrine therapy drugs for breast cancer

tamoxifen
anastrozole

33

when treating pre-monopausal women for breast cancer what other thing should be done in addition to endocrine drugs

ovarian suppression or ablation

34

treatment regimen for ER/PR - and HER2 -

paclitaxel + carboplatin
THEN
ddAC

35

induction treatment for stage 1-3 breast cancer

surgery +/- radiation

36

consolidation treatment for stage 1-3 breast cancer

ddAC+T and add HER2 mabs if necessary

37

maintenance treatment for stage 1-3 breast cancer

trastuzumab to finish a year if HER2+
and/or antihormonal if ER positive

38

general treatment for locoregional metastasis

surgery
radiation

39

general treatment for systemic metastasis

endocrine therapy
chemotherapy
targeted therapy

40

goal of treatment in stage 4 breast cancer

preserve maximum quality of life

41

additional drug class you can add to endocrine therapy for breast cancer metastasis

CDK-4/6 inhibitor

42

main determinants of breast cancer therapy

-stage of the disease
-receptor status
-intent of therapy

43

lifetime risk of prostate cancer

1 in 6

44

the controversy of prostate cancer screening

it is a slow growing cancer and you can go a long time without symptoms, leading to overtreating unnecessary cases and treatment can be invasive and debilitating with little benefit

45

prostate screening techniques

-digital rectal exam
-prostate specific antigen
-transrectal ultrasonography

46

what is PSA

enzyme normally secreted from prostate that is elevated in serum in prostate cancer

47

PSA can be elevated in

-BPH
-inflammtion
-ejactulation
-peritoneal trauma
-acute urinary retention

48

prostate treatment decision is based on

-life expectancy
-gleason grade
-risk stratificatin
-PSA
-symptoms
-patient wishes

49

PSA risk grading

low = <10
intermediate = 10-20
high = >20

50

gleason score grading

low =< 6
intermediate = 7
high => 8

51

treatment options for localized tumors

-active surveillance
-radical prostatectomy
-radiation therapy

52

active surveillance of prostate cancer consists of

serial PSAs and repeat biopsies

53

why is there hesitation for surgery/radiation therapy in prostate cancer?

-urinary incontinence/impotence rate is about 30%
-urinary strictures requiring treatment occur at about 15%

54

sensitive parts of anatomy near prostate

cavernous nerves and dorsal veil complex make surgery hard

55

post prostate surgery/radiation therapy options

-watch and wait
-androgen deprivation therapy for high risk

56

in recurrent or advanced prostate cancer ADT can be started with...(types of treatment)

-luteinizing hormone releasing hormone agonist
-LHRH antagonist
-complete androgen blockate
-orchiectomy
-estrogen therapy

57

LHRH agonist

leuprolide

58

LHRH antagonist

degarelixc

59

side effects of ADT

-decreased libido
-hot flashes
-gynecomastia
-loss of muscle mass
-increased weight gain
-decrease in bone density

60

castration resistant prostate cancer treatment

continue ADT and add:
-anti-androgen
-ketoconazole
-diethylstilbestrol

61

treatment for metastatic prostate cancer

-bisphosphonates or denosumab to prevent it from going to bone

-change therapy to:
+chemo with docetaxel or cabazitaxel
+2nd gen anti-androgen
+androgen biosynthesis inhibitor

62

chemo drugs and regimen for prostate cancer

-docetaxel + daily prednisone
21 day cycle, 6 cycles
-carbazitaxel + daily prednisone
21 day cycle, 6 cycles

63

monitoring for docetaxel/prednisone

-ANC, anemia, platelets
-AST/ALT
-neuropathy
-infusion reactions

64

side effects to watch for in prostate cancer chemo/ADT

-bone marrow suppression
-fluid retention
-skin and nail changes
-neuropathy