Chapter 11: Nutritional Effects Of Cancer Treatment Flashcards

1
Q

What is medical oncology?

A

The diagnosis and treatment of cancer using antineoplastic therapies (chemotherapy, hormone therapy and biotherapy)

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2
Q

What is radiation oncology?

A

The diagnosis and treatment of cancer utilizing a spectrum of ionizing teletherapy (external beam radiarion machines), brachytherapy (sealed sources of radiation), radiopharmaceutical therapy (unsealed sources of radiation)

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3
Q

What is chemotherapy?

A

The use of chemical agents or drugs to systematically kill cancer cells. Usually done in cycles.

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4
Q

Which body cells have rapid turnover and are susceptible to chemotherapy?

A

Bone marrow, hair follicles, gonads (testes and ovaries) GI mucosa.

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5
Q

What are cell cycle non-specific chemotherapeutic agents?

A

They damage cells in all phases of the cell cycle (alkylating agents), antitumor antibiotics, hormone therapies, nitrosoureas

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6
Q

What are cell cycle specific chemotherapeutic agents?

A

They exert their effect within a specific phase of the cell cycle. Include: antimetabolites, camptothecins (synthesis phase), plant alkaloydes and taxanes (mitosis phase)

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7
Q

T/F: It can take weeks, months and even years for treatment related side effects to resolve.

A

True

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8
Q

What is Biotherapy?

A

The treatment to boost or restore the ability of the immune system to fight cancer, infection and other diseases by inducing, enhancing, or suppressing an individual’s own immune response. (AKA Immunotherapy or Biological Response Modifier)

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9
Q

What are some types of biotherapy?

A

Monoclonal Antibodies, protein-targeted therapies, angiogenesis inhibitors, cytokines, and cancer vaccine.

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10
Q

What is Hormone Therapy?

A

Use in the treatment of hormone-sensitive cancers (breast, ovarian, prostate)

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11
Q

What are the types of Radiation Therapy?

A

External beam radiation, Brachytherapy or internal radiation or radiopharmaceutical therapy

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12
Q

Diarrhea is an acute side effect of radiation to ___, ___, and ___.

A

pelvis, rectum, and stomach/abdomen

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13
Q

Fatigue is an acute side effect of radiation to which sites>

A

All sites (brain, breast, chest, head/neck, pelvis, rectum, stomach/abdomen).

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14
Q

Hair loss is an acute side effect of radiation to which sites?

A

All sites (brain, breast, chest, head/neck, pelvis, rectum, stomach/abdomen).

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15
Q

Nausea/Vomiting are acute side effects of radiation to which sites?

A

Brain, chest, stomach/abdomen

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16
Q

Throat changes are an acute side effect of radiation to which sites?

A

chest, head/neck

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17
Q

T/F: Myelosuppression, nausea, vomiting, diarrhea, fatigue are common side effects of chemotherapeutic agents.

A

True

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18
Q

Acute side effects of radiation to the brain?

A
Fatigue
hair loss
N/V
skin changes
headache
blurry vision
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19
Q

Late side effects of radiation to the brain?

A
Headache
cognitive impairment 
Memory loss
Leukoencephalopathy
Dementia
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20
Q

Acute side effects of radiation to the breast?

A

Fatigue
Hair loss
Skin changes
Breast swelling and tenderness

21
Q

Acute side effects of radiation to the chest?

A
Fatigue
Hair loss
N/V
Skin changes
Cough
Dyspnea (difficulty breathing)
22
Q

Acute side effects of radiation to the head and neck?

A

Fatigue
Hair loss
Skin changes
Throat changes (dysphasia, odynophagia, esophagitis)

23
Q

Acute side effects of radiation to the pelvis?

A
Diarrhea
Fatigue 
Hair loss
Fertility / sexual changes
Skin changes
Urinary/Bladder changes
24
Q

Acute side effects of radiation to the rectum?

A
Diarrhea
Fatigue 
Hair loss
Fertility / sexual changes
Skin changes
Urinary / Bladder changes (urinary frequency, cystitis, incontinence)
25
Q

Late side effects of radiation to the bone?

A

Damage to osteoblasts

Osteopenia

26
Q

Late side effects of radiation to the chest (cardiovascular area)?

A

Angina upon exertion
Pericarditis
Cardiac enlargement
CHF

27
Q

Late side effects of radiation to the esophagus?

A

Esophageal stenosis, fibrosis or necrosis

28
Q

Late side effects of radiation to the GI tract?

A

Diarrhea
Malabsorption
Chronic enteritis/colitis
Intestinal changes ( obstruction, stricture, ulceration, fistula, etc)

29
Q

Late side effects of radiation to the head and neck?

A

Trismus
Permanent xerostomia
Alterations in taste and smell
Osteoradionecrosis (bone death)

30
Q

Late side effects of radiation to the lymphatics?

A

Secondary lymphedema in irradiated area

31
Q

Late side effects of radiation to the lungs?

A

Dyspnea
Cough
Pneumonitis

32
Q

Late side effects of radiation to the sexual organs?

A

Infertility

33
Q

Late side effects of radiation to the skin?

A

Telangiectasis (dialation of the capillaries causing red or purple color)
Pigmentation changes
Atrophy
Fibrosis

34
Q

Late side effects of radiation to the bladder area?

A

Hematuria

Cystitis

35
Q

Possible side effects of monoclonal antibodies?

A
Infusion symptoms 
GI (n/v/d) usu mild
Cardiotoxicity
Myelosuppression
Pulmonary toxicity
Skin problems/rash
36
Q

Examples of protein targeted therapies?

A

Tyrosine kinase inhibitors
mTOR Inhibitors
Proteasome Inhibitors

37
Q

Examples of tyrosine kinase inhibitors?

A
Erlotinib (Tarceva)
Gefitinib (Iressa)
Imatinib (Gleevec)
Sorafenib (Nexavar)
Sunitib (Sutent)
38
Q

Examples of mTOR inhibitors?

A

Temsirolimus (Torisel)

Everolimus (Affinitor)

39
Q

Example of a proteasome inhibitor?

A

Bortezomib (Velcade)

40
Q

Possible side effects of protein targeted therapies?

A

Skin problems / rash
Cardiotoxicity
GI (n/v/d, decr appetite)

41
Q

Examples of angiogenesis inhibitors?

A

VEGF - Bevacizumab (Avastin)
Immunomodulary Drugs - Lenalidomide (Revlimid) and
Thalidomide

42
Q

Possible side effects of angiogenesis inhibitors?

A
HTN
Cardiac (MI, stroke)
Proteinuria
Hemorrhage
GI perforation
Hypothyroidism
43
Q

Examples of cytokines?

A

Interleukein-2 (IL-2) (Aldesleukin)

Interferon-a (Roferin or Intron A)

44
Q

Possible side effects of cytokines?

A
Flu-like Symptoms 
Fatigue 
Anorexia
Myelosuppression
GI (n/v/d)
Renal and cardiotoxicity
45
Q

Types of hormonal agents?

A
SERMS,
Aromatase inhibitirs,
Progesterones,
Antiandrogens,
LHRH Agonists
46
Q

Examples of SERMS

Selective Estrogen Receptor Modulators

A

Tamoxifen (Novaldex)
Toremifene (Fareston)
Raloxifene (Evista)

47
Q

Side effects of SERMS?

A

Menstrual symptoms (hot flashes, sweating, n/v)
Fluid retention / peripheral edema
Increased risk for endometrial changes and cancer
Thrombembolic complications
Skin changes / rash
Joint pain
Weight gain

48
Q

Examples of aromatase inhibitors?

A

Anastozole (Arimidex)
Letrozole (Femara)
Exemestane (Aromasin)

49
Q

Side effects of aromatase inhibitors?

A
Joint pain
Hot flashes
N/V -mild
Thromboembolic events
High cholesterol 
Fever / malaise