Chemotherapy Flashcards Preview

Oncology + Palliative > Chemotherapy > Flashcards

Flashcards in Chemotherapy Deck (25):
1

Radical vs primary

Radical = curative intent

Primary = alone for cure

2

Neo-adjuvant/ adjuvant/ chemoradiation

Neo-adjuvant = before an operation Adjuvant = after an operation Chemoradiation = with radiotherapy

3

Palliative vs high dose - what is given in high dose to help?

Palliative = incurably advanced disease

High dose = with bone marrow transplant of stem cell support

4

What are the consequences of chemo targeted at cells with low rate of renewal?

SE can increase over time eg cardiomyopathy, neuropathy, deafness

Carboplatin = more you have it, more likely you are to have a reaction

5

How to manage N+V with chemo?

Prevent with ondansetron + dexamethasone IV

Post dose = metoclopramide, dexamethasone

Beware effects of steroids on blood sugars

6

How many cancer patients require chemo?

60-70%

7

What is the mechanism of action of chemo?

Usually targets DNA

Toxic towards actively proliferating cells

8

What cancers are treated with neo-adjuvant chemo?

Used in osteosarcoma 

Breast cancer

9

When is prophylactic chemo used + give an example?

Before overt malignancy appears eg tamoxifen used for in-situ breast cancer before invasive cancer is recognised

10

Which cells in the body are usually affected by chemo + what occurs?

Haematopoietic stem cells

Lining of GI tract

Causes myelosuppression + mucositis

11

How long is the average course of chemo?

6 sessions in 6 months

12

What supportive care can be given during high dose treatment?

Bone marrow support with growth factors of blood stem cells/ bone marrow

13

What cancers are treated with high dose chemo?

Hodgkins + Ewings Sarcoma

14

When is chemo given intravesically?

For superficial bladder cancer

15

When is chemo given intraperitoneally?

Tumours that have spread trans-coelomically (ovarian)

16

When is chemo given intra-arterially?

For tumours with well-defined bloody supply eg hepatic artery infusion for liver mets

17

How is chemo dose calculated + what are the exceptions to this rule?

Using body surface area (BSA) Formula of DuBois + DuBois Carboplatin is calculated according to renal function Trastuzumab is calculated on body weight alone

18

SE of chemo

N+V, GI side effects, GU - nephrotoxicity + bladder toxicity, hepatic toxicity 

Skin + soft tissue toxicity - hand foot syndrome, extravasation, photosensitivity

Lethargy + myalgia, myelosuppression, alopecia

Peripheral neuropathy

19

Why does chemo cause myelosuppression?

Kills haematopoietic progenitor cells

Leads to leucopenia + thrombocytopenia

20

What is the nadir?

Lowest point of neutrophil drop (drops 10-14 days after chemo)

21

What are the GI SE with chemo + why do they happen?

Oral mucositis = reflects damage to epithelium

Diarrhoea due to colitis or small bowel mucosal inflammation

Constipation due to dehydration = can develop into paralytic ileus caused by autonomic neuropathy 

22

How is alopecia caused + what can be done about it?

Due to damage to rapidly dividing cells in hair follicle

Use of cold cap to reduce blood flow to scalp

23

What neurological SE are there?

Peripheral + autonomic neuropathy

CNS toxicity

Ototoxicity - cochlear damage causing high tone hearing loss

24

What is extravasation?

Highly vesicant drugs cause tissue damage

25

What is palmar plantar erythema?

Hand foot syndrome