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Flashcards in GU tumours Deck (14)
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1
Q

what are the features of good prognosis of seminomas?

A

any primary site
no non-pulm visc mets

markers:
normal aFP
any bhCG
any LDH

2
Q

what are features of good prognosis of non-seminomatous test CA?

A

test or retroperitoneal primary
no non0pulm mets

afp <1.5 ULN

3
Q

what are the treatments of stage 1 non-seminoma?

A

while this is a good prognosis condition, relapse is around 25%

if there are compliance concerns then we use BEP for 2 cycles

4
Q

what is the chemo treatment for metastatic renal cancer?

A

sunitinib and pazopanib are both multi target oral TKi

5
Q

what are some of the side effects of the TKIs?

A

fatigue
hand-foot syndrome

hypertension

BM suprression

some LFT derangement

6
Q

what do flutamide and bicalutamide do?

A

both of these are androgen receptor antagonists working particularly at the prostate itself

7
Q

what are the new treatments for prostate cancer?

A

castrate refractory prostate cancer now has a pre-docetaxel and post-docetaxel scenario

there are 4 drugs with survival benefit post-docetaxel

cabazitaxel (this is a taxane)

abiraterone - this is an adrenal gland synthesis blocker (blocks CYP17) - given with pred due to hypoadrenalism. Can get hyperaldosteronism

enzalutamide - this is an antagonist for the adrenal hormone binding inside the cellular cytoplasm

radium-233 - preferentially taken up by the mets

8
Q

what subtype of ovarian CA is the most nasty?

A

the serous subtype has the worst 5 year survival, but all are pretty bad

9
Q

what is the role of CEA?

A

really only used to see response to reduction surgery

no role is monitoring for recurrence, prognosis or diagnosis

10
Q

what are the PARP-inhibitors?

A

these are useful in BRCA mutation cancers

the regular repair mechanisms for a cell are two modes:
1. homologous recombination (base the repair off the matching DNA strand)
the BRCA mutation impairs this function

  1. base-excision repair (removal of the base somehow?)
    the PARP1 gene is responsible for this.

The PARP1 inhibitors impair this function, and so, in a cancer cell with both BRCA and PARP1, you can essentially remove the cancer cell’s self repair mechanism

11
Q

what is the treatment for locally advanced cervical cancer?

A

radiotherapy with possibly chemotherapy (cisplatin)

once there is distant mets, then we use platinums or taxanes

there may be a role for VEGF inhibitor bevacizumab

12
Q

how does elevated bhcg cause gynaecomastia?

A

the bhcg works on the testicles and upregulates the aromatase activity in Leydig cells

this leads to increased oestrodiol activity

13
Q

what are the three major antibodies associated with paraneoplastic syndrome?

what sorts of cancers are they associated with

A

Anti-Hu from SCLC, sarcoma, neuroblastoma

Anti-Yo from ovary, uterus, breast and SCLC

Anti-Tr from HL and NHL

14
Q

what is the cut off size for adrenal CA v adrenal incidentaloma?

what is the Hounslow unit cut off?

A

4cm

10 HU