p.61
Management of Chemotherapy Side Effects
What should be done for Ms. Wong's 'bloody urine' after the first cycle of chemotherapy?
Monitor her condition and ensure hydration; if symptoms persist, further evaluation may be needed.
p.51
Endocrine Therapy in Cancer Treatment
What is a characteristic of hormone receptor-positive breast cancer?
It is regulated by hormones such as oestrogen or progesterone.
p.27
Clinical Applications of Chemotherapy
What is the primary use of a Paclitaxel infusion set filter?
To prevent particulate contamination during the administration of Paclitaxel.
p.10
Combination Chemotherapy Strategies
What is a requirement for the toxic effects of drugs in combination chemotherapy?
They should have different toxic effects.
p.5
Clinical Applications of Chemotherapy
What is the goal of primary induction chemotherapy?
Cure cancer, palliate symptoms, improve quality of life, and increase time to tumor progression.
p.54
Endocrine Therapy in Cancer Treatment
What is the late switch regimen for pre-menopausal women using Tamoxifen?
Tamoxifen for 5 years followed by Letrozole for up to a further 5 years.
p.62
Management of Chemotherapy Side Effects
What should be considered regarding Ms. Wong's 4th cycle of paclitaxel?
The decision to continue should be based on the severity of her symptoms and consultation with her healthcare provider.
p.15
Types of Chemotherapy Drugs
Name an example of an antimetabolite.
5-fluorouracil (5-FU), Methotrexate, Gemcitabine (Gemzar), or Capecitabine (Xeloda).
p.24
Chemotherapy Classifications and Mechanisms
What is CAV in the context of small cell lung cancer?
CAV stands for Cyclophosphamide, Doxorubicin, and Vincristine.
p.21
Clinical Applications of Chemotherapy
What is the dosage of Capecitabine for home use?
1000mg/m2 BID for 14 days oral after food.
p.2
Clinical Applications of Chemotherapy
What does the ESMO guideline for localized colon cancer cover?
Diagnosis, treatment, and follow-up.
p.61
Chemotherapy Classifications and Mechanisms
Which drug(s) may cause cardiac toxicity in chemotherapy?
Doxorubicin is known to cause cardiac toxicity.
p.25
Chemotherapy Classifications and Mechanisms
How do Taxanes affect cancer cells?
They interfere with the mitotic spindle.
p.10
Combination Chemotherapy Strategies
What should the drugs in combination chemotherapy have?
Different mechanisms of action.
p.27
Clinical Applications of Chemotherapy
Why is filtration important during Paclitaxel infusion?
To ensure patient safety by removing potential harmful particles.
p.25
Clinical Applications of Chemotherapy
How should Docetaxel IV be administered?
Through polyethylene-lined (PE) administration sets.
p.56
Case Studies in Colorectal and Breast Cancer
How can case studies contribute to medical knowledge?
They provide detailed insights into patient experiences, treatment outcomes, and disease progression.
p.37
Clinical Applications of Chemotherapy
What are the pre-medications used to prevent chemotherapy induced nausea and vomiting (CINV) in FOLFOX?
Common pre-medications include 5-HT3 receptor antagonists, NK1 receptor antagonists, and corticosteroids.
p.63
Management of Chemotherapy Side Effects
What issue did Ms. Wong experience after taking tamoxifen for 1 week?
Insomnia due to hot flushes at midnight.
p.39
Clinical Applications of Chemotherapy
When should Mr. Yu receive the next cycle of chemotherapy?
Typically, the next cycle should be given after recovery from side effects, often 2-3 weeks after the previous cycle.
p.22
Chemotherapy Classifications and Mechanisms
What are the main Vinca alkaloids?
Vinblastine, Vincristine, and Vinorelbine.
p.54
Endocrine Therapy in Cancer Treatment
What is the early switch regimen for pre-menopausal women using Tamoxifen?
Tamoxifen for 2-3 years followed by Anastrozole or Exemestane for up to 5-10 years in total.
p.3
Overview of Cancer Treatment Modalities
What types of therapies are commonly included in colorectal cancer treatment protocols?
Surgery, chemotherapy, and targeted therapies.
p.15
Chemotherapy Classifications and Mechanisms
What are antimetabolites?
A class of chemotherapy drugs that interfere with DNA and RNA growth.
p.33
Case Studies in Colorectal and Breast Cancer
How can case studies contribute to medical knowledge?
They provide detailed insights into unique patient scenarios, treatment responses, and outcomes.
p.57
Case Studies in Colorectal and Breast Cancer
What was Ms. Wong's diagnosis?
Stage 2, HER-2 positive, ER positive breast cancer (T2N0M0).
p.17
Management of Chemotherapy Side Effects
What are common adverse drug reactions (ADRs) of 5-FU?
Gastrointestinal distress (especially diarrhea), mucositis, alopecia, Hand-foot syndrome, and myelosuppression.
p.31
Clinical Applications of Chemotherapy
What is a recommended adjuvant chemotherapy regimen for stage II colon cancer?
CAPOX, which is capecitabine plus oxaliplatin.
p.10
Combination Chemotherapy Strategies
What is a key advantage of combination chemotherapy?
It enhances response, reduces development of drug resistance, and increases survival.
p.63
Management of Chemotherapy Side Effects
Should Ms. Wong stop taking tamoxifen due to her insomnia?
Consultation with her healthcare provider is necessary before making a decision.
p.25
Management of Chemotherapy Side Effects
What are common adverse drug reactions (ADRs) associated with Paclitaxel?
Neutropenia, thrombocytopenia, high incidence of peripheral neuropathy, and possible hypersensitivity reactions during infusion.
p.25
Management of Chemotherapy Side Effects
What are the common ADRs associated with Docetaxel?
Neurotoxicity and bone marrow depression.
p.35
TNM Staging System for Cancer
What does 'N1' signify in Stage IIIA?
Regional lymph node involvement with 1 to 3 positive nodes.
p.22
Clinical Applications of Chemotherapy
What is Vincristine primarily used to treat?
Acute leukaemia and lymphomas.
p.2
Clinical Applications of Chemotherapy
What is the focus of clinical applications in chemotherapy?
Selected malignant diseases.
p.47
Targeted Cancer Therapies
What does Erlotinib inhibit in chronic myelogenous leukemia (CML)?
The tyrosine kinase activity of the protein product of the bcr-abl oncogene.
p.2
Clinical Applications of Chemotherapy
Which guideline provides information on early breast cancer treatment?
ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.
p.41
Case Studies in Colorectal and Breast Cancer
What was revealed by the colonoscopy?
A 9-cm mass in the descending colon.
p.5
Clinical Applications of Chemotherapy
What is adjuvant chemotherapy?
Chemotherapy given after surgery or radiation to reduce the risk of recurrence.
p.31
Clinical Applications of Chemotherapy
What is another adjuvant chemotherapy option for stage II colon cancer?
FOLFOX, which includes leucovorin, fluorouracil, and oxaliplatin.
p.18
Management of Chemotherapy Side Effects
What is a treatment option for pain associated with hand-foot syndrome?
Analgesics or topical anesthetics (lidocaine).
p.41
Case Studies in Colorectal and Breast Cancer
What is the diagnosis for Mrs. Chong?
Stage IV colorectal cancer with liver metastasis (T4, N3, M1a).
p.45
Targeted Cancer Therapies
What effect does Bevacizumab have on angiogenesis?
It reduces angiogenesis, which includes endothelial proliferation and the formation of new blood vessels.
p.52
Endocrine Therapy in Cancer Treatment
What is one of the primary uses of Tamoxifen?
Prevention of breast cancer in high-risk patients.
p.39
Management of Chemotherapy Side Effects
What cytotoxic drug is most likely causing Mr. Yu's loose stools?
5-Fluorouracil (5-FU) is commonly associated with diarrhea.
p.12
Chemotherapy Classifications and Mechanisms
What is the primary mechanism of action of alkylating agents?
They work by adding alkyl groups to DNA, leading to DNA cross-linking and damage.
p.5
Chemotherapy Classifications and Mechanisms
What are cytotoxic drugs?
Drugs that can damage cells.
p.35
TNM Staging System for Cancer
What does the 'T2' in Stage IIIA indicate?
The tumor has invaded the muscularis propria but not through the serosa.
p.12
Chemotherapy Classifications and Mechanisms
What is a common consequence of DNA damage caused by alkylating agents?
Induction of apoptosis or programmed cell death.
p.17
Clinical Applications of Chemotherapy
What types of cancer is 5-FU used to treat?
Bladder, breast, colon, anal, head and neck, liver, and ovarian cancers.
p.35
TNM Staging System for Cancer
What does 'M0' represent in Stage IIIA?
No distant metastasis is present.
p.26
Management of Chemotherapy Side Effects
What should be done if allergic reactions occur during Paclitaxel infusion?
Stop the infusion and give Hydrocortisone 100 to 200 mg IV and Chlorpheniramine 10 mg IV.
p.3
Management of Chemotherapy Side Effects
How is the effectiveness of colorectal cancer treatment monitored?
Through regular imaging and clinical assessments.
p.40
Case Studies in Colorectal and Breast Cancer
What is a case study in the context of cancer treatment?
A detailed analysis of a specific patient or group of patients to understand treatment outcomes and effectiveness.
p.33
Case Studies in Colorectal and Breast Cancer
What is a key benefit of using case studies in cancer treatment?
They help in understanding the effectiveness of different treatment modalities in real-world scenarios.
p.57
Chemotherapy Classifications and Mechanisms
What chemotherapy regimen is Ms. Wong receiving?
Adjuvant AC-TH chemotherapy: 8 cycles of Doxorubicin-Cyclophosphamide-Paclitaxel.
p.56
Case Studies in Colorectal and Breast Cancer
What can be a limitation of case studies?
They may not be generalizable to the broader population due to their focus on individual cases.
p.15
Clinical Applications of Chemotherapy
What additional action do antimetabolites have besides cytotoxic effects?
Immunosuppressant actions.
p.36
Chemotherapy Classifications and Mechanisms
How is Oxaliplatin administered on Day 1?
IV Infusion of 85 mg/m² over 2 hours.
p.7
Types of Chemotherapy Drugs
What are some plant-derived anti-tumor drugs?
Vinblastine, vincristine, vinorelbine, paclitaxel, docetaxel.
p.13
Management of Chemotherapy Side Effects
What are common adverse drug reactions (ADRs) of alkylating agents?
GI distress, mild hematotoxicity, neurotoxicity (peripheral neuritis and acoustic nerve damage), nephrotoxicity.
p.45
Clinical Applications of Chemotherapy
In which types of cancer is Bevacizumab used?
Colorectal, breast, non-small cell lung, and renal cancer.
p.41
Clinical Applications of Chemotherapy
How do colorectal tumors with RAS mutations affect clinical outcomes?
They frequently predict poorer clinical outcomes than RAS wild-type.
p.55
Endocrine Therapy in Cancer Treatment
What is the effect of aromatase inhibitors on recurrence rates compared to tamoxifen?
They reduce recurrence rates by about 30%.
p.25
Clinical Applications of Chemotherapy
What types of cancers are treated with Taxanes?
Breast, ovarian, lung, gastroesophageal, prostate, bladder, and head and neck cancers.
p.10
Combination Chemotherapy Strategies
What phases do combination chemotherapy drugs target?
Multiple phases in the cell cycles.
p.17
Chemotherapy Classifications and Mechanisms
What is the mechanism of action of Fluorouracil (5-FU)?
It inhibits thymidylate synthase, leading to 'thymineless death' of cells.
p.47
Targeted Cancer Therapies
Name an example of a Tyrosine Kinase Inhibitor.
Erlotinib (Tarceva®), Imatinib (Glivec®), gefitinib (Iressa®).
p.22
Clinical Applications of Chemotherapy
What types of cancer is Vinblastine used for?
Lymphomas, neuroblastoma, and testicular carcinoma.
p.21
Clinical Applications of Chemotherapy
What is the dosage and administration method for Oxaliplatin on Day One?
130mg/m2 IV infusion in 500ml D5 over 2 hours.
p.33
Case Studies in Colorectal and Breast Cancer
What types of cancer are often highlighted in case studies?
Colorectal and breast cancer.
p.34
Case Studies in Colorectal and Breast Cancer
What is Mr. Yu's age and diagnosis?
62 years old with Stage IIIA Colorectal Cancer.
p.62
Management of Chemotherapy Side Effects
Should the trastuzumab infusion be discontinued due to Ms. Wong's symptoms?
The infusion may not need to be discontinued, but monitoring and evaluation by healthcare professionals are necessary.
p.13
Chemotherapy Classifications and Mechanisms
What are the main alkylating agents mentioned?
Cisplatin IV, carboplatin IV, and oxaliplatin IV.
p.7
Types of Chemotherapy Drugs
What are some examples of alkylating agents used in chemotherapy?
Cyclophosphamide, cisplatin, carboplatin, oxaliplatin.
p.43
Types of Chemotherapy Drugs
Name two antimetabolites used in chemotherapy.
5-fluorouracil (5-FU) and methotrexate.
p.8
Chemotherapy Classifications and Mechanisms
What is the significance of the G0 phase in relation to drug effectiveness?
It is the resting phase where Cell Cycle-Nonspecific drugs can act on tumor cells.
p.45
Targeted Cancer Therapies
How does Bevacizumab affect tissue growth?
It retards the growth of all tissues, including metastatic tissue.
p.28
Chemotherapy Classifications and Mechanisms
What are anthracyclines?
A class of anti-tumor antibiotics including doxorubicin and daunorubicin.
p.16
Clinical Applications of Chemotherapy
What types of cancer is Methotrexate used to treat?
Acute leukaemia, non-Hodgkin lymphoma, breast cancer, head and neck cancer, and bladder cancer.
p.32
Types of Chemotherapy Drugs
Can you name some anti-tumor antibiotics?
Dactinomycin, bleomycin, doxorubicin.
p.36
Management of Chemotherapy Side Effects
What is the recommended discharge oral medication?
Ondansetron, dexamethasone, metoclopramide.
p.48
Targeted Cancer Therapies
What treatment is recommended for HER2-positive breast cancer?
Chemotherapy plus anti-HER2 therapy.
p.39
Management of Chemotherapy Side Effects
What is an appropriate management for Mr. Yu's loose stools?
Consider using loperamide or adjusting the chemotherapy regimen.
p.12
Chemotherapy Classifications and Mechanisms
What effect do alkylating agents have on DNA?
They cause DNA strand breaks and inhibit DNA replication.
p.19
Management of Chemotherapy Side Effects
What is palmar-plantar erythrodysesthesia?
A side effect characterized by redness and pain on the palms of the hands and soles of the feet, often associated with chemotherapy.
p.26
Clinical Applications of Chemotherapy
What is the administration method for Paclitaxel in locally advanced breast cancer?
Weekly using a non-PVC set with a 0.22 micron filter.
p.33
Case Studies in Colorectal and Breast Cancer
What is the primary focus of a case study in a clinical context?
To analyze and understand specific instances of patient care or treatment outcomes.
p.29
Chemotherapy Classifications and Mechanisms
What is the combination of drugs used in the CAV regimen for small cell lung cancer?
Cyclophosphamide, Doxorubicin, and Vincristine.
p.17
Combination Chemotherapy Strategies
What is commonly given before 5-FU to enhance its effects?
Folinic acid (Leucovorin) IV infusion.
p.8
Chemotherapy Classifications and Mechanisms
What is a Cell Cycle-Specific (CCS) drug?
A drug that is most effective on tumor cells during specific phases of the cell cycle.
p.22
Management of Chemotherapy Side Effects
What are common adverse drug reactions (ADRs) of Vincristine?
Neurotoxic actions, areflexia, peripheral neuritis, and paralytic ileus.
p.56
Case Studies in Colorectal and Breast Cancer
What is a key benefit of using case studies in cancer treatment?
They help in understanding the effectiveness of different treatment modalities in real-world scenarios.
p.32
Types of Chemotherapy Drugs
What are some examples of alkylating agents used in chemotherapy?
Cyclophosphamide, cisplatin, carboplatin, oxaliplatin.
p.24
Types of Chemotherapy Drugs
What are the components of the CAV chemotherapy regimen?
Cyclophosphamide, Doxorubicin, and Vincristine.
p.13
Clinical Applications of Chemotherapy
What types of cancer are treated with cisplatin and carboplatin?
Testicular carcinoma, cancers of the bladder, lung, and ovary.
p.18
Management of Chemotherapy Side Effects
Which treatment is recommended for inflammation in hand-foot syndrome?
Topical high-potency corticosteroids.
p.40
Case Studies in Colorectal and Breast Cancer
How can case studies influence future cancer treatment strategies?
By highlighting successful approaches and potential complications, guiding future research and clinical practices.
p.64
Chemotherapy Classifications and Mechanisms
What is the primary effect of cytotoxic drugs in the cell cycle?
They disrupt the normal progression of the cell cycle.
p.46
Management of Chemotherapy Side Effects
What should be administered if infusion-related reactions occur?
Hydrocortisone 100 mg IV, chlorpheniramine 10 mg IV, paracetamol 1000 mg po.
p.52
Endocrine Therapy in Cancer Treatment
What is another use of Tamoxifen besides prevention?
Adjuvant therapy of breast cancer.
p.11
Types of Chemotherapy Drugs
What is a common nitrogen mustard used as an alkylating agent?
Cyclophosphamide IV (Endoxan).
p.25
Chemotherapy Classifications and Mechanisms
What are the two main Taxanes mentioned?
Paclitaxel (Taxol®) and Docetaxel (Taxotere®).
p.14
Clinical Applications of Chemotherapy
What is the protocol involving cisplatin for treating oesophagus cancer?
Cisplatin and Fluorouracil over 4 days.
p.30
Clinical Applications of Chemotherapy
What is the purpose of adjuvant chemotherapy in colorectal cancer treatment?
To reduce the risk of cancer recurrence after surgery.
p.3
Clinical Applications of Chemotherapy
What is the primary focus of the treatment protocol for colorectal cancer?
To provide guidelines for the management and treatment of colorectal cancer.
p.22
Chemotherapy Classifications and Mechanisms
How do Vinca alkaloids affect cell division?
They block the formation of the mitotic spindle by preventing the assembly of tubulin dimers into microtubules during the M phase.
p.56
Case Studies in Colorectal and Breast Cancer
What is the primary focus of a case study in a medical context?
To analyze a specific instance of a disease or treatment to draw conclusions or insights.
p.3
Chemotherapy Classifications and Mechanisms
What is the role of chemotherapy in colorectal cancer treatment?
To kill cancer cells and reduce tumor size, often used in conjunction with surgery.
p.27
Chemotherapy Classifications and Mechanisms
What is the mechanism of action of Paclitaxel?
It stabilizes microtubules and prevents their disassembly, inhibiting cell division.
p.56
Case Studies in Colorectal and Breast Cancer
What type of cancer is often examined in case studies?
Colorectal and breast cancer.
p.8
Chemotherapy Classifications and Mechanisms
What is a Cell Cycle-Nonspecific (CCNS) drug?
A drug that acts on tumor cells while they are actively cycling and in the resting phase (G0).
p.33
Case Studies in Colorectal and Breast Cancer
What can be learned from analyzing case studies in cancer?
Patterns in treatment responses and potential complications that may arise.
p.44
Targeted Cancer Therapies
How are targeted therapies often used in cancer treatment?
In combination with cytotoxic anticancer agents to achieve higher response rates.
p.7
Types of Chemotherapy Drugs
Name a few antimetabolites used in chemotherapy.
5-fluorouracil (5-FU), methotrexate, capecitabine, gemcitabine.
p.50
Overview of Cancer Treatment Modalities
What does OFS stand for in breast cancer treatment?
Ovarian function suppression.
p.31
Clinical Applications of Chemotherapy
What does MSS stand for?
Microsatellite stability.
p.64
Types of Chemotherapy Drugs
What are alkylating agents?
A class of chemotherapy drugs that work by adding alkyl groups to DNA, preventing cell division.
p.32
Types of Chemotherapy Drugs
What are examples of targeted therapy in chemotherapy?
Gefitinib, erlotinib, bevacizumab, trastuzumab.
p.28
Chemotherapy Classifications and Mechanisms
How do anthracyclines affect DNA?
They interfere with enzymes involved in DNA replication.
p.44
Targeted Cancer Therapies
What factors can lead to resistance in targeted anticancer therapy?
Mutations in the molecular target, decreased expression of the target, alterations in target pathways, changes in drug efflux and metabolism.
p.1
Overview of Cancer Treatment Modalities
What is the focus of the course PDN1306?
Applied Pharmacology and Microbiology.
p.14
Management of Chemotherapy Side Effects
What can reduce cisplatin-induced renal damage?
Mannitol with forced hydration pre- and post-cisplatin infusion.
p.30
Clinical Applications of Chemotherapy
What are the main treatment options for colorectal cancer?
Surgery, radiofrequency ablation, cryosurgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.
p.37
Management of Chemotherapy Side Effects
Should mannitol infusion be given before oxaliplatin to reduce renal damage?
Yes, mannitol infusion is sometimes used to help protect the kidneys from potential damage caused by oxaliplatin.
p.51
Endocrine Therapy in Cancer Treatment
What type of cancers are often hormone-dependent?
Breast and prostate cancer.
p.10
Combination Chemotherapy Strategies
How do combination chemotherapy drugs differ from single drugs?
Combinations are frequently more toxic than single drugs.
p.30
Clinical Applications of Chemotherapy
When should adjuvant chemotherapy ideally commence after surgery for colorectal cancer?
As soon as possible and ideally not later than 8 weeks.
p.14
Management of Chemotherapy Side Effects
When should hydration occur in relation to cisplatin infusion?
Pre- and post-cisplatin infusion.
p.19
Management of Chemotherapy Side Effects
What is the primary focus of the 5FU Toxicity Monitoring Protocol?
To monitor toxicity associated with 5FU and Folinic Acid in colorectal cancer treatment.
p.51
Endocrine Therapy in Cancer Treatment
What benefits does endocrine therapy provide?
It can extend survival and delay or prevent tumor recurrence.
p.12
Chemotherapy Classifications and Mechanisms
What type of cancer treatment do alkylating agents fall under?
They are classified as chemotherapy agents.
p.5
Chemotherapy Classifications and Mechanisms
What is the purpose of chemotherapy drugs?
Used in treating malignancies.
p.51
Endocrine Therapy in Cancer Treatment
What are the four main groups of endocrine therapy?
Corticosteroids, gonadal hormones, estrogen antagonists and aromatase inhibitors, and androgen antagonists.
p.47
Targeted Cancer Therapies
What are small molecules in targeted anticancer therapy?
Tyrosine Kinase Inhibitors (oral).
p.2
Overview of Cancer Treatment Modalities
What are the main classifications of cancer therapies discussed?
Chemotherapies, targeted cancer therapies, and endocrine therapy.
p.38
Case Studies in Colorectal and Breast Cancer
What stage of cancer does Mr. Yu have?
Stage IIIA Colorectal Cancer.
p.19
Management of Chemotherapy Side Effects
What is the significance of the CRP09 CR004 protocol?
It outlines the monitoring procedures for patients receiving 5FU and Folinic Acid.
p.62
Management of Chemotherapy Side Effects
What symptoms did Ms. Wong experience after the 3rd cycle of paclitaxel?
Mild numbness and weakness in her right hand.
p.27
Chemotherapy Classifications and Mechanisms
What type of drug is Paclitaxel?
A chemotherapy medication used to treat various cancers.
p.26
Management of Chemotherapy Side Effects
When do reactions commonly occur during Paclitaxel infusion?
Within the first few minutes of starting the infusion.
p.5
Clinical Applications of Chemotherapy
When is primary induction chemotherapy typically used?
When no alternative treatment exists.
p.38
Clinical Applications of Chemotherapy
When will the 5FU infusion finish?
It could finish on 1 Apr, 2 Apr, or 3 Apr, depending on the treatment schedule.
p.8
Chemotherapy Classifications and Mechanisms
What are the five phases of the cell cycle that all dividing cells must traverse?
G0 (resting stage), G1, S, G2, M.
p.22
Clinical Applications of Chemotherapy
What cancers is Vinorelbine used to treat?
Non-small cell lung cancer and breast cancer.
p.26
Clinical Applications of Chemotherapy
What is the purpose of using a non-PVC set with a 0.22 micron filter for Paclitaxel?
To prevent contamination and ensure safe administration.
p.3
Clinical Applications of Chemotherapy
What factors influence the choice of treatment in colorectal cancer?
Stage of cancer, patient health, and specific tumor characteristics.
p.46
Targeted Cancer Therapies
What is the function of Trastuzumab (Herpcetin)?
It binds to the HER-2 receptors on cancer cells, inhibiting their proliferation.
p.50
Overview of Cancer Treatment Modalities
What does HER2 stand for?
Human Epidermal growth factor Receptor 2.
p.52
Endocrine Therapy in Cancer Treatment
How does Tamoxifen work?
As a competitive inhibitor of estradiol binding to the estrogen receptor (ER).
p.31
Clinical Applications of Chemotherapy
What does CEA stand for in the context of colon cancer?
Carcinoembryonic antigen.
p.43
Types of Chemotherapy Drugs
What are some plant-derived anti-tumor drugs?
Vinblastine, vincristine, vinorelbine, paclitaxel, docetaxel.
p.41
Clinical Applications of Chemotherapy
What was the result of the expanded RAS testing?
Negative for mutation (wild-type).
p.31
Clinical Applications of Chemotherapy
What is the ESMO-Magnitude of Clinical Benefit Scale (MCBS)?
A scale used to evaluate the clinical benefit of cancer treatments.
p.50
TNM Staging System for Cancer
What does cT and N represent in cancer staging?
cT refers to clinical Tumor category, and N refers to node category.
p.13
Chemotherapy Classifications and Mechanisms
How does carboplatin compare to cisplatin in terms of nephrotoxicity?
Carboplatin is less nephrotoxic than cisplatin.
p.20
Combination Chemotherapy Strategies
What is CAPOX?
A combination of capecitabine plus oxaliplatin.
p.52
Endocrine Therapy in Cancer Treatment
What is the recommended regimen for Tamoxifen?
Tamoxifen 20 mg Daily Oral for 5-10 years.
p.32
Types of Chemotherapy Drugs
What are aromatase inhibitors used in chemotherapy?
Anastrozole, exemestane, letrozole.
p.13
Management of Chemotherapy Side Effects
What is a notable difference in side effects between carboplatin and cisplatin?
Carboplatin is less likely to cause tinnitus and hearing loss but has greater myelosuppressant actions.
p.64
Targeted Cancer Therapies
What is targeted therapy?
A treatment that uses drugs or other substances to precisely identify and attack cancer cells.
p.54
Endocrine Therapy in Cancer Treatment
What are the aromatase inhibitors mentioned in the regimens?
Anastrozole, Exemestane, and Letrozole.
p.5
Clinical Applications of Chemotherapy
What is the goal of neoadjuvant chemotherapy?
To reduce the size of the tumor before surgery.
p.47
Targeted Cancer Therapies
When is Erlotinib used as a first-line treatment?
For non-small-cell lung cancer if it is positive for epidermal growth factor tyrosine kinase mutation.
p.43
Types of Chemotherapy Drugs
What are alkylating agents used in chemotherapy?
Cyclophosphamide, cisplatin, carboplatin, oxaliplatin.
p.22
Management of Chemotherapy Side Effects
What are common ADRs associated with Vinblastine and Vinorelbine?
Gastrointestinal distress, alopecia, and bone marrow suppression.
p.46
Targeted Cancer Therapies
What type of protein does Anti-HER-2 target?
Human epidermal growth factor receptor 2 protein (HER-2).
p.32
Types of Chemotherapy Drugs
Name a few antimetabolites used in chemotherapy.
5-fluorouracil (5-FU), methotrexate, capecitabine, gemcitabine.
p.46
Clinical Applications of Chemotherapy
What is the recommended regimen for Trastuzumab administration?
6 mg/kg in NS 250 ml IV infusion over 90 minutes.
p.16
Chemotherapy Classifications and Mechanisms
What processes does Methotrexate interfere with?
Nucleic acid and protein metabolism.
p.24
Chemotherapy Classifications and Mechanisms
What is the mechanism of action of Cyclophosphamide?
It is an alkylating agent that cross-links DNA, leading to cell death.
p.44
Targeted Cancer Therapies
What do small molecules in targeted therapy do?
Enter cells and engage intracellular targets, such as enzyme kinases.
p.53
Endocrine Therapy in Cancer Treatment
Name three examples of Aromatase Inhibitors.
Anastrozole (Arimidex), exemestane (Aromasin), letrozole (Femara).
p.41
Combination Chemotherapy Strategies
What chemotherapy regimen is planned for Mrs. Chong?
Bevacizumab + CAPOX (capecitabine plus oxaliplatin).
p.45
Management of Chemotherapy Side Effects
What adjustment can be made to the infusion time of Bevacizumab in subsequent cycles?
Shorten to 60min/30min if well tolerated.
p.20
Clinical Applications of Chemotherapy
What is the dosing regimen for Capecitabine?
1000 mg/m2 BID on Day 1-14 (per 21-day cycle).
p.64
Management of Chemotherapy Side Effects
What are common side effects of chemotherapy?
Nausea, fatigue, hair loss, and increased risk of infection.
p.65
Management of Chemotherapy Side Effects
What should be done if chills and fever occur during Ms. Wong's first infusion?
Continue infusion and monitor closely if any other reactions occur.
p.41
Case Studies in Colorectal and Breast Cancer
What were the symptoms experienced by Mrs. Chong?
Abdominal pain, fatigue, and remarkable weight loss.
p.62
Management of Chemotherapy Side Effects
What symptoms did Ms. Wong develop during the 1st trastuzumab infusion?
Chills and mild fever (38.2 C).
p.20
Chemotherapy Classifications and Mechanisms
What is Capecitabine?
A rationally designed 5-FU pro-drug developed to mimic continuous infusion of 5-FU.
p.45
Targeted Cancer Therapies
What is the function of Bevacizumab (Avastin)?
It binds to vascular endothelial growth factor (VEGF) and inhibits its interaction with receptors.
p.8
Chemotherapy Classifications and Mechanisms
During which phase are tumor cells usually most responsive to specific drugs?
During the specific phases indicated for Cell Cycle-Specific drugs.
p.50
Endocrine Therapy in Cancer Treatment
What is the purpose of endocrine therapy in breast cancer treatment?
To block hormones that can promote the growth of cancer cells.
p.57
Endocrine Therapy in Cancer Treatment
What is the follow-up therapy after trastuzumab for Ms. Wong?
Tamoxifen therapy, switching to an aromatase inhibitor for a total of 5-10 years.
p.52
Endocrine Therapy in Cancer Treatment
What are some high-risk factors for breast cancer that Tamoxifen can help prevent?
Strong family history, prior non-malignant breast pathology, or inheritance of the BRCA1 or BRCA2 genes.
p.65
Clinical Applications of Chemotherapy
What medications were administered to Mr. Yu for colorectal cancer?
Ondansetron (Zofran) IV and dexamethasone IV.
p.53
Endocrine Therapy in Cancer Treatment
What are Aromatase Inhibitors (AIs) used for?
To decrease estrogen-mediated cancer cell proliferation in hormone receptor-positive breast cancer.
p.16
Clinical Applications of Chemotherapy
What are some non-cancer uses of Methotrexate?
Rheumatoid arthritis and inflammatory bowel diseases.
p.34
Clinical Applications of Chemotherapy
What treatment did Mr. Yu receive and what is planned next?
He received surgery and is planned to start FOLFOX chemotherapy.
p.6
TNM Staging System for Cancer
What does T0 signify in the TNM staging system?
The main tumor cannot be found.
p.34
Clinical Applications of Chemotherapy
What does FOLFOX stand for?
FOLFOX is a combination chemotherapy regimen that includes Folinic acid (leucovorin), Fluorouracil (5-FU), and Oxaliplatin.
p.28
Clinical Applications of Chemotherapy
What cancers is doxorubicin used to treat?
Hodgkin and non-Hodgkin lymphoma, myelomas, sarcomas, and breast, lung, ovarian, and thyroid cancers.
p.48
Overview of Cancer Treatment Modalities
What characterizes locally advanced breast cancer?
T3 tumour without nodal involvement (T3N0).
p.11
Management of Chemotherapy Side Effects
What is a significant adverse reaction (ADR) of alkylating agents?
They can cause long-term damage to the bone marrow.
p.64
Endocrine Therapy in Cancer Treatment
How do hormones play a role in cancer treatment?
They can be used to block or lower the amount of hormones in the body that fuel certain cancers.
p.64
Management of Chemotherapy Side Effects
How can the side effects of chemotherapy be managed?
Through medications, lifestyle changes, and supportive care.
p.35
TNM Staging System for Cancer
What is the overall classification of Stage IIIA?
It indicates locally advanced colorectal cancer.
p.29
Management of Chemotherapy Side Effects
What is the required cardiac ejection fraction to proceed with Doxorubicin treatment?
Must be greater than 50%.
p.2
Overview of Cancer Treatment Modalities
Where can one find chemotherapy protocols and tools?
Cancer Institute NSW Australia website.
p.48
Management of Chemotherapy Side Effects
What is the clinical stage of early-stage breast cancer?
Clinical stage I, IIA (T2N1).
p.20
Clinical Applications of Chemotherapy
What types of cancer is Capecitabine used to treat?
Colorectal cancer, gastric cancer, and breast cancer.
p.34
Case Studies in Colorectal and Breast Cancer
What did the colonoscopy reveal?
A 6-cm mass in the ascending colon, which was diagnosed as adenocarcinoma.
p.43
Types of Chemotherapy Drugs
List two anti-tumor antibiotics used in chemotherapy.
Dactinomycin and doxorubicin.
p.6
TNM Staging System for Cancer
What does TX indicate in the TNM staging system?
The main tumor cannot be measured.
p.59
Chemotherapy Classifications and Mechanisms
What is the dosage of Paclitaxel given during the infusion?
175 mg/m2 intravenous infusion in 500ml NS over 180 minutes.
p.32
Types of Chemotherapy Drugs
What are some hormones used in cancer treatment?
Tamoxifen (antiestrogen), Flutamide (antiandrogen).
p.65
Management of Chemotherapy Side Effects
What supportive care measures are recommended for Mr. Yu?
5FU, loperamide or codeine phosphate, maintain hydration, may require dose adjustment if severe.
p.36
Chemotherapy Classifications and Mechanisms
Why is Oxaliplatin incompatible with saline?
It is a specific incompatibility noted in the treatment protocol.
p.65
Clinical Applications of Chemotherapy
What medications were administered to Ms. Wong for breast cancer?
Doxorubicin and trastuzumab.
p.4
Overview of Cancer Treatment Modalities
Which cancer is the fifth most common in Hong Kong?
Hepatocellular carcinoma (liver cancer).
p.38
Chemotherapy Classifications and Mechanisms
What is the role of Calcium Leucovorin (folinic acid)?
It enhances the efficacy of 5FU chemotherapy.
p.50
Overview of Cancer Treatment Modalities
What is triple-negative breast cancer?
A type of breast cancer that does not have any of the three common receptors known to fuel most breast cancer growth.
p.58
Types of Chemotherapy Drugs
Which chemotherapy drugs are included in the treatment regimen?
Doxorubicin (Adriamycin), Cyclophosphamide, and Paclitaxel (Taxol).
p.44
Targeted Cancer Therapies
What do most targeted therapies attack?
Cells with mutant versions of certain genes or cells that express too many copies of a particular gene.
p.34
Case Studies in Colorectal and Breast Cancer
What symptoms did Mr. Yu present with?
Bloating, abdominal cramps, altered bowel habit, and unintentional weight loss.
p.24
Chemotherapy Classifications and Mechanisms
What is the role of Doxorubicin in the CAV regimen?
It acts as an anthracycline antibiotic that interferes with DNA replication.
p.48
Management of Chemotherapy Side Effects
What are the two main treatment options for early-stage breast cancer?
Breast-conserving therapy (surgery plus radiation therapy) or mastectomy (with or without radiation therapy).
p.11
Types of Chemotherapy Drugs
Name three examples of platinum drugs used as alkylating agents.
Cisplatin IV, carboplatin IV, and oxaliplatin (Eloxatin) IV.
p.43
Types of Chemotherapy Drugs
What are examples of targeted therapy in chemotherapy?
Gefitinib, erlotinib, bevacizumab, trastuzumab.
p.52
Endocrine Therapy in Cancer Treatment
What are some adverse drug reactions (ADRs) associated with Tamoxifen?
Headache, hot flushes, fluid retention and oedema, thromboembolism, arthralgia and myalgia, endometrial changes, and uterine malignancies.
p.11
Chemotherapy Classifications and Mechanisms
How do alkylating agents affect DNA?
They alkylate nucleophilic groups on DNA bases, damaging DNA directly.
p.16
Management of Chemotherapy Side Effects
How can the toxic effects of Methotrexate be reduced?
By administering Folic acid (5 mg weekly, 4 days after Methotrexate).
p.28
Chemotherapy Classifications and Mechanisms
How might liposomal formulations of doxorubicin differ from standard formulations?
They may be less cardiotoxic.
p.40
Case Studies in Colorectal and Breast Cancer
Why are case studies important in cancer research?
They provide insights into real-world applications of treatment modalities and help identify best practices.
p.29
Management of Chemotherapy Side Effects
What evaluation should be performed if needed before administering Doxorubicin?
Baseline LVEF (Left Ventricular Ejection Fraction) evaluation.
p.40
Case Studies in Colorectal and Breast Cancer
What types of data are typically included in a cancer case study?
Patient demographics, treatment protocols, outcomes, and follow-up results.
p.34
Case Studies in Colorectal and Breast Cancer
What is Mr. Yu's past medical history?
Hypertension (on losartan) and hyperlipidaemia (on atorvastatin).
p.41
Management of Chemotherapy Side Effects
What is the management plan for Mrs. Chong?
Surgery + chemotherapy based on molecular testing.
p.40
Case Studies in Colorectal and Breast Cancer
What role do case studies play in understanding specific cancers like colorectal and breast cancer?
They help in identifying unique characteristics, treatment responses, and patient experiences related to these cancers.
p.59
Chemotherapy Classifications and Mechanisms
What is the dosage of Metoclopramide on Day One?
10 mg oral or intravenous.
p.57
Targeted Cancer Therapies
What is the significance of HER-2 positive in Ms. Wong's diagnosis?
It indicates a specific type of breast cancer that may respond to targeted therapies.
p.59
Management of Chemotherapy Side Effects
What is the take-home medication for Metoclopramide?
10 mg three times a day when required, oral (for 21 days).
p.7
Endocrine Therapy in Cancer Treatment
What are some hormones used in cancer treatment?
Tamoxifen (antiestrogen), Flutamide (antiandrogen).
p.6
TNM Staging System for Cancer
What do T1, T2, T3, and T4 represent in the TNM system?
They refer to the size and/or extent of the main tumor, with higher numbers indicating larger tumors or more growth into nearby tissues.
p.11
Clinical Applications of Chemotherapy
What is the primary effect of alkylating agents on cancer cells?
They prevent the cancer cell from reproducing.
p.53
Endocrine Therapy in Cancer Treatment
Why are Aromatase Inhibitors ineffective in premenopausal women?
In the absence of ovarian suppression, compensatory physiological responses induce ovarian estrogen production.
p.65
Endocrine Therapy in Cancer Treatment
Did anastrozole work well for Ms. Wong, a premenopausal woman?
No, anastrozole (AIs) did not work well in premenopausal women.
p.15
Chemotherapy Classifications and Mechanisms
How do antimetabolites interfere with cellular processes?
By substituting the normal building blocks of RNA and DNA.
p.20
Chemotherapy Classifications and Mechanisms
How is Capecitabine converted to its active form?
Enzymatically in the GI tract to active 5-FU.
p.31
Clinical Applications of Chemotherapy
What does MSI refer to in colon cancer treatment?
Microsatellite instability.
p.32
Types of Chemotherapy Drugs
What are some plant-derived anti-tumor drugs?
Vinblastine, vincristine, vinorelbine, paclitaxel, docetaxel.
p.20
Combination Chemotherapy Strategies
What is FOLFOX?
A combination of fluorouracil plus oxaliplatin.
p.7
Types of Chemotherapy Drugs
Can you name some anti-tumor antibiotics?
Dactinomycin, bleomycin, doxorubicin.
p.65
Management of Chemotherapy Side Effects
Is mannitol infusion given during cisplatin infusion for Mr. Yu?
No, mannitol infusion is given pre- and post-cisplatin infusion only.
p.64
Types of Chemotherapy Drugs
What do antimetabolites do?
They interfere with DNA and RNA synthesis by mimicking the building blocks of these molecules.
p.16
Management of Chemotherapy Side Effects
What are common adverse drug reactions (ADRs) of Methotrexate?
Bone marrow suppression, toxic effects on skin and gastrointestinal mucosa (mucositis).
p.20
Management of Chemotherapy Side Effects
What side effects are associated with CAPOX?
More grade 3 diarrhoea and hand-foot skin reactions.
p.48
Combination Chemotherapy Strategies
What is the purpose of neoadjuvant systemic therapy?
To treat locally advanced breast cancer before surgery.
p.48
Overview of Cancer Treatment Modalities
What stage is referred to as distant metastases in breast cancer?
Stage IV (around 5% at diagnosis).
p.65
Management of Chemotherapy Side Effects
What side effect did Ms. Wong experience from paclitaxel?
Grade 1 peripheral neuropathy; continue chemotherapy.
p.44
Targeted Cancer Therapies
What are the two major types of targeted therapies?
Monoclonal antibodies and small molecules.
p.24
Chemotherapy Classifications and Mechanisms
How does Vincristine work in cancer treatment?
It inhibits microtubule formation, preventing cell division.
p.44
Targeted Cancer Therapies
What do monoclonal antibodies target?
Cell surface or shed antigens, such as growth factor receptors or receptor ligands.
p.18
Management of Chemotherapy Side Effects
What ointments are recommended for erosions in hand-foot syndrome?
Petroleum/lanolin-based ointments.
p.20
Management of Chemotherapy Side Effects
What are the side effects associated with FOLFOX?
More neutropenia and venous thrombotic events.
p.7
Types of Chemotherapy Drugs
What are examples of targeted therapy in chemotherapy?
Gefitinib, erlotinib, bevacizumab, trastuzumab.
p.36
Chemotherapy Classifications and Mechanisms
What is the dose of 5 Fluorouracil administered as a bolus?
400 mg/m² over 5 minutes.
p.65
Chemotherapy Classifications and Mechanisms
Why is 5FU used in Mr. Yu's treatment?
To enhance 5FU cytotoxic effects.
p.18
Management of Chemotherapy Side Effects
What topical treatment contains 99% dimethylsulfoxide (DSMU)?
Topical 99% dimethylsulfoxide (DSMU).
p.6
TNM Staging System for Cancer
What does N0 indicate in the TNM staging system?
There is no cancer in nearby lymph nodes.
p.6
TNM Staging System for Cancer
What do N1, N2, and N3 signify in the TNM system?
They refer to the number and location of lymph nodes that contain cancer, with higher numbers indicating more affected lymph nodes.
p.45
Clinical Applications of Chemotherapy
What is the typical regimen for administering Bevacizumab?
5-10 mg/kg every 2-3 weeks in 100ml NS over 90 mins IV infusion.
p.50
Endocrine Therapy in Cancer Treatment
What is a consideration for patients with bone metastases or osteoporosis in breast cancer treatment?
Endocrine therapy may be used to manage these conditions.
p.53
Endocrine Therapy in Cancer Treatment
How do Aromatase Inhibitors work?
They inhibit the enzyme aromatase, blocking the conversion of androgens into estrogens.
p.64
Types of Chemotherapy Drugs
What is the role of anti-tumor antibiotics in chemotherapy?
They inhibit DNA and RNA synthesis in cancer cells.
p.28
Management of Chemotherapy Side Effects
What are common adverse drug reactions (ADRs) of doxorubicin?
Bone marrow suppression, gastrointestinal distress, severe alopecia, and red urine.
p.6
TNM Staging System for Cancer
What does M1 indicate in the TNM staging system?
Cancer has spread to other parts of the body.
p.18
Management of Chemotherapy Side Effects
What oral supplement is suggested for hand-foot syndrome?
Oral vitamin B6 (Pyridoxine) 400 mg.
p.52
Endocrine Therapy in Cancer Treatment
How does the risk of endometrial changes and uterine malignancies relate to Tamoxifen therapy?
The risk increases with the duration of Tamoxifen therapy.
p.28
Management of Chemotherapy Side Effects
What can result from lifetime cumulative doses of doxorubicin?
Dose-dependent cardiomyopathy and heart failure.
p.65
Management of Chemotherapy Side Effects
What is a common side effect of doxorubicin in Ms. Wong?
Urine discoloration (red) is a normal effect.
p.6
TNM Staging System for Cancer
What does M0 signify in the TNM staging system?
Cancer has not spread to other parts of the body.
p.46
Management of Chemotherapy Side Effects
What are some adverse drug reactions (ADRs) associated with Trastuzumab?
Cardiotoxicity, acute respiratory distress syndrome, infusion-related effects.
p.64
Types of Chemotherapy Drugs
What are plant-derived anti-tumor drugs?
Chemotherapy agents derived from plants that inhibit cancer cell growth.
p.53
Endocrine Therapy in Cancer Treatment
Why are Aromatase Inhibitors effective in postmenopausal women?
Because the aromatase pathway is the primary source of estrogen in postmenopausal women.
p.6
TNM Staging System for Cancer
What does NX mean in the context of regional lymph nodes?
Cancer in nearby lymph nodes cannot be measured.
p.13
Management of Chemotherapy Side Effects
What is a significant side effect of oxaliplatin?
Dose-limiting neurotoxicity.
p.7
Endocrine Therapy in Cancer Treatment
What are aromatase inhibitors used in cancer treatment?
Anastrozole, exemestane, letrozole.
p.43
Types of Chemotherapy Drugs
What are aromatase inhibitors used in chemotherapy?
Anastrozole, exemestane, letrozole.
p.53
Management of Chemotherapy Side Effects
What are some common adverse drug reactions (ADRs) associated with Aromatase Inhibitors?
Headache, hot flushes, hyperlipidaemia, hypercholesterolaemia, fluid retention, edema, arthralgia, myalgia, and vaginal atrophy.
p.6
TNM Staging System for Cancer
What does MX indicate regarding distant metastasis?
Metastasis cannot be measured.
p.64
Clinical Applications of Chemotherapy
What is the significance of constructing systemic chemotherapies for colorectal and breast cancer?
It allows for tailored treatment plans that improve patient outcomes.
