Cancer Lecture Notes
Key Terminology
- Tumor/Neoplasm: New, abnormal growth, uncontrolled and progressive.
- Angiogenesis: Formation of new blood vessels from existing ones, feeding growing tumors.
- Bev Zumab: Angiogenesis inhibitor, slows tumor growth.
- Benign Neoplasm: Non-cancerous, uniform in shape and size, non-invasive.
- Malignant Neoplasm: Cancerous, invasive, harder to remove.
- Metastasis: Spread of cancer from original site.
Chemotherapy and Antineoplastic Agents
- Antineoplastic Agents/Chemotherapy: Drugs used to treat cancer.
- Cell Cycle Specific (CCS): Cytotoxic during specific cellular growth phases.
- Cell Cycle Non-Specific (CCNS): Cytotoxic in any phase of cellular growth.
- Nadir: Lowest point in fluctuating values, e.g., lowest WBC and platelet count after chemo.
Antimetabolites
- Role: Act as false substitute for folic acid, inhibit DNA/RNA synthesis.
- Methotrexate: Folate antagonist, decreases toxic effects with leucovorin.
- Uses: Solid tumors, hematologic cancers, autoimmune diseases.
Mitotic Inhibitors
- Role in Cancer Treatment: Activity before/during mitosis, decreases cell division.
- Paclitaxel: Prototype for mitotic inhibitors (CCS).
Topoisomerase Inhibitors
- Role: Binds DNA, impairs relegation, used for ovarian/colorectal cancers.
- Topotecan: Prototype.
Alkylating Agents
- Role in Cancer Treatment: Attach alkyl group to DNA, prevent replication.
- Cisplatin: Prototype, nephrotoxic, requires renal function monitoring.
Cytotoxic Antibiotics
- Role in Cancer Treatment: Insert between DNA strands, blocks synthesis.
- Doxorubicin: Prototype, cardiotoxic, requires ejection fraction monitoring.
Side Effects and Management
- Typical Side Effects: Nausea, vomiting, hair loss, fatigue, renal damage, bone marrow suppression.
- Management:
- Allergic Response: Diphenhydramine (Benadryl).
- Inflammatory Response: Dexamethasone.
- Nausea/Vomiting: Ondansetron (Zofran).
- Renal Damage: Hydration, monitor labs, adjust drug dosage.
- Bone Marrow Suppression: Limit exposure, avoid fresh produce, rest.
Diagnostic Studies
- Diagnosis: Blood work, biopsy, clinical manifestations.
- Staging (TNM): Tumor extent (T), lymph nodes spread (N), metastasis presence (M).
- CBC: Monitor WBCs, platelets.
- Tumor Markers: CEA, higher in people with cancer.
- Imaging: CT scans, PET scans (radioactive tracers to reveal cancer cells).
Patient Education
- Disease Process: Understanding diagnosis and treatment plan.
- Drug Action and Side Effects: Education on medication effects and management strategies.
- Avoiding Infections: Monitoring nadir, managing bone marrow suppression.
- Special Considerations:
- Post-chemotherapy contact precautions, especially for pregnant individuals and children.
- Radioactive implants require no contact for two months.
Note: Reach out for clarification if needed.