Cam Onco

Front 1

2 essential questions to addressed to determine appropriate therapy for oncology patients

Back 1

1. What is it?
2. Has it spread?

Front 2

Fine needle aspirate

Back 2

almost always before biopsy
give idea of type of lesion (infection, inflam, tumor)
may provide specific ddx (fungal infection, mast cell tumor)
minimally invasive and rapid result

Front 3

Fine needle aspirate of regional lymph node

Back 3

Important part of staging (see if tumor has spread) and determine treatment decisions (if spread, surgery along not curative)

Front 4

Q to ask when looking at cytology

Back 4

1. Cellularity (cells or just blood)
2. inflam or non- inflam (neutrophils?)
3. Did i hit the site I intend to sample
4. if non- inflam, cells round, mesenchymal or epithelial?
5. If mesehcymal or epi, criteria of malignancy can be assesed (by clinial pathologist)

Front 5

Biopsy

Back 5

most impt ddx test for animal with tumor
histological evaluation
gold standard for ddx of most tumor types

Front 6

tumor grade vs. stage

Back 6

grade= histological description (cell morphology, architecture, local invasion, mitotic rate etc.), often linked to prognosis
Stage= how far it has spread (Stage= spread)

Front 7

Incisional biopsy vs. excisional biopsy

Back 7

incisional= small sample of tumor is taken
excisional- entire tumor is removed

Front 8

plan biopsy site

Back 8

1. ensure adequate sample is obtained
2. be sure biopsy tract will be removed at time of definitive surgery (to remove tumor cells seeded)

Front 9

staging

Back 9

describe systemic extent of disease
impt prognotic factor, and dictate most appropriate tx
even if appeared to be localized, consider bio behavior of tumor when deciding on chemotherapy(e.g. osteosarcoma)

Front 10

Staging test

Back 10

minimnum database (CBC, chem, UA)
rads, ultrasoundm fine needle aspirate, bone marrow aspirate

Actual test run depend on tumor type and site of metastasis

Front 11

Local treatment option

Back 11

surgery
radiation therapy
local chemotherapy

Front 12

Surgery

Back 12

potential for cure for localized dz or part of combination therapy
impt to know if using surgery as debulking agent to increase efficacy of chemo or RT, or if it has chance to cure patient

Front 13

Recurring theme for surgical oncology

Back 13

First surgery has best chance to cure
Surgical margin need to be WIDE
Need AGGRESSIVE approach, Should not be peeled out if cure is expected

Front 14

Radiation Therapy

Back 14

potential for cure for localized tumor
may be combined with surgery for aggressive local therapy, or combined with chemo to address local and distant dz

Front 15

How RT work

Back 15

divided into external beam(commonly used) or brachytherapy (radioactive implant, not commonly used)
works by sterilizing cells and keeping them from successful mitosis. Large tumor may not shrink immediately but live out their natural life span. They will be unable to divide and die resulting in shrinkage eventually

Front 16

Usage of RT

Back 16

works well for localized round cell tumor (lymphoma, mast cell tumor) and in microscopic residual epithelial and mesenchymal neoplasms

Front 17

curative vs. palliative intent for RT

Back 17

Curative intent- small daily fraction over 3-4 weeks
Palliative (relieve without curing) intent- large fraction once a week for 3-6 weeks

Front 18

Side effect or RT (acute vs. chronic)

Back 18

acute: in tissue within RT field that are growing and rapidly dividing, mostly cutaneous and resolve with minimal nursing care, not dose limiting
Chronic: tissue to tissue within RT field that are slow renewing (bone, CNS, vasculature) e.g. bone sequestram retinal lesion, cataracts and CNS signs, DOSE LIMITING

Front 19

Photodynamic therapy and Cryotherapy

Back 19

not commonly use, photodynamic therapy use light and oxygen free radicals to damage cancer cell and vessles feeding it and cryo use cold temp to induce cell death

Front 20

Chemotherapy indications

Back 20

indicated for systemic or metastatic dz
also used to sensitize tissue for radiation therapy
majority of vet patients enjoy quality of life while on chemo

Front 21

Immunotherapy

Back 21

2 main route:
1. nonspecific immune stimulant e.g. bacillus Calmette-Guerin (bCG), acemannan and L-MTP-PE
2. specific immun- stimulant e.g. MoAb 231, Avastin

Front 22

Nonspecific immune- stimulation

Back 22

nonspecifically stimulate the host immune system
increase T cell number and proliferative response as well as chemotatic and phagocytic activites of nutrophils, monocye and macrophage
Patient with implanted infection live twice as long

Front 23

Specific immune- stimulation

Back 23

ideally use tumor specific Ag as target for immunotherapy, unfortunately, no completely tumor specific Ag has been identified , so monoclonal Ab (MoAb)overexpressed on tumor tissue is used
once bound, Fc portion of MoAb recognized by Fc receptor cell of effector cell nd effector cell lyse tumor target

Front 24

Small molecule inhibitor

Back 24

creation of small molecule to block a step critical to cancer cells
Tyrosine kinase receptor antagonist
Palladia- FDA approved for canine mast cell tumor

Front 25

liposome encapsulation

Back 25

drug delivery system that makes a lipophilic outer coating for substances so they can more easily enter cells and maybe CNS? Cause all very lipophilic
liposomes are self assembling colloidal particles in which a phosholipid bilayer encapsulate an aqueous medium
conventional liposome get engulfed and then activated
nonreactive liposome- avoid uptake and increase half life of drug

Front 26

Gene therapy

Back 26

introduction of genetic material into an organism to cause therapeutic response
not been proven to be highly effective

Front 27

Retinoids

Back 27

Use of vit A and its natural sythetic derivatives to affect biological functions. (cell proliferation, differenitaion and mophogenesis)
remission have been attained but short lived

Front 28

KNOW THESE

Back 28

1. Describe the 2 main questions that should be answered before addressing therapy in an (what is it and has it spread)oncology patient and be able to explain why these questions need to be answered.
2. Know the difference between tumor grade and tumor stage.
3. Compare and contrast cytology vs. histopathology.
4. Be able to describe the principles of surgical oncology.
5. Know what tissues are affected by acute and chronic side effects of radiation therapy.
6. Know the difference between specific and non-specific immunotherapy and be able to give examples of each.

Front 29

omas

Back 29

carcinoma= epithelial cell (lining) that is malignant.
Lymphoma always malignant (some exceptios)
Sarcoma= structural maglinant