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34 Cards in this Set
- Front
- Back
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Breast Cancer Staging
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■ Stage I - 100%
○ tumors < 2 cm and negative nodes ■ Stage II - 86% ○ tumors < 2 cm and one to three nodes ○ tumors 2-5 cm and 0 to 3 nodes ○ tumors > 5 cm and 0 nodes ■ Stage III - 57% ○ tumors > 5 cm and 1-3 nodes tumors that extend into chest wall |
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Breast Cancer Tx - Adjuvent endocrine - 5 yrs
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○ Tamoxifen premenopausal women with early-stage
aromatase inhibitors + bisphosphanates- postmenopausal women tamoxifen contraindicated - ovarian ablation |
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Breast Cancer Surgical Tx
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■ DCIS
○ lumpectomy plus radiation therapy) or mastectomy ○ Lymph node evaluation is not typically not done ○ tamoxifen for 5 years ■ Invasive Breast Cancer ○ mastectomy and sentinel lymph node evaluation; or lumpectomy and sentinel lymph node evaluation followed by whole-breast radiation therapy (less suitable for tumor>5cm) ○ Staging with a CT scan and bone scan ○ Postmastectomy radiation if positive surgical margins despite mastectomy, inflammatory breast cancer ,large tumors (>5 cm), or any positive axillary lymph nodes |
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Breast CA Adjuvant chemotherapy
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○ if size > 1 cm or +ve nodes
- 3 to 6 months of treatment with two or three agents, administered concurrently or sequentially. |
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laryngal CA tx
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T1a- T2 - radiation
T3 - induction chemo folllowed by radiation T4 - total laryngectomy |
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Cervical Cancer - 3 levels |
Treatment ( 3 levels) I and IIA Radiation therapy or surgery with radical hysterectomy observation if not candidate for surgery IIB, III, and IVA Radiation therapy and concurrent chemotherapy usually cisplatin IVB Palliative chemo and radiation for local symptoms |
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Cervical cancer stages |
stage IA (limited to microscopic lesions) stage IIA (presence of macroscopic disease, nonbulky) Stage IIB (bulky, cancer extends beyond the uterus but does not invade the pelvic side wall or lower third of the vagina) stage III Extension to the side wall or lower vagina or the presence of urethral obstruction |
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Colon Cancer staging |
I. does not invade full thickness
II. invades fullthickness and may invade pericolonic fat III. one or mare lymph nodes IV. Metastatic |
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Colon Cancer tx |
-Stage I or II - surgical resection -NO benefit of adjuvant chemo in stage II unless high risk features -Stage III - surgery + adjuvant FOLFOL or CAPOX for 6 months - Stage IV - modified 5FU regimen, can use FOLFOX or FOLFIRI check Kras and Nras, can add bevacizumab Usually dont radiate in Colon CA postop surveillance - CEA q3-6mo, pan CT q1y for 3-5 yr, c-scope at 1yr then q3-5 yr |
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Rectal CA Rx |
-Stage I (T1-T2) N0 - surgery, no chemo or rad -Locally advanced T3-4 add neoadjuvant -Stage II or III - preop radiation and neoadjuvant chemo and adjuvant chemo |
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Anal CA rx |
squamous cell CA no surgery Radiation with concurrent 5 fu + mitomycin |
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gastroesophogeal CA tx |
Stages I-III - surgery + neoadjuvant +- adjuvant chemo stage IV - palliative - cisplatin based 20-30 % HER 2 + - traztuzamab |
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Neuroendocrine tumors Rx |
1. if tumor is hormonally symptomatic and has shown to have somatostatin receptors can use ocreotide 2. hepatic arterial embolization, radiofrequency ablation, or surgical debulking, may be used to reduce symptomatic tumor bulk 3. indolent tumors - expectant observation and serial imaging using triple-phase contrast-enhanced CT scanning or MRI with gadolinium. |
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GIST dx and tx |
c-kit, cd117 surgery of localized imatinib |
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BRCA1/2 testing (3 scenarios) |
1. patients diagnosed with breast cancer before age 45 years 2. patients with breast cancer at any age and a family history of breast and/or ovarian cancer 3. patients with triple-negative breast cancers diagnosed before age 60 years. |
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atypical ductal hyperplasia tx |
should be offered breast cancer chemoprophylaxis; exemestane is associated with the greatest reduction in breast cancer risk. Can also use tamoxifen or reloxifen |
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mantle radiation breast CA screening |
Women who received chest wall radiationbetween the ages of 10 and 30 years are at high risk for developing breast cancer and should be screened with annual mammograms and breast MRIs. The risk starts 10 years after radiation exposure and peaks 25 to 34 years |
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small cell paraneoplastic syndromes |
SIADH Cushing Lambert Eaton |
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CIN I CINII CIN III txs |
CIN I: observation vs cryotherapy CIN II: ablation or excision CIN III: ablation or escision after must follow w/ frequent paps, q3-4 ms |
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Ovarian CA staging |
Stage I - confined to ovary Stage II - extension to adjacent structures in pelvis Stage III - peritoneal spread Stage IV - mets outside abdomen |
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ovarian CA tx |
Stage I - surgery Later stage- surgery + chemo |
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testicular CA tumor markers |
seminomas never produce aFP, may have Bhcg nonseminomas can produce aFP, bHCG, and LDH |
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Testical CA late sequelae of therapy |
infertility and sexual dysfunction second primary germ cell tumor secondary AML Secondary GI malignancies metabolic syndrome kidney disease peripheral neuropathy |
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Lung CA staging |
I. 3-5 cm with no nodes (70-80% cure) II. > 5 cm with no nodes or 3-5 with nodes (50% cure) III. nodes in mediastinum or contralateral xrt 1 yr - 30%, 2 yr 15%, 3 yr 5% xrt + chemo 1 yr 60%, 2 yr 30%, 3 yr 15% IV. METS |
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Lung CA tx (3 levels) |
stage I or II - resection + adjuvant Stage III - chemo + radiation stage IV - palliative chemo +/- EGFR |
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Central Lung CA tumors |
squamous small cell |
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peripheral tumors |
adenocarcinoma and large cell |
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lung CA that cavitates |
squamous cell |
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postpolypectomy surveillance |
A. 1-2 < 10 mm tubular adenomas - 5-10 years B. 3-10 adenomas, > 10mm, villous histology or high grade dysplasia - 3 years c. > 10 adenomas - < 3 yrs, search for genetic cause D. a few hyperplastic distal polyps - 10 yrs |
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BRCA1/2 carrier bilateral oopharectamy age |
35-45 after childbearing complete |
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SCLC staging and tx |
limited stage - one lesion with ipsilateral nodes that can fit in one radiation field tx. radiation + chemo extensive stage tx. palliative chemo, add chest and brain irradiation if show goo response from chemo |
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leukoreduction |
-Reduces number of leukocytes - Reduces HLA antibody production - Use for -Reduce CMV - Febrile nonhemolytic transfusion reactions |
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Irradiation |
- Destroys lymphocytes - Used to Prevent GVHD -Use for -T cell immunodeficiency - hodgekins - stem cell transplant pts - pts on purine analog chemo |
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Washing |
-Removesproteins in the small amt of plasmaname - Used in Pts with a hx of severe allergic reactions IgA deficiency Complenment dependendent autoimmune hemolytic anemia |
