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13 Cards in this Set

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Cancer Toxicities

classifications
acute or subacute
most common examples:
- rapidly dividing cells
- mucous membranes
- hair, skin, GI tract, bone marrow

Chronic and/or cumulative
- delayed
- nephrotoxicity
- neurotoxicity
- cardiomyopathy
- pulmonary fibrosis
- secondary malignancies
Cancer

prevention and treatment of
chemothearpy-induced n/v (CINV)

drugs for highly to moderate CINV
5-HT3 R antagonists
- these drugs at a minimum for the prevention of acute CINV

also consider (Aprepitant)
Cancer

prevention and treatment of
chemothearpy-induced n/v (CINV)

low-risk to unlikely emetogenic regimens
dexamethasone

a phenothiazine
Cancer

prevention and treatment of
chemothearpy-induced n/v (CINV)

delayed CINV
> 24 h after admin of chemotx

metocloproamide and dexamethasone are recommended at a minimum
what should all pts receiving potentially emetogenic regimens receive wrt CINV?
1. prophylactic tx for CINV

2. resuce meds for CINV
Cancer

goals of tx

localized or regional dz
localized or regional dz
- ie stages I, II, and early III
- curative
- inhibition of recurrence of dz
Cancer

goals of tx

advanced or metastiasized dz
- ie advanced stage III and stage IV
- palliate sx
- reduce tunor load
- prolong survival
- increase qol
Cancer

survival and repsonse definitions

cure, complete response, partial response, stable dz, progression
Cure: 5 yrs of cancer-free survival

CR: absence of all neoplastic dz for min
of 1 month

PR: >50% dec in tumor size or other
markers for min of 1 month

stable dz: no change or criteria for PR
not met

progression: >25% inc in tumor size or
new lesion
Cancer

cell cycle phases (5)
G0 = resting phase
- no cell division

G1 = postmitotic phase
- enzymes for DNA syn are made

S = DNA synthesis
- DNA separation and replication

G2 = premitotic phase
- specialized proteins and RNA made

M = mitosis
- actual cell division occurs
Cancer

drug tx principles
chemo has greatest effect on rapidly growing cells

agents can be phase-specific or phase-nonspecific
Cancer

treatment priciples

neoadjuvant therapy
tx given prior to primary tx

goal is to shrink the tumor to increase the efficacy of the primary treatment

examples - chemo or radiation
Cancer

treatment principles

adjuvant tx
additional tx given after main treatment

goal is to make sure all residual dz is gone
Cancer

four main treatments
surgery

radiation

chemo

biologic tx