principles of cancer and cancer treatment
Chapter 081. Principles of Cancer Treatment (Part 1) docx
... benefit One of the challenges of cancer treatment is to use the various treatment modalities alone and together in a fashion that maximizes the chances for patient benefit Cancer treatments are ... treatment has the potential to cause harm, and treatment may be given that produces toxicity with no benefit The therapeutic index of many interventions is quite narrow, and most treatments ... radiotherapy-, and internal medicine–related areas of expertise Treatments for patients with hematologic malignancies are often shared by hematologists and medical oncologists In many ways, cancer mimics...
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Chapter 081. Principles of Cancer Treatment (Part 2) ppsx
... tumor and reduce its size can result in an increase in the growth fraction and an increase in growth rate Principles of Cancer Surgery Surgery is used in cancer prevention, diagnosis, staging, treatment ... a 20% risk of developing breast cancer over the next years as a threshold However, patient fears play a major role in defining candidates for cancer prevention surgery Counseling and education ... lightmicroscopic inspection of a tumor for pattern of growth, degree of cellular atypia, invasiveness, and morphologic features that aid in the differential diagnosis, sufficient tissue is of value in searching...
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Chapter 081. Principles of Cancer Treatment (Part 3) pps
... information for treatment planning and may determine the extent and nature of primary cancer treatment Treatment Surgery is the most effective means of treating cancer Today about 40% of cancer patients ... resection of the primary lesion takes place in the presence of metastases, acceleration of metastatic growth may occur, perhaps based on the removal of a source of angiogenesis inhibitors and mass-related ... a surgeon or center for primary cancer treatment, consideration must be given to the volume of cancer surgeries undertaken by the site Studies in a variety of cancers have shown that increased...
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Chapter 081. Principles of Cancer Treatment (Part 4) pdf
... patient's perception of successful therapy Plastic and reconstructive surgery can correct the effects of disfiguring primary treatment Principles of Radiation Therapy Physical Properties and Biologic ... sun and other cosmic sources, the ground, the air we breathe, the food we ingest, and from within our bodies Radiation therapy uses radiation to treat cancer Radiation is a physical form of treatment ... its path; its selectivity for cancer cells may be due to defects in a cancer cell's ability to repair sublethal DNA and other damage Radiation causes breaks in DNA and generates free radicals from...
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Chapter 081. Principles of Cancer Treatment (Part 5) ppt
... human form and substance Radiation dose has three determinants: total absorbed dose, number of fractions, and time A frequent error is to omit the number of fractions and the duration of treatment ... are generated from decay of atomic nuclei in radioisotopes such as cobalt and radium These waves behave biologically as packets of energy, called photons Particulate forms of radiation are also ... specialized uses, particulate forms of radiation such as neutrons, protons, and negative mesons, which should more tissue damage because of their higher linear energy transfer and be less dependent on oxygen,...
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Chapter 081. Principles of Cancer Treatment (Part 6) ppsx
... number of diseases, including breast cancer, Hodgkin's disease, head and neck cancer, prostate cancer, and gynecologic cancers Radiation therapy can also palliate disease symptoms in a variety of ... die Hematoporphyrins and light are being used with increasing frequency to treat skin cancer; ovarian cancer; and cancers of the lung, colon, rectum, and esophagus Palliation of recurrent locally ... relief of bone pain from metastatic disease, control of brain metastases, reversal of spinal cord compression and superior vena caval obstruction, shrinkage of painful masses, and opening of threatened...
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Chapter 081. Principles of Cancer Treatment (Part 7) docx
... in providing a basis for patients to make sensible choices Cancer Drugs: Overview and Principles for Use Cancer drug treatments are of four broad types Conventional chemotherapy agents were historically ... treated with palliative intent should be aware of their diagnosis and the limitations of the proposed treatments, have access to supportive care, and have suitable "performance status," according ... action of, e.g., oncogene products, loss of cell cycle inhibitors, or loss of cell death regulation, and have acquired the capacity to replicate chromosomes indefinitely, invade, metastasize, and...
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Chapter 081. Principles of Cancer Treatment (Part 8) ppt
... metastatic cancers If a tumor is localized to a single site, serious consideration of surgery or primary radiation therapy should be given, as these treatment modalities may be curative as local treatments ... Chemotherapy may be employed after the failure of these modalities to eradicate a local tumor or as part of multimodality approaches to offer primary treatment to a clinically localized tumor In ... clinical settings (Table 81-1, D) Table 81-1 Curability of Cancers with Chemotherapy A Advanced cancers with possible cure Acute lymphoid and acute myeloid leukemia (pediatric/adult) Hodgkin's...
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Chapter 081. Principles of Cancer Treatment (Part 9) pdf
... Modulation of apoptosis by manipulation of signal transduction pathways has emerged as a basis for understanding the actions of drugs and designing new strategies to improve their use A general view of ... least an increased time to further progression of disease Active efforts are being made to quantitate effects of anticancer agents on quality of life Cancer drug clinical trials conventionally use ... progresses Another potential outcome is to induce cancer cell differentiation or dormancy with loss of tumor cell replicative potential and reacquisition of phenotypic properties resembling normal cells...
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Chapter 081. Principles of Cancer Treatment (Part 10) pdf
... novel mechanisms of action, combinations of drugs and targeted agents may maximize the chances of affecting critical pathways in the tumor Chemotherapeutic Agents Used for Cancer Treatment Table ... 81-2 lists commonly used cancer chemotherapy agents and pertinent clinical aspects of their use The drugs and schedules listed are examples that have proved tolerable and useful; the specific ... efflux of chemotherapeutic agents in resistant cells Certain neoplasms, particularly hematopoietic tumors, have an adverse prognosis if they express high levels of p170PGP, and modulation of this...
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Chapter 081. Principles of Cancer Treatment (Part 11) potx
... qd cyclophosphamide x + of Bladder mesna More lipid Neurologic soluble Metabolic Greater acidosis activity vs testicular Neuropathy neoplasms and sarcomas Must use Liver and mesna Procarbazine ... mg/m2 IV Skin changes days and idine dehydrogenase deficiency increases toxicity Metabolizes in tissues Capecitabine 665 mg/m2 Diarrhea bid Prodrug 5FU due of to Hand-foot continuous; intratumoral ... syndrome 1250 mg/m metabolism bid weeks on/ off; 829 mg/m2 bid weeks on/ off + 60 mg/d leucovorin Cytosine arabinoside 100 mg/m2 Marrow per Enhances activity of alkylating Mucositis day qd x7 by continuous...
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Chapter 081. Principles of Cancer Treatment (Part 12) ppsx
... Busulfan can cause profound myelosuppression, alopecia, and pulmonary toxicity but is relatively "lymphocyte sparing." Its routine use in treatment of CML has been curtailed in favor of imatinib (Gleevec)or ... damage, cumulatively related to dose and time of exposure Procarbazine is metabolized in the liver and possibly in tumor cells to yield a variety of free radical and alkylating species In addition ... that covalently modify bases in DNA This leads to cross-linkage of DNA strands or the appearance of breaks in DNA as a result of repair efforts "Broken" or cross-linked DNA is intrinsically unable...
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Chapter 081. Principles of Cancer Treatment (Part 13) docx
... or G2 of the cell cycle in cells with p53 and Rb pathway lesions as the result of defective checkpoint mechanisms in cancer cells Owing to the role of topoisomerase I in the procession of the ... the presence of liver dysfunction Daunorubicin is closely related to doxorubicin and was actually introduced first into leukemia treatment, where it remains part of curative regimens and has been ... attenuated cardiac toxicity and antitumor activity in Kaposi's sarcoma and ovarian cancer Bleomycin refers to a mixture of glycopeptides that have the unique feature of forming complexes with Fe2+...
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Chapter 081. Principles of Cancer Treatment (Part 14) pps
... particularly in the adjuvant treatment of breast cancer While chemotherapy-associated leukemia is generally of the acute myeloid type, APL arising in the setting of prior mitoxantrone treatment had the ... identify active members of this series Topoisomerase I is responsible for unwinding the DNA strand by introducing single-strand breaks and allowing rotation of one strand about the other In S-phase, ... resealed lead to progress of the replication fork off the end of a DNA strand The DNA damage is a potent signal for induction of apoptosis Camptothecins promote the stabilization of the DNA linked to...
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Chapter 081. Principles of Cancer Treatment (Part 15) ppsx
... activity of 5FU by promoting formation of the ternary covalent complex of 5FU, the reduced folate, and TS Less frequent toxicities include CNS dysfunction, with prominent cerebellar signs, and endothelial ... multimers of a heterodimer of α and subunits of the protein tubulin Vincristine binds to the tubulin dimer with the result that microtubules are disaggregated This results in the block of growing ... have useful activity in a variety of solid tumors, with limited nonmyelosuppressive toxicities 6Thioguanine and 6-mercaptopurine (6MP) are used in the treatment of acute lymphoid leukemia Although...
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Chapter 081. Principles of Cancer Treatment (Part 16) pot
... medroxyprogesterone acetate, androgens including fluoxymesterone (Halotestin), and, paradoxically, estrogens—have approximately the same degree of activity in primary hormonal treatment of breast cancers that ... adjuvant treatment of breast cancer in postmenopausal patients with estrogen receptor–positive tumors Letrozole treatment affords benefit following tamoxifen treatment Adverse effects of aromatase ... expression of estrogen receptor protein Estrogen is not used often owing to prominent cardiovascular and uterotropic activity Aromatase refers to a family of enzymes that catalyze the formation of estrogen...
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Chapter 081. Principles of Cancer Treatment (Part 17) pdf
... understanding of cancer cell biology has suggested many new targets for cancer drug discovery and development These include the products of oncogenes and tumor-suppressor genes, regulators of cell ... for discovery of the candidate drug is the a priori importance of the target in the biology of the tumor, rather than the initial detection of drug candidates based on the phenomenon of tumor cell ... notable response rates to withdrawal of tamoxifen itself or to subsequent addition of an aromatase inhibitor or progestin Likewise, initial treatment of prostate cancers with leuprolide plus flutamide...
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Chapter 081. Principles of Cancer Treatment (Part 18) pps
... one stimulus for degradation of the inhibitory subunit of the NFκB transcription factor by the proteosome Bortezomib inhibits this process and can prevent activation of NFκB-dependent genes, among ... superior to interferon plus chemotherapy in the initial treatment of the chronic phase of this disorder It has lesser activity in the blast phase of CML, where the cells may have acquired additional ... the result of the chromosome 15,17 translocation pathogenic for most forms of APL Administered orally, it causes differentiation of the neoplastic promyelocytes to mature granulocytes and attenuates...
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Chapter 081. Principles of Cancer Treatment (Part 19) pptx
... function Titration of this effect determines the MTD of the agent on a given schedule The normal kinetics of blood cell turnover influence the sequence and sensitivity of each of the formed elements ... orifices by gentle palpation); chest x-ray; and Gram stain and culture of blood, urine, and sputum (if any) to define a putative site of infection In the absence of any originating site, a broadly acting ... inhibitor, has activity in renal and breast cancer It produces some hyperlipidemia (10%), myelosuppression (10%), and rare lung toxicity Acute Complications of Cancer Chemotherapy Myelosuppression...
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Chapter 081. Principles of Cancer Treatment (Part 20) doc
... and IL-11 are currently approved for use The American Society of Clinical Oncology has developed practice guidelines for the use of G-CSF and GM-CSF (Table 81-3) Table ... leukemia G-CSF of minor or no benefit GM-CSF of no benefit and may be harmful In myelodysplastic syndromes Not routinely beneficial Use intermittently in subset with neutropenia and recurrent ... Uses Afebrile neutropenic patients No evidence of benefit Febrile neutropenic patients No evidence of benefit May feel compelled to use in the face of clinical deterioration from sepsis, pneumonia,...
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