principles of cancer therapy
Chapter 081. Principles of Cancer Treatment (Part 1) docx
... benefit Cancer treatments are divided into four main types: surgery, radiation therapy (including photodynamic therapy) , chemotherapy (including hormonal therapy and molecularly targeted therapy) , ... biologic therapy (including immunotherapy and gene therapy) The modalities are often used in combination, and agents in one category can act by several mechanisms For example, cancer chemotherapy ... antibodies (a form of immunotherapy) can be used to deliver radiation therapy Surgery and radiation therapy are considered local treatments, though their effects can influence the behavior of tumor at...
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Chapter 081. Principles of Cancer Treatment (Part 2) ppsx
... rate Principles of Cancer Surgery Surgery is used in cancer prevention, diagnosis, staging, treatment (for both localized and metastatic disease), palliation, and rehabilitation Prophylaxis Cancer ... 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 ... incisional biopsy is the procedure of second choice A wedge of tissue is removed, and an effort is made to include the majority of the cross-sectional diameter of the tumor in the biopsy to minimize...
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Chapter 081. Principles of Cancer Treatment (Part 3) pps
... nature of primary cancer treatment Treatment Surgery is the most effective means of treating cancer Today about 40% of cancer patients are cured by surgery Unfortunately, a large fraction of patients ... growth If 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 ... 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
... Radiation therapy uses radiation to treat cancer Radiation is a physical form of treatment that damages any tissue in its path; its selectivity for cancer cells may be due to defects in a cancer ... therapy Plastic and reconstructive surgery can correct the effects of disfiguring primary treatment Principles of Radiation Therapy Physical Properties and Biologic Effects Exposure to ionizing ... a cancer patient to full health Orthopedic procedures may be necessary to assure proper ambulation Breast reconstruction can make an enormous impact on the patient's perception of successful therapy...
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Chapter 081. Principles of Cancer Treatment (Part 5) ppt
... tumor tissues; and (3) systemic therapy, with radionuclides targeted in some fashion to a site of tumor Teletherapy is the most commonly used form of radiation therapy Radiation from any source ... in three ways: (1) teletherapy, with beams of radiation generated at a distance and aimed at the tumor within the patient; (2) brachytherapy, with encapsulated sources of radiation implanted ... the basis of the amount of radiation absorbed in the patient; it is not based on the amount of radiation generated by the machine The rad (radiation absorbed dose) is defined as 100 erg of energy...
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Chapter 081. Principles of Cancer Treatment (Part 6) ppsx
... 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 settings: relief of bone ... the delivery of higher doses of radiation to the target volume without increasing complications in the transit volume Radiation therapy is a component of curative therapy for a number of diseases, ... no increased risk of breast cancer No data suggest that a threshold dose of therapeutic radiation exists below which the incidence of second cancers is decreased High rates of second tumors occur...
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Chapter 081. Principles of Cancer Treatment (Part 7) docx
... 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 derived ... evidence for the activity of the agent in assessing its value to the patient If cure is not possible, chemotherapy may be undertaken with the goal of palliating some aspect of the tumor's effect ... pathways that lead to uncontrolled proliferation through the action of, e.g., oncogene products, loss of cell cycle inhibitors, or loss of cell death regulation, and have acquired the capacity to replicate...
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Chapter 081. Principles of Cancer Treatment (Part 8) ppt
... C Cancers possibly cured with chemotherapy as adjuvant to surgery Breast carcinoma Colorectal carcinomaa Osteogenic sarcoma Soft tissue sarcoma D Cancers possibly cured with "high-dose" chemotherapy ... potential in defined 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) ... 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...
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Chapter 081. Principles of Cancer Treatment (Part 9) pdf
... 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 ... during the ontogeny of the organism Anoikis refers to the death of epithelial cells after removal from the normal milieu of substrate, particularly from cell-to-cell contact Cancer chemotherapeutic ... 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...
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Chapter 081. Principles of Cancer Treatment (Part 10) pdf
... better outcome after chemotherapy for ovarian carcinoma) A better understanding of the relationship of cell death and cell survival mechanisms is needed Resistance to chemotherapy drugs has been ... with 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 ... important in regulating cellular proliferation and the behavior of tumor cells in vitro, in vivo it is unclear whether all of the actions of chemotherapeutic agents to cause cell death can be attributed...
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Chapter 081. Principles of Cancer Treatment (Part 11) potx
... 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 ... Carboplatin 365 mg/m2 Marrow platelets IV > WBCs q3–4 weeks Reduce dose according to CrCl: to AUC of 5–7 mg/mL Nausea as adjusted Renal (high dose) dose/(CrCl + 25)] for CrCl Oxaliplatin 130 mg/m2 ... Mucositis Vesicant Alopecia Mitomycin C 6–10 mg/m2 Marrow q6 Treat superficial bladder Vesicant weeks cancers Hemolytic- by intravesical infusion uremic syndrome Delayed Lung marrow toxicity CV—heart...
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Chapter 081. Principles of Cancer Treatment (Part 12) ppsx
... 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 ... 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 ... body surface area or the presence of nephrectomy Several alkylating agents are less commonly used Nitrogen mustard (mechlorethamine) is the prototypic agent of this class, decomposing rapidly...
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Chapter 081. Principles of Cancer Treatment (Part 13) docx
... incidence of anaphylaxis with early preparations of the drug has led to the practice of administering a test dose of 0.5– unit before the rest of the dose The most feared complication of bleomycin ... 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 replication fork, topoisomerase I poisons ... cardiotoxicity in the form of atrial and ventricular dysrhythmias, but these are rarely of clinical significance In contrast, cumulative doses >550 mg/m are associated with a 10% incidence of chronic cardiomyopathy...
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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 ... 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 ... breakpoints of the translocation appeared to be at topoisomerase II sites that would be preferred sites of mitoxantrone action, clearly linking the action of the drug to the generation of the leukemia...
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Chapter 081. Principles of Cancer Treatment (Part 15) ppsx
... motile and secretory processes occur Microtubules are composed of repeating noncovalent multimers of a heterodimer of α and subunits of the protein tubulin Vincristine binds to the tubulin dimer ... clotting function abnormalities Close monitoring of clotting functions should accompany use of asparaginase Paradoxically, owing to depletion of rapidly turning over anticoagulant factors, thromboses ... refractory cancers Intravenous administration of 5FU leads to bone marrow suppression after short infusions but to stomatitis after prolonged infusions Leucovorin augments the activity of 5FU by...
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Chapter 081. Principles of Cancer Treatment (Part 16) pot
... approximately the same degree of activity in primary hormonal treatment of breast cancers that have elevated expression of estrogen receptor protein Estrogen is not used often owing to prominent cardiovascular ... levels of expression Side effects include a somewhat increased risk of estrogen-related cardiovascular complications, such as thromboembolic phenomena, and a small increased incidence of endometrial ... much more rarely, varying degrees of heart block These have not emerged as clinically significant in the majority of patients Docetaxel causes comparable degrees of myelosuppression and neuropathy...
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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 ... stimulation of the LHRH receptor, with the loss of its normal pulsatile activation resulting in decreased output of LH by the anterior pituitary Therefore, as primary hormonal manipulation in prostate cancer, ...
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Chapter 081. Principles of Cancer Treatment (Part 18) pps
... Imatinib is 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 ... is an inhibitor of the proteasome, the multi-subunit assembly of protease activities responsible for the selective degradation of proteins important in regulating activation of transcription ... may persist after discontinuation of the drug The quality of response to imatinib enters into the decision about when to refer patients with CML for consideration of transplant approaches Nilotinib...
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Chapter 081. Principles of Cancer Treatment (Part 19) pptx
... Complications of Cancer Chemotherapy Myelosuppression The common cytotoxic chemotherapeutic agents almost invariably affect bone marrow function Titration of this effect determines the MTD of the agent ... risk of death is markedly increased Management of febrile neutropenia has conventionally included empirical coverage with antibiotics for the duration of neutropenia (Chap 82) Selection of antibiotics ... cytotoxic agents The nadir count of each cell type in response to classes of agents is characteristic Maximal neutropenia occurs 6–14 days after conventional doses of anthracyclines, antifolates,...
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Chapter 081. Principles of Cancer Treatment (Part 20) doc
... fever) delays therapy Therapeutic 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 ... day subcutaneously Peg-filgrastim: one dose of mg 24 h after chemotherapy When Should Therapy Begin and End? When indicated, start 24–72 h after chemotherapy Continue until absolute neutrophil ... use The American Society of Clinical Oncology has developed practice guidelines for the use of G-CSF and GM-CSF (Table 81-3) Table 81-3 Indications for the Clinical Use of G-CSF or GM-CSF Preventive...
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