Cancer Treatments. Kumar&Clark's. Bachelor Medicine, Geneeskunde (RUG) - 2.1.3. Neoplasms
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Course
2.1.3. Neoplasms
Institution
Rijksuniversiteit Groningen (RuG)
Book
Kumar and Clark\'s Clinical Medicine
material covered in 3rd block of semester 2.1 (Neoplasms) for medicine RUG. The summary covers material from Kumar & Clark’s: ‘Clinical Medicine’, Power-points provided by the university and pdf "Oncology for General Practice". It summarises the main characteristics and mechanism of cancer tr...
Clinical Medicine Ch. 23, 24 - Acute Respiratory Diseases
Diseases of the heart and large blood vessels
Peptic Ulcer Treatment
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Rijksuniversiteit Groningen (RuG)
International Bachelor Medicine, Geneeskunde
2.1.3. Neoplasms
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OneNote 19/11/2019, 17)17
Cancer treatment
Saturday, November 9, 2019 12:38 PM
Chemotherapy
- Direct damage to DNA/RNA apoptosis or frank necrosis
- Cytotoxic drugs not cancer-specific narrow therapeutic-window
- Dose and schedule of chemo are limited by normal tissue tolerance (especially in high
proliferative tissues ex. Bone marrow, GI tract mucosa)
- Limit toxicity to normal tissues ← supplying growth factors like granulocyte-stimulating
factor (G-CSF) or infusing stem cell preparations (diminish bone marrow toxicity)
- Resistance though changes in membrane transport and DNA repair pathways →
intermittent combination chemotherapy
Side effects
• Extravasation of intravenous drugs: leakage can cause severe local tissue
necrosis. Treatment; steroids, antihistamines
• Nausea + vomiting: especially with platinum analogues
• Hair loss, skin + nails effects
• Fatigue: anemia, depression
• Bone marrow and immuno-suppression: transfusions (anemia, thrombocytopenia).
Prophylactic antimicrobials
• Mucositis: high sensitivity of mucosa to antimitotic agents. Pain oropharynx +
difficulty swallowing. Treatment; antiseptic and anti-candida mouthwash
• Cardiotoxicity: acute arrythmia during administration or HF due to cardiomyopathy
after chronic exposure
• Neurotoxicity
• Nephrotoxicity
• Sterility and premature menopause: gonadal damage, loss of ovarian estrogen
production
• Secondary malignancies: mutagenic potential. Acute leukemias!
Endocrine therapy
Estrogens → growth in breast and endometrial cancers
Androgens → growth in prostate cancer
1. Removal of growth factors by manipulation of hormonal environment (surgical
removal of hormone-producing organ)
2. Influence production of certain hormones
3. Competitive antagonists of hormones
Acute leukemias – allogenic hemopoietic stem cell transplantation HSCT
Tumor immunoglobulin from B-cell lymphomas (1) and melanoma antigens (2) vaccines
Chimeric antigen receptors (CARs) direct T to specific antigenic targets
1. Interferons
INF-α → advanced melanoma, renal cell carcinoma
Side effects: influenza-like symptoms
2. Interleukins
IL-2 activates T cell responses
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