Cancer Treatment & Risk Factors
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Questions and Answers

What is the approximate percentage of cancers that are potentially preventable?

  • 50%
  • 40% (correct)
  • 60%
  • 30%

    • What is the primary goal of the Language Matters campaign in the context of cancer treatment?

  • To provide financial support to cancer patients
  • To raise awareness about cancer risk factors
  • To use non-judgmental language when discussing cancer risk with patients (correct)
  • To promote vaccination against cancer-causing infections

    • What is the approximate lifetime risk of getting a cancer diagnosis for those born in 1961?

  • 1 in 5
  • 1 in 10
  • 1 in 3
  • 1 in 2 (correct)

    • What is the primary role of pharmacists in cancer treatment according to the text?

    <p>To identify those at risk and raise awareness about cancer prevention</p> Signup and view all the answers

    What is the approximate percentage of cancers caused by inherited or acquired genetic defects?

    <p>5%</p> Signup and view all the answers

    What is the primary reason for the increasing cost to the NHS in cancer treatment?

    <p>The development of new cancer drugs</p> Signup and view all the answers

    What is the primary goal of curative treatment?

    <p>To get rid of the cancer forever</p> Signup and view all the answers

    What is the primary focus of palliative care?

    <p>To relieve symptoms and improve quality of life</p> Signup and view all the answers

    What does the 'T' in the TNM staging system represent?

    <p>Tumour size from 1-4</p> Signup and view all the answers

    What is the primary mechanism of action for cytotoxics?

    <p>Interfering with DNA replication</p> Signup and view all the answers

    What is the main difference between adjuvant and neo-adjuvant therapy?

    <p>Adjuvant therapy is used after surgery, while neo-adjuvant therapy is used before surgery</p> Signup and view all the answers

    What is the purpose of hormone therapy in cancer treatment?

    <p>To block hormone production and 'starve' the tumour</p> Signup and view all the answers

    What is the term for the 'round' of treatment or chemotherapy?

    <p>Cycle</p> Signup and view all the answers

    What is the primary goal of concurrent treatment?

    <p>To improve survival rates</p> Signup and view all the answers

    What is the term for the removal of healthy tissue to reduce the risk of cancer?

    <p>Prophylactic surgery</p> Signup and view all the answers

    What is the purpose of the ECOG system in cancer treatment?

    <p>To assess the patient's performance status</p> Signup and view all the answers

    What is the primary mechanism of action of CISPLATIN?

    <p>Binding to DNA, interfering with mitosis</p> Signup and view all the answers

    What is the main function of the kinetochore microtubules during mitosis?

    <p>To attach to kinetochores and regulate chromosome movement</p> Signup and view all the answers

    Which of the following is NOT a side effect of VINCRISTINE?

    <p>Nephrotoxicity</p> Signup and view all the answers

    What is the primary mechanism of action of PALBOCICLIB?

    <p>Inhibition of CDK4/6</p> Signup and view all the answers

    What is the primary function of the Hedgehog pathway during embryonic development?

    <p>Regulation of cell signaling and growth</p> Signup and view all the answers

    What is the primary mechanism of action of DARATUMUMAB?

    <p>Binding to CD38 and provoking an immune response</p> Signup and view all the answers

    What is the primary mechanism of action of OLAPARIB?

    <p>Inhibition of PARP</p> Signup and view all the answers

    What is the primary function of the pharmacist in the traditional role?

    <p>Clinical check of prescription and checking blood results</p> Signup and view all the answers

    What is the primary function of the cyclin-dependent kinase (CDK) 4/6 inhibitor in cancer treatment?

    <p>Prevention of the passage of the checkpoint, preventing cell division</p> Signup and view all the answers

    What is the primary mechanism of action of VISMODEGIB?

    <p>Inhibition of the Hedgehog pathway</p> Signup and view all the answers

    What is the primary purpose of calculating a patient's Body Surface Area (BSA) in cancer treatment?

    <p>To determine the appropriate dosage of IV SACT</p> Signup and view all the answers

    What is the main reason for performing DPD testing in cancer treatment?

    <p>To determine the patient's suitability for 5-FU/capecitabine treatment</p> Signup and view all the answers

    What is the primary method of managing acute nausea and vomiting in cancer treatment?

    <p>All of the above</p> Signup and view all the answers

    What is the primary action to take if a patient on SACT develops possible toxicity?

    <p>Contact a 24-hour chemo helpline</p> Signup and view all the answers

    What is the primary reason for reducing the dose or changing the treatment regimen in cancer treatment?

    <p>To manage severe adverse effects</p> Signup and view all the answers

    What is the primary purpose of running clinics in the pharmacist's role in cancer treatment?

    <p>To run clinical trials</p> Signup and view all the answers

    What is the approximate number of new cancer cases reported in the UK every day?

    <p>1,000</p> Signup and view all the answers

    What percentage of cancers are potentially preventable?

    <p>40%</p> Signup and view all the answers

    What is an example of a modifiable risk factor for cancer?

    <p>Smoking</p> Signup and view all the answers

    What is the purpose of the Language Matters campaign in the context of cancer treatment?

    <p>To use appropriate language when communicating with patients</p> Signup and view all the answers

    What is an example of an inherited genetic defect that can increase the risk of cancer?

    <p>BRCA1/2</p> Signup and view all the answers

    What is the approximate percentage of people who will survive for 10+ years after a cancer diagnosis?

    <p>50%</p> Signup and view all the answers

    What is the main goal of palliative treatment?

    <p>To relieve symptoms and improve quality of life</p> Signup and view all the answers

    What does the 'M' in the TNM staging system represent?

    <p>Metastasis</p> Signup and view all the answers

    What is the purpose of neo-adjuvant therapy?

    <p>To shrink tumours before surgery</p> Signup and view all the answers

    What is the main mechanism of action of cytotoxics?

    <p>Interfering with DNA replication</p> Signup and view all the answers

    What is the purpose of hormone therapy?

    <p>To block hormone production</p> Signup and view all the answers

    What is the main purpose of the ECOG system?

    <p>To measure patient functioning</p> Signup and view all the answers

    What is the main difference between adjuvant and neo-adjuvant therapy?

    <p>Adjuvant therapy is used after surgery, while neo-adjuvant therapy is used before surgery</p> Signup and view all the answers

    What is the main goal of concurrent treatment?

    <p>To improve survival rates by combining two or more treatments</p> Signup and view all the answers

    What is a 'cycle' in the context of cancer treatment?

    <p>A round of treatment or chemotherapy</p> Signup and view all the answers

    What is the main goal of curative treatment?

    <p>To get rid of cancer forever</p> Signup and view all the answers

    What is the purpose of calculating a patient's Body Surface Area (BSA) in cancer treatment?

    <p>To determine the optimal dosage of SACT</p> Signup and view all the answers

    What is the primary action to take if a patient on SACT develops possible toxicity?

    <p>Contact the 24-hour chemo helpline or A&amp;E</p> Signup and view all the answers

    What is the primary goal of pharmacist-led clinics in cancer treatment?

    <p>To provide patient counselling and education</p> Signup and view all the answers

    What is the purpose of performing DPD testing in cancer treatment?

    <p>To identify patients at risk of 5-FU/capecitabine toxicity</p> Signup and view all the answers

    What is the primary mechanism of managing acute nausea and vomiting in cancer treatment?

    <p>Dexamethasone and 5-HT3 antagonists</p> Signup and view all the answers

    What is the primary reason for reducing the dose or changing the treatment regimen in cancer treatment?

    <p>To reduce the risk of toxicity</p> Signup and view all the answers

    What is the primary way that myosin 2 and actin filament rings contribute to the cell cycle?

    <p>Cleaving the cell in two</p> Signup and view all the answers

    Which stage of the cell cycle is characterized by the condensation of chromatin into chromosomes?

    <p>Prophase</p> Signup and view all the answers

    What is the primary mechanism by which PARP inhibitors, such as OLAPARIB, exert their therapeutic effect?

    <p>Preventing the repair of DNA damage</p> Signup and view all the answers

    What is the primary role of kinetochore microtubules during mitosis?

    <p>Invading the nuclear space and attaching to kinetochores</p> Signup and view all the answers

    What is the primary mechanism of action of VINCRISTINE?

    <p>Inhibiting the formation of microtubules</p> Signup and view all the answers

    What is the primary mechanism of action of CISPLATIN?

    <p>Binding to DNA and interfering with mitosis</p> Signup and view all the answers

    What is the primary role of the pharmacist in the traditional role?

    <p>Performing clinical checks on prescriptions</p> Signup and view all the answers

    What is the primary mechanism of action of VISMODEGIB?

    <p>Blocking the Hedgehog pathway</p> Signup and view all the answers

    What is the primary mechanism of action of DARATUMUMAB?

    <p>Provoking an immune response against cancer cells</p> Signup and view all the answers

    What is the primary mechanism of action of PALBOCICLIB?

    <p>Inhibiting the CDK4/6 pathway</p> Signup and view all the answers

    What percentage of people born in 1961 are likely to get a cancer diagnosis in their lifetime?

    <p>1 in 2</p> Signup and view all the answers

    Which of the following is a modifiable risk factor for cancer?

    <p>Smoking</p> Signup and view all the answers

    What is the approximate number of new cancer cases reported in the UK every day?

    <p>1000</p> Signup and view all the answers

    What is the main goal of the Language Matters campaign in the context of cancer treatment?

    <p>To promote empathy and understanding in communication with patients</p> Signup and view all the answers

    What percentage of cancers are potentially preventable?

    <p>40%</p> Signup and view all the answers

    What can pharmacists do to contribute to cancer treatment?

    <p>Identify those at risk and raise awareness</p> Signup and view all the answers

    What is the primary purpose of calculating a patient's Body Surface Area (BSA) in cancer treatment?

    <p>To determine the dosage of chemotherapy</p> Signup and view all the answers

    Why is echocardiography used in cancer treatment?

    <p>To monitor the patient's heart function</p> Signup and view all the answers

    What is the primary reason for performing genetic testing, such as DPD testing, in cancer treatment?

    <p>To determine the patient's risk of toxicity</p> Signup and view all the answers

    What is the primary goal of managing neutropenia in cancer treatment?

    <p>To reduce the risk of infection</p> Signup and view all the answers

    What is the primary action to take if a patient on SACT develops possible toxicity?

    <p>Call the 24-hour chemo helpline</p> Signup and view all the answers

    What is the primary role of pharmacists in cancer treatment, according to the text?

    <p>To provide patient counselling</p> Signup and view all the answers

    What is the primary goal of palliative treatment?

    <p>To relieve symptoms and improve quality of life</p> Signup and view all the answers

    What does the TNM staging system represent?

    <p>Tumour size, lymph node involvement, and metastasis</p> Signup and view all the answers

    What is the difference between adjuvant and neo-adjuvant therapy?

    <p>Adjuvant therapy is used after surgery, while neo-adjuvant therapy is used before surgery</p> Signup and view all the answers

    What is the primary mechanism of action of chemotherapy?

    <p>Interfering with DNA replication or cell division</p> Signup and view all the answers

    What is the purpose of hormone therapy in cancer treatment?

    <p>To block the action of hormones</p> Signup and view all the answers

    What is the term for the removal of healthy tissue to reduce the risk of cancer?

    <p>Prophylactic removal</p> Signup and view all the answers

    What is the primary goal of curative treatment?

    <p>To get rid of cancer forever</p> Signup and view all the answers

    What is the term for the 'round' of treatment or chemotherapy?

    <p>Cycle</p> Signup and view all the answers

    What is the purpose of the ECOG system in cancer treatment?

    <p>To guide treatment choices</p> Signup and view all the answers

    What is the primary mechanism of action of radiotherapy?

    <p>Direct effect on DNA, leading to cell death</p> Signup and view all the answers

    What happens to the nuclear membrane during the prophase of mitosis?

    <p>It breaks down</p> Signup and view all the answers

    What is the primary mechanism of action of CISPLATIN?

    <p>It binds to DNA and interferes with mitosis</p> Signup and view all the answers

    What is the role of kinetochore microtubules during mitosis?

    <p>They invade the nuclear space and attach to kinetochores</p> Signup and view all the answers

    What is the primary mechanism of action of VINCRISTINE?

    <p>It binds to tubulin and prevents microtubule formation</p> Signup and view all the answers

    What is the primary goal of targeted therapy?

    <p>To exploit differences in cancer cells</p> Signup and view all the answers

    What is the role of the pharmacist in the traditional role?

    <p>To screen prescriptions and check blood results</p> Signup and view all the answers

    What is the primary mechanism of action of OLAPARIB?

    <p>It prevents DNA repair</p> Signup and view all the answers

    What is the primary mechanism of action of DARATUMUMAB?

    <p>It binds to CD38 and provokes an immune response</p> Signup and view all the answers

    What is the primary goal of growth blockers?

    <p>To inhibit cell signalling and growth</p> Signup and view all the answers

    What is the primary mechanism of action of PALBOCICLIB?

    <p>It inhibits the cyclin-dependent kinase 4/6</p> Signup and view all the answers

    Study Notes

    Here are the study notes based on the provided text:

    Cancer Treatment

    • 1,000 new cancer cases are diagnosed in the UK every day
    • Almost 1 in 2 people have a lifetime risk of getting a cancer diagnosis (for those born in 1961)
    • ~50% of cancer patients will survive for 10+ years
    • ~40% of cancers are potentially preventable
    • Cancer treatment requires a multidisciplinary team (MDT) approach

    Risk Factors

    Non-Modifiable:

    • Age
    • Genetics
    • Infections

    Modifiable:

    • Smoking
    • Alcohol
    • Infection
    • Materials
    • Radiation
    • Obesity
    • Medication
    • Co-morbidities

    Genetics and Cancer

    • Inherited or acquired genetic defects can increase cancer risk
    • Examples: BRCA1/2 defects (breast/ovarian/prostate/pancreatic cancer), Lynch syndrome (mainly bowel cancer), TP53 (Li-Fraumeni syndrome) (various cancers)
    • These genetic defects are relatively rare compared to other cancers (~5%)

    Infections and Cancer

    • Chronic infections can increase cancer risk
    • Examples: HPV (leading cause of cervical cancer), EBV, Hepatitis B/C, HIV
    • Modifiable risk factors: vaccinations, public health campaigns, protected sex

    Pharmacist's Role

    • Identify those at risk
    • Opportunistic questioning
    • Use the right language - Language Matters campaign
    • Avoid attribution of fault
    • Not all modifiable risks will be under control of the patient
    • Raise awareness

    Treatment

    Surgery

    • Removal of tumour
    • 'Prophylactic' removal (e.g. breast reduction in high-risk patients)
    • Healthy vs tumour tissue sometimes hard to distinguish

    Radiotherapy

    • High energy external beam therapy
    • Internal radiation (e.g. brachytherapy)
    • Caution: risk to young people/pregnant women!

    Chemotherapy (SACT)

    • Systemic Anti-Cancer Therapy
    • Falls into three categories: Hormone therapy, Cytotoxics, Targeted therapy
    • Drug(s) prescribed will depend on various factors (e.g. cancer staging, tumour site, tumour pathology, previous treatment, patient factors)

    Naming Conventions

    • Combination regimens often have acronyms
    • Letters might relate to drug or original brand name
    • Examples: CX - Cisplatin and capecitabine (Xeloda), FOLFIRI - Folinic acid, fluorouracil, irinotecan

    Treatment Decisions

    Hormone Therapy

    • Used for hormone-sensitive tumours
    • Blocks hormones to 'starve' the tumour
    • Examples: Tamoxifen, Anastrozole, Clomifene
    • Not usually curative when used alone
    • Adjuvant or palliative treatment options

    Cytotoxics

    • Literally meaning toxic to cells
    • Variety of mechanisms → cell death
    • Typically involve interference with DNA replication or other aspect of cell division
    • Examples: Cisplatin, Vincristine

    Targeted Therapy

    • Treatments that exploit differences in cancer cells

    • Three main categories: Monoclonal antibodies, Growth blockers, Cell or endothelial growth, PARP inhibitors

    • Examples: Daratumumab, Vismodegib, Olaparib### Aims of Treatment

    • Curative treatment aims to eliminate cancer forever, with a chance of recurrence

    • Palliative treatment aims to relieve symptoms and improve quality of life, suitable for patients at any stage of illness

    Staging

    • Cancer staging systems: TNM (Tumor size, Node involvement, Metastases) and Number staging
    • Staging criteria relates to grades: T (Tumor size 1-4), N (Node involvement 0-3), M (Metastases 0-1)
    • Stage meanings:
      • I: Small size, contained
      • II: Larger, possibly some local spread
      • III: Larger, usually some spread and lymph node involvement
      • IV: Metastatic cancer, spread to other organs

    Treatment Timing

    • Adjuvant treatment: happens after another intervention, e.g., chemotherapy after tumor removal surgery
    • Neoadjuvant treatment: happens before another intervention, e.g., hormone therapy before prostate surgery
    • Concurrent treatment: two or more treatments happening at the same time

    Cycles

    • Each 'round' of treatment/chemotherapy is called a cycle
    • Cycles vary in length, treatment may be: a set number of cycles, continuous until a certain point, or different depending on the cycle number

    Performance Status

    • Measure of patient 'functioning', using various systems of scoring, e.g., ECOG system
    • Can guide treatment choices

    Treatments

    • Surgery: removal of tumor, 'prophylactic' removal, e.g., breast reduction in high-risk patients
    • Radiotherapy: high energy external beam therapy, internal radiation (e.g., brachytherapy), caution for young people and pregnant women
    • Chemotherapy (SACT): Systemic Anti-Cancer Therapy, normally falls into one of three categories: hormone therapy, cytotoxics, and targeted therapy

    Naming Conventions

    • Combination regimens often have acronyms, e.g., CX (Cisplatin and capecitabine), FOLFIRI (Folinic acid, fluorouracil, irinotecan), FEC-T (Fluorouracil, epirubicin, cyclophosphamide, docetaxel)

    Treatment Decisions

    • Hormone therapy: used for tumors that are hormone-sensitive, blocking hormones can 'starve' the tumor
    • Cytotoxics: literally meaning toxic to cells, aim to kill cancer cells more quickly than healthy cells
    • Targeted therapy: treatments that exploit differences in cancer cells, divided into three main categories: monoclonal antibodies, growth blockers, and cell or endothelial growth

    Examples of Treatments

    • Cisplatin: platinum-based, wide range of cancers, binds to DNA, interferes with mitosis, adverse effects: nephrotoxicity, highly emetogenic, ototoxicity, neurotoxicity
    • Vincristine: primarily used in hematological cancers, binds to tubulin, prevents formation of microtubules, leads to apoptosis, adverse effects: peripheral neuropathy, hair loss, sleep disorders, pancytopenia
    • Palbociclib: treatment of ER+ HER2-ve breast cancer, used in combination with letrozole/similar, CDK4/6 inhibitor, prevents passing of checkpoint, adverse effects: neutropenia, GI effects, fatigue

    Role of Pharmacists

    • Identifying those at risk, opportunistic questioning, using the right language, avoiding attribution of fault
    • Raising awareness, providing vaccination, cessation services, and medication review
    • Screening, clinical check of prescription, checking blood results, and ensuring it's safe to proceed
    • Running clinics, pharmacist prescribers, consultant posts, trial PIs, and ACP roles

    Screening SACT

    • Common set of information for all prescriptions, including height, CRCL, and imaging
    • Treatment/disease history, lifetime maximum dose of some agents, funding requirements, and genetic testing
    • Drug-specific blood tests, e.g., FBC, LFTs, U+Es, and possibly others

    Toxicity

    • Neutropenia, common side effect, can reduce dose or delay cycle, but effect on cancer, can boost WCC with ...
    • Nausea and vomiting, often abbreviated to CINV, individual drug risk varies, mainstay treatments: dexamethasone, 5-HT3 antagonists, metoclopramide, and aprepitant
    • Other common effects, e.g., fatigue, infections, hair loss, GI system problems, oral mucosa problems, and others

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    Description

    Learn about the importance of cancer treatment, its risk factors, and the latest developments in the field. Discover how modifiable and non-modifiable factors contribute to cancer diagnosis. Test your knowledge on this critical topic!

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