Types of Cancer and Clinical Trials

Types of Cancer

• Carcinoma: Cancer originating from epithelial tissue.
• Sarcoma: Malignant tumor derived from mesodermal tissue.
• Lymphoma: Cancer affecting the lymph system's nodes or glands.
• Leukemia: Cancer of the bone marrow, impeding normal blood cell production.
• Myeloma: Cancer affecting plasma cells in bone; known as multiple myeloma when widespread.

Tumor Differentiation

• Well-differentiated (low grade): Tumor cells closely resemble normal cells, usually growing more slowly.
• Undifferentiated (high grade): Cancer cells appear abnormal, linked with poorer prognosis.

Clinical Trial Phases

• Phase 1: Focuses on patient safety, toxicity evaluation, establishing maximum tolerated dose, and administration schedule.
• Phase 2: Gathers preliminary effectiveness data and studies short-term adverse reactions, comparing new treatment with standard options.
• Phase 3: Comprehensive evaluation of overall benefit versus risk; determines if the new treatment outperforms existing standards with large randomized samples.
• Phase 4: Conducted post-FDA approval; aims to refine treatment protocols and assess long-term effects.

Immunology

• Lymphocytes: White blood cells that produce antibodies; include B cells (form in bone marrow) and T cells (mature in the thymus).
• Phagocytes: Cells that ingest and destroy foreign substances.
• Basophils: Cells that trigger allergic reactions at injury sites.
• Cytokines: Molecules promoting white blood cell maturity and immune responses.
• Interferons: Released early during viral invasion to combat infection.
• Interleukins: Produced by T cells, playing roles in immune responses.

Bone Marrow Transplants

• Allogenic: Bone marrow transplant from a compatible donor.
• Syngeneic: Donation from an identical twin.
• Autologous: Patient receives their own bone marrow.

Cancer Development

• Carcinogenesis: Process of normal cells transforming into cancer cells.
• Carcinomatosis: Widespread cancerous tumors throughout the body.

Cell Division

• Meiosis: Type of cell division producing gametes with half the parent's DNA.

Chemotherapy Agents

• Anti-metabolites: Block DNA synthesis by inhibiting necessary enzymes (e.g., cytarabine, 5-FU).
• Antitumor antibiotics: Disrupt DNA transcription and inhibit DNA/RNA synthesis (e.g., doxorubicin, bleomycin).
• Alkylating agents: Form bonds with nucleic acids to interfere with duplication and mitosis.
• Nitrosoureas: Similar action to alkylating agents, inhibiting both DNA and RNA synthesis.

Pain Management

• Nociceptive Pain: Pain linked to tissue damage; includes somatic (specific and local) and visceral (vague and dull) pain.
• Neuropathic Pain: Caused by nerve damage, often presenting as tingling or numbness.
• Opioids: Used for managing pain; some options like propoxyphene should be avoided in cancer treatment due to toxicity risks.
• Stimulants: (e.g., methylphenidate) counter sedation effects.
• Anticonvulsants: Treat neuropathic pain; may cause sedation and nausea (e.g., gabapentin).
• Antidepressants: Used for neuropathic pain; potential side effects include sedation and dry mouth (e.g., amitriptyline).
• Benzodiazepines: Manage anxiety and muscle spasms but may cause sedation and respiratory depression (e.g., lorazepam).

Blood Cell Disorders

• Neutropenia: Low neutrophil count (<1,000 cells/mm3), normal range is 2,500-6,000 cells/mm3.
• Meylosuppression: Reduced blood cell production due to compromised bone marrow.
• Pancytopenia: Deficiency in all types of blood cells.
• Thrombocytopenia: Low platelet count (<100,000); normal range is 150,000-350,000.

Effects of Steroids on Neutrophils

• Steroids impair neutrophil function, hindering their ability to detect and combat bacterial infections, weakening the immune response.