Blood/Treatment of Cancer

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Objectives

Basic principles

  • The student should be able to state the reasons why tissue diagnosis and staging is so important for a patient presenting with a presumed cancer.
  • Presented with a patient with cancer the student should be able to define the goals of the following types of treatment: curative, adjuvant and palliative. Additionally the student should be able to identify what treatment modalities could be used for each goal of treatment.

Principles of chemotherapy

  • Students should be able to describe in general terms the mechanisms of action of chemotherapy agents.
  • Students should be able to list and describe the common side effects seen with chemotherapy - both acute, sub acute and long term.
  • Students should be able to describe the benefits of combination vs. single agent chemotherapy. They should also be able to describe potential routes of administration and scheduling.

Principles of radiation treatment

  • Students should be able to describe the effect of radiation on both normal and malignant cells.
  • Students should be able to describe how radiation is given and explain to patient what is the purpose of and process in planning radiation. The should also be able to explain to a patient why radiation is given in fractions over a prolonged period of time.

Oncologic surgery

  • Students should be able to define the principles of oncologic surgery. They should be familiar with the potential risks and benefits of this type of

The cancer delivery system in Ontario

  • Students should be able to describe the role of the regional cancer centre in cancer care delivery.
  • Students should be able to able to access supportive care (palliative care psychosocial services, nutrition, etc.) facilities for their patients.

Exam

  • Mechanism of action of radiation
    1. Direct action on DNA in malignant cell
    2. Indirect action - formation of OH radicals which then interact with DNA (>23 .....
  • Four Rs of radiation biology are why treatments are fractionated:
    1. Repair - Fractionation of radiation allows the normal cells repair the the sublethal damage incurred from radiation while the malignant cell, being deranged in function, are unable to do this.
    2. Reoxygenation - Tumour cell that are well oxygenated are more effectively killed by a given dose of radiation than hypoxic cells. Fractionation allows the hypoxic cells to reoxygenate and improves the cellkill.
    3. Repopulation - Normal cells resting in the G0 phase are recruited into the cell cycle during radiotherapy and this helps healing of the acute radiation side effects.
    4. Redistribution - Fractionation allows redistribution of the tumour cells into the more radiosensitive phases of the cellcycle ieG2 and M phases and improves the cell kill.


Notes