Comprehensive Oncology and Cancer Treatment: Definitions, Screening, and Therapies

What is adjuvant chemotherapy?

Chemotherapy given after surgery to eliminate residual disease and prevent recurrence.

What is neoadjuvant chemotherapy?

Chemotherapy given before surgery to shrink tumor size.

What is oncogene addiction?

Cancer cell survival depends heavily on one overactive oncogene, so inhibiting that target causes massive cell death.

What is the therapeutic window?

The range between minimum effective dose and maximum tolerated dose.

What is pharmacodynamics?

Effects of the drug on the body.

What is pharmacokinetics?

What the body does to the drug (absorb, distribute, metabolize, eliminate).

What does ADME stand for?

Absorption, Distribution, Metabolism, Elimination.

What screening methods are available for breast cancer?

Mammography.

What screening methods are available for colorectal cancer?

Faecal occult blood test (FOBT).

What screening methods are available for gastric cancer?

Endoscopy.

What screening methods are available for prostate cancer?

PSA, digital rectal examination.

What screening methods are available for cervical cancer?

Papanicolaou (PAP) smear, colposcopy.

What screening methods are available for ovarian cancer?

CA125, transvaginal ultrasound.

What screening methods are available for lung cancer?

Chest radiography, sputum cytology.

What is sensitivity in cancer screening?

Percentage of people with cancer correctly identified as positive.

What is specificity in cancer screening?

Percentage of people without cancer correctly identified as negative.

What does low sensitivity indicate?

Many false negatives (missed cancers).

What does low specificity indicate?

Many false positives (healthy people incorrectly flagged).

What does high sensitivity and specificity indicate?

More accurate testing.

How does a CT scan work?

Uses special X-ray equipment and radioactive tracer to obtain cross-sectional pictures of the body.

How does an MRI scan work?

Uses a magnetic field to create images.

How does a PET scan work?

Measures how fast radioactive glucose is used by the cells.

What are the modalities of cancer treatment?

Surgery, Radiation, Chemotherapy, Immunotherapy, Targeted therapy.

What is the criteria for complete response in cancer treatment?

Disappearance of all detectable disease.

What is the criteria for partial response in cancer treatment?

More than 50% decrease in tumor size.

What is stable disease in cancer treatment?

No growth or new lesions.

What is progressive disease in cancer treatment?

More than 25% increase in new lesions.

What is the difference between chemotherapeutic agents and targeted therapeutics?

Chemotherapeutic agents are non-specific cytotoxic drugs; targeted therapy inhibits specific molecules or pathways.

What is a problem with inhibitors designed for kinases?

Binding pockets of different kinases are structurally similar, causing off-target toxicity and side effects.

What is Gleevec?

A targeted tyrosine kinase inhibitor used for Chronic Myelogenous Leukemia and Gastrointestinal stromal tumors.

What does Gleevec target?

The BCR-ABL fusion protein created by the Philadelphia chromosome.

What mechanisms can lead to resistance to Gleevec?

Point mutations, gene amplification, activation of alternative pathways, and increased drug efflux pump expression.

What are cancer stem cells (CSCs)?

1-2% of total tumor capable of self-renewal and differentiation into various tumor cell types.

Why are CSCs resistant to cancer therapeutics?

High levels of drug pumps, anti-apoptotic molecules, resistance to oxidative stress, and slow cell cycle division.

What are properties of an ideal anticancer target?

Malignant cell survival, not expressed in normal tissue, biologically important, predicts clinical benefit, minimal toxicity.

What are the phases of human clinical trials?

Phase I: Safety and dosage; Phase II: Effectiveness; Phase III: Comparison to standard therapy; Phase IV: Post-market monitoring.