What is the loading dose of trastuzumab?
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8 mg/kg.
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What is the loading dose of trastuzumab?
8 mg/kg.
What should be done for Ms. Wong's 'bloody urine' after the first cycle of chemotherapy?
Monitor her condition and ensure hydration; if symptoms persist, further evaluation may be needed.
What is a characteristic of hormone receptor-positive breast cancer?
It is regulated by hormones such as oestrogen or progesterone.
What is the primary use of a Paclitaxel infusion set filter?
To prevent particulate contamination during the administration of Paclitaxel.
What is a requirement for the toxic effects of drugs in combination chemotherapy?
They should have different toxic effects.
What is the goal of primary induction chemotherapy?
Cure cancer, palliate symptoms, improve quality of life, and increase time to tumor progression.
What is the late switch regimen for pre-menopausal women using Tamoxifen?
Tamoxifen for 5 years followed by Letrozole for up to a further 5 years.
What should be considered regarding Ms. Wong's 4th cycle of paclitaxel?
The decision to continue should be based on the severity of her symptoms and consultation with her healthcare provider.
Name an example of an antimetabolite.
5-fluorouracil (5-FU), Methotrexate, Gemcitabine (Gemzar), or Capecitabine (Xeloda).
What is CAV in the context of small cell lung cancer?
CAV stands for Cyclophosphamide, Doxorubicin, and Vincristine.
What is the dosage of Capecitabine for home use?
1000mg/m2 BID for 14 days oral after food.
What does the ESMO guideline for localized colon cancer cover?
Diagnosis, treatment, and follow-up.
Which drug(s) may cause cardiac toxicity in chemotherapy?
Doxorubicin is known to cause cardiac toxicity.
How do Taxanes affect cancer cells?
They interfere with the mitotic spindle.
What should the drugs in combination chemotherapy have?
Different mechanisms of action.
What is the age of Mr. Yu?
62 years old.
Why is filtration important during Paclitaxel infusion?
To ensure patient safety by removing potential harmful particles.
How should Docetaxel IV be administered?
Through polyethylene-lined (PE) administration sets.
How often is the 5FU and Folinic Acid administered according to the protocol?
Weekly.
How can case studies contribute to medical knowledge?
They provide detailed insights into patient experiences, treatment outcomes, and disease progression.
What are the pre-medications used to prevent chemotherapy induced nausea and vomiting (CINV) in FOLFOX?
Common pre-medications include 5-HT3 receptor antagonists, NK1 receptor antagonists, and corticosteroids.
What issue did Ms. Wong experience after taking tamoxifen for 1 week?
Insomnia due to hot flushes at midnight.
When should Mr. Yu receive the next cycle of chemotherapy?
Typically, the next cycle should be given after recovery from side effects, often 2-3 weeks after the previous cycle.
What are the main Vinca alkaloids?
Vinblastine, Vincristine, and Vinorelbine.
What is the early switch regimen for pre-menopausal women using Tamoxifen?
Tamoxifen for 2-3 years followed by Anastrozole or Exemestane for up to 5-10 years in total.
What types of therapies are commonly included in colorectal cancer treatment protocols?
Surgery, chemotherapy, and targeted therapies.
What are antimetabolites?
A class of chemotherapy drugs that interfere with DNA and RNA growth.
How can case studies contribute to medical knowledge?
They provide detailed insights into unique patient scenarios, treatment responses, and outcomes.
What was Ms. Wong's diagnosis?
Stage 2, HER-2 positive, ER positive breast cancer (T2N0M0).
What are common adverse drug reactions (ADRs) of 5-FU?
Gastrointestinal distress (especially diarrhea), mucositis, alopecia, Hand-foot syndrome, and myelosuppression.
What is a recommended adjuvant chemotherapy regimen for stage II colon cancer?
CAPOX, which is capecitabine plus oxaliplatin.
When should Capecitabine be started?
On Day 1 evening.
What is a key advantage of combination chemotherapy?
It enhances response, reduces development of drug resistance, and increases survival.
Should Ms. Wong stop taking tamoxifen due to her insomnia?
Consultation with her healthcare provider is necessary before making a decision.
What are common adverse drug reactions (ADRs) associated with Paclitaxel?
Neutropenia, thrombocytopenia, high incidence of peripheral neuropathy, and possible hypersensitivity reactions during infusion.
What are the common ADRs associated with Docetaxel?
Neurotoxicity and bone marrow depression.
What does 'N1' signify in Stage IIIA?
Regional lymph node involvement with 1 to 3 positive nodes.
What is Vincristine primarily used to treat?
Acute leukaemia and lymphomas.
What is the focus of clinical applications in chemotherapy?
Selected malignant diseases.
What does Erlotinib inhibit in chronic myelogenous leukemia (CML)?
The tyrosine kinase activity of the protein product of the bcr-abl oncogene.
Which guideline provides information on early breast cancer treatment?
ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.
What was revealed by the colonoscopy?
A 9-cm mass in the descending colon.
What is adjuvant chemotherapy?
Chemotherapy given after surgery or radiation to reduce the risk of recurrence.
What is another adjuvant chemotherapy option for stage II colon cancer?
FOLFOX, which includes leucovorin, fluorouracil, and oxaliplatin.
What is a treatment option for pain associated with hand-foot syndrome?
Analgesics or topical anesthetics (lidocaine).
What is the diagnosis for Mrs. Chong?
Stage IV colorectal cancer with liver metastasis (T4, N3, M1a).
What effect does Bevacizumab have on angiogenesis?
It reduces angiogenesis, which includes endothelial proliferation and the formation of new blood vessels.
What is one of the primary uses of Tamoxifen?
Prevention of breast cancer in high-risk patients.
What cytotoxic drug is most likely causing Mr. Yu's loose stools?
5-Fluorouracil (5-FU) is commonly associated with diarrhea.
What is the primary mechanism of action of alkylating agents?
They work by adding alkyl groups to DNA, leading to DNA cross-linking and damage.
What are cytotoxic drugs?
Drugs that can damage cells.
What does the 'T2' in Stage IIIA indicate?
The tumor has invaded the muscularis propria but not through the serosa.
What is a common consequence of DNA damage caused by alkylating agents?
Induction of apoptosis or programmed cell death.
What types of cancer is 5-FU used to treat?
Bladder, breast, colon, anal, head and neck, liver, and ovarian cancers.
What does 'M0' represent in Stage IIIA?
No distant metastasis is present.
What should be done if allergic reactions occur during Paclitaxel infusion?
Stop the infusion and give Hydrocortisone 100 to 200 mg IV and Chlorpheniramine 10 mg IV.
How is the effectiveness of colorectal cancer treatment monitored?
Through regular imaging and clinical assessments.
What is a case study in the context of cancer treatment?
A detailed analysis of a specific patient or group of patients to understand treatment outcomes and effectiveness.
What is a key benefit of using case studies in cancer treatment?
They help in understanding the effectiveness of different treatment modalities in real-world scenarios.
What did the CT scan reveal about Mrs. Chong's condition?
Multiple liver masses.
What chemotherapy regimen is Ms. Wong receiving?
Adjuvant AC-TH chemotherapy: 8 cycles of Doxorubicin-Cyclophosphamide-Paclitaxel.
What can be a limitation of case studies?
They may not be generalizable to the broader population due to their focus on individual cases.
What additional action do antimetabolites have besides cytotoxic effects?
Immunosuppressant actions.
What type of drug is Paclitaxel commonly known as?
Taxol.
How is Oxaliplatin administered on Day 1?
IV Infusion of 85 mg/m² over 2 hours.
What are some plant-derived anti-tumor drugs?
Vinblastine, vincristine, vinorelbine, paclitaxel, docetaxel.
What are common adverse drug reactions (ADRs) of alkylating agents?
GI distress, mild hematotoxicity, neurotoxicity (peripheral neuritis and acoustic nerve damage), nephrotoxicity.
In which types of cancer is Bevacizumab used?
Colorectal, breast, non-small cell lung, and renal cancer.
How do colorectal tumors with RAS mutations affect clinical outcomes?
They frequently predict poorer clinical outcomes than RAS wild-type.
What is the effect of aromatase inhibitors on recurrence rates compared to tamoxifen?
They reduce recurrence rates by about 30%.
Who is the instructor for the course on malignant diseases treatment?
Dr. Windy SY Chan.
What types of cancers are treated with Taxanes?
Breast, ovarian, lung, gastroesophageal, prostate, bladder, and head and neck cancers.
What phases do combination chemotherapy drugs target?
Multiple phases in the cell cycles.
What is the mechanism of action of Fluorouracil (5-FU)?
It inhibits thymidylate synthase, leading to 'thymineless death' of cells.
What is the first medication administered on Day One of the CAPOX regimen?
Dexamethasone 8mg PO/IV.
Name an example of a Tyrosine Kinase Inhibitor.
Erlotinib (Tarceva®), Imatinib (Glivec®), gefitinib (Iressa®).
What types of cancer is Vinblastine used for?
Lymphomas, neuroblastoma, and testicular carcinoma.
What is the dosage and administration method for Oxaliplatin on Day One?
130mg/m2 IV infusion in 500ml D5 over 2 hours.
What types of cancer are often highlighted in case studies?
Colorectal and breast cancer.
What is Mr. Yu's age and diagnosis?
62 years old with Stage IIIA Colorectal Cancer.
Should the trastuzumab infusion be discontinued due to Ms. Wong's symptoms?
The infusion may not need to be discontinued, but monitoring and evaluation by healthcare professionals are necessary.
What are the main alkylating agents mentioned?
Cisplatin IV, carboplatin IV, and oxaliplatin IV.
What are some examples of alkylating agents used in chemotherapy?
Cyclophosphamide, cisplatin, carboplatin, oxaliplatin.
Name two antimetabolites used in chemotherapy.
5-fluorouracil (5-FU) and methotrexate.
How long will Ms. Wong receive trastuzumab (Herceptin)?
18 cycles over one year.
What is the significance of the G0 phase in relation to drug effectiveness?
It is the resting phase where Cell Cycle-Nonspecific drugs can act on tumor cells.
How does Bevacizumab affect tissue growth?
It retards the growth of all tissues, including metastatic tissue.
What are anthracyclines?
A class of anti-tumor antibiotics including doxorubicin and daunorubicin.
What types of cancer is Methotrexate used to treat?
Acute leukaemia, non-Hodgkin lymphoma, breast cancer, head and neck cancer, and bladder cancer.
Can you name some anti-tumor antibiotics?
Dactinomycin, bleomycin, doxorubicin.
What is the recommended discharge oral medication?
Ondansetron, dexamethasone, metoclopramide.
What treatment is recommended for HER2-positive breast cancer?
Chemotherapy plus anti-HER2 therapy.
What hormone therapy was Ms. Wong considering for her breast cancer?
Anastrozole.
What is an appropriate management for Mr. Yu's loose stools?
Consider using loperamide or adjusting the chemotherapy regimen.
What effect do alkylating agents have on DNA?
They cause DNA strand breaks and inhibit DNA replication.
What is palmar-plantar erythrodysesthesia?
A side effect characterized by redness and pain on the palms of the hands and soles of the feet, often associated with chemotherapy.
What is the administration method for Paclitaxel in locally advanced breast cancer?
Weekly using a non-PVC set with a 0.22 micron filter.
What is the primary focus of a case study in a clinical context?
To analyze and understand specific instances of patient care or treatment outcomes.
What is the combination of drugs used in the CAV regimen for small cell lung cancer?
Cyclophosphamide, Doxorubicin, and Vincristine.
What is commonly given before 5-FU to enhance its effects?
Folinic acid (Leucovorin) IV infusion.
What is the maximum cumulative dose of Doxorubicin in the CAV regimen?
450 to 550 mg/m2.
What is a Cell Cycle-Specific (CCS) drug?
A drug that is most effective on tumor cells during specific phases of the cell cycle.
What are common adverse drug reactions (ADRs) of Vincristine?
Neurotoxic actions, areflexia, peripheral neuritis, and paralytic ileus.
What is a key benefit of using case studies in cancer treatment?
They help in understanding the effectiveness of different treatment modalities in real-world scenarios.
What are some examples of alkylating agents used in chemotherapy?
Cyclophosphamide, cisplatin, carboplatin, oxaliplatin.
What are the components of the CAV chemotherapy regimen?
Cyclophosphamide, Doxorubicin, and Vincristine.
What types of cancer are treated with cisplatin and carboplatin?
Testicular carcinoma, cancers of the bladder, lung, and ovary.
Which treatment is recommended for inflammation in hand-foot syndrome?
Topical high-potency corticosteroids.
How can case studies influence future cancer treatment strategies?
By highlighting successful approaches and potential complications, guiding future research and clinical practices.
What is the primary effect of cytotoxic drugs in the cell cycle?
They disrupt the normal progression of the cell cycle.
What should be administered if infusion-related reactions occur?
Hydrocortisone 100 mg IV, chlorpheniramine 10 mg IV, paracetamol 1000 mg po.
What is the size of the mass found in Ms. Wong's breast?
3.5 cm.
What is another use of Tamoxifen besides prevention?
Adjuvant therapy of breast cancer.
What is a common nitrogen mustard used as an alkylating agent?
Cyclophosphamide IV (Endoxan).
What are the two main Taxanes mentioned?
Paclitaxel (Taxol®) and Docetaxel (Taxotere®).
What is the protocol involving cisplatin for treating oesophagus cancer?
Cisplatin and Fluorouracil over 4 days.
What is the purpose of adjuvant chemotherapy in colorectal cancer treatment?
To reduce the risk of cancer recurrence after surgery.
What is the primary focus of the treatment protocol for colorectal cancer?
To provide guidelines for the management and treatment of colorectal cancer.
How do Vinca alkaloids affect cell division?
They block the formation of the mitotic spindle by preventing the assembly of tubulin dimers into microtubules during the M phase.
What is the primary focus of a case study in a medical context?
To analyze a specific instance of a disease or treatment to draw conclusions or insights.
What is the role of chemotherapy in colorectal cancer treatment?
To kill cancer cells and reduce tumor size, often used in conjunction with surgery.
What is the mechanism of action of Paclitaxel?
It stabilizes microtubules and prevents their disassembly, inhibiting cell division.
How many cycles of treatment are specified?
8 cycles.
What type of cancer is often examined in case studies?
Colorectal and breast cancer.
What surgical procedure is Ms. Wong scheduled for?
Partial mastectomy.
What is a Cell Cycle-Nonspecific (CCNS) drug?
A drug that acts on tumor cells while they are actively cycling and in the resting phase (G0).
What is the cycle length for FOLFOX treatment?
Every 14 days.
What can be learned from analyzing case studies in cancer?
Patterns in treatment responses and potential complications that may arise.
How are targeted therapies often used in cancer treatment?
In combination with cytotoxic anticancer agents to achieve higher response rates.
Name a few antimetabolites used in chemotherapy.
5-fluorouracil (5-FU), methotrexate, capecitabine, gemcitabine.
What type of agents are alkylating agents classified as?
Cell Cycle-Nonspecific.
What does OFS stand for in breast cancer treatment?
Ovarian function suppression.
What does MSS stand for?
Microsatellite stability.
What are alkylating agents?
A class of chemotherapy drugs that work by adding alkyl groups to DNA, preventing cell division.
How long should reactions be observed during the first infusion of Trastuzumab?
6 hours.
What are examples of targeted therapy in chemotherapy?
Gefitinib, erlotinib, bevacizumab, trastuzumab.
How do anthracyclines affect DNA?
They interfere with enzymes involved in DNA replication.
What factors can lead to resistance in targeted anticancer therapy?
Mutations in the molecular target, decreased expression of the target, alterations in target pathways, changes in drug efflux and metabolism.
What is the focus of the course PDN1306?
Applied Pharmacology and Microbiology.
What can reduce cisplatin-induced renal damage?
Mannitol with forced hydration pre- and post-cisplatin infusion.
What are the main treatment options for colorectal cancer?
Surgery, radiofrequency ablation, cryosurgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.
Should mannitol infusion be given before oxaliplatin to reduce renal damage?
Yes, mannitol infusion is sometimes used to help protect the kidneys from potential damage caused by oxaliplatin.
What type of cancers are often hormone-dependent?
Breast and prostate cancer.
How do combination chemotherapy drugs differ from single drugs?
Combinations are frequently more toxic than single drugs.
When should adjuvant chemotherapy ideally commence after surgery for colorectal cancer?
As soon as possible and ideally not later than 8 weeks.
When is the course on drugs used in the treatment of malignant diseases scheduled?
July 2024.
When should hydration occur in relation to cisplatin infusion?
Pre- and post-cisplatin infusion.
What is the primary focus of the 5FU Toxicity Monitoring Protocol?
To monitor toxicity associated with 5FU and Folinic Acid in colorectal cancer treatment.
What institution offers the Professional Diploma in Nursing?
St Teresa’s Hospital.
What benefits does endocrine therapy provide?
It can extend survival and delay or prevent tumor recurrence.
What type of cancer treatment do alkylating agents fall under?
They are classified as chemotherapy agents.
What is the purpose of chemotherapy drugs?
Used in treating malignancies.
What is the duration of each cycle of trastuzumab treatment?
21 days.
What are the four main groups of endocrine therapy?
Corticosteroids, gonadal hormones, estrogen antagonists and aromatase inhibitors, and androgen antagonists.
What are small molecules in targeted anticancer therapy?
Tyrosine Kinase Inhibitors (oral).
What are the main classifications of cancer therapies discussed?
Chemotherapies, targeted cancer therapies, and endocrine therapy.
What stage of cancer does Mr. Yu have?
Stage IIIA Colorectal Cancer.
What is the significance of the CRP09 CR004 protocol?
It outlines the monitoring procedures for patients receiving 5FU and Folinic Acid.
What symptoms did Ms. Wong experience after the 3rd cycle of paclitaxel?
Mild numbness and weakness in her right hand.
How many total cycles of trastuzumab are administered?
18 cycles.
What type of drug is Paclitaxel?
A chemotherapy medication used to treat various cancers.
When do reactions commonly occur during Paclitaxel infusion?
Within the first few minutes of starting the infusion.
What is the dosage of Ondansetron given on Day One?
8mg PO/IV.
When is primary induction chemotherapy typically used?
When no alternative treatment exists.
What is the duration of the treatment cycle mentioned?
21 days.
When will the 5FU infusion finish?
It could finish on 1 Apr, 2 Apr, or 3 Apr, depending on the treatment schedule.
What are the five phases of the cell cycle that all dividing cells must traverse?
G0 (resting stage), G1, S, G2, M.
What cancers is Vinorelbine used to treat?
Non-small cell lung cancer and breast cancer.
What is the purpose of using a non-PVC set with a 0.22 micron filter for Paclitaxel?
To prevent contamination and ensure safe administration.
What factors influence the choice of treatment in colorectal cancer?
Stage of cancer, patient health, and specific tumor characteristics.
What is the function of Trastuzumab (Herpcetin)?
It binds to the HER-2 receptors on cancer cells, inhibiting their proliferation.
What does HER2 stand for?
Human Epidermal growth factor Receptor 2.
How does Tamoxifen work?
As a competitive inhibitor of estradiol binding to the estrogen receptor (ER).
What does CEA stand for in the context of colon cancer?
Carcinoembryonic antigen.
What is Methotrexate an inhibitor of?
Dihydrofolate reductase.
What are some plant-derived anti-tumor drugs?
Vinblastine, vincristine, vinorelbine, paclitaxel, docetaxel.
What is used to treat hyperkeratosis in hand-foot syndrome?
Topical keratolytics.
What was the result of the expanded RAS testing?
Negative for mutation (wild-type).
What was the staging of Mr. Yu's cancer?
Stage IIIA: T2, N1, M0.
What is the ESMO-Magnitude of Clinical Benefit Scale (MCBS)?
A scale used to evaluate the clinical benefit of cancer treatments.
What does cT and N represent in cancer staging?
cT refers to clinical Tumor category, and N refers to node category.
How does carboplatin compare to cisplatin in terms of nephrotoxicity?
Carboplatin is less nephrotoxic than cisplatin.
What is CAPOX?
A combination of capecitabine plus oxaliplatin.
What is the recommended regimen for Tamoxifen?
Tamoxifen 20 mg Daily Oral for 5-10 years.
What are aromatase inhibitors used in chemotherapy?
Anastrozole, exemestane, letrozole.
What is a notable difference in side effects between carboplatin and cisplatin?
Carboplatin is less likely to cause tinnitus and hearing loss but has greater myelosuppressant actions.
What is targeted therapy?
A treatment that uses drugs or other substances to precisely identify and attack cancer cells.
What are the aromatase inhibitors mentioned in the regimens?
Anastrozole, Exemestane, and Letrozole.
What is the goal of neoadjuvant chemotherapy?
To reduce the size of the tumor before surgery.
When is Erlotinib used as a first-line treatment?
For non-small-cell lung cancer if it is positive for epidermal growth factor tyrosine kinase mutation.
What type of cancer is treated with the CAV regimen?
Small cell lung cancer.
What are alkylating agents used in chemotherapy?
Cyclophosphamide, cisplatin, carboplatin, oxaliplatin.
What are common ADRs associated with Vinblastine and Vinorelbine?
Gastrointestinal distress, alopecia, and bone marrow suppression.
What type of protein does Anti-HER-2 target?
Human epidermal growth factor receptor 2 protein (HER-2).
Name a few antimetabolites used in chemotherapy.
5-fluorouracil (5-FU), methotrexate, capecitabine, gemcitabine.
What is the recommended regimen for Trastuzumab administration?
6 mg/kg in NS 250 ml IV infusion over 90 minutes.
What processes does Methotrexate interfere with?
Nucleic acid and protein metabolism.
What does the TNM staging system stand for?
Tumor, Node, Metastasis.
What diluent is used for the infusion of 5 Fluorouracil over 46 hours?
0.9% Sodium Chloride.
What is the mechanism of action of Cyclophosphamide?
It is an alkylating agent that cross-links DNA, leading to cell death.
What do small molecules in targeted therapy do?
Enter cells and engage intracellular targets, such as enzyme kinases.
Name three examples of Aromatase Inhibitors.
Anastrozole (Arimidex), exemestane (Aromasin), letrozole (Femara).
What chemotherapy regimen is planned for Mrs. Chong?
Bevacizumab + CAPOX (capecitabine plus oxaliplatin).
What adjustment can be made to the infusion time of Bevacizumab in subsequent cycles?
Shorten to 60min/30min if well tolerated.
How many cycles of Doxorubicin-Cyclophosphamide-Paclitaxel are planned?
8 cycles of 21 days.
What is the infusion rate for Glucose 5% used for line flush?
Fast running.
What is the dosing regimen for Capecitabine?
1000 mg/m2 BID on Day 1-14 (per 21-day cycle).
What rare condition can result from the long-term use of alkylating agents?
Acute leukemia.
What are common side effects of chemotherapy?
Nausea, fatigue, hair loss, and increased risk of infection.
What should be done if chills and fever occur during Ms. Wong's first infusion?
Continue infusion and monitor closely if any other reactions occur.
What were the symptoms experienced by Mrs. Chong?
Abdominal pain, fatigue, and remarkable weight loss.
What symptoms did Ms. Wong develop during the 1st trastuzumab infusion?
Chills and mild fever (38.2 C).
During which phase of the cell cycle do antimetabolites act?
S phase.
What type of drug is Tamoxifen?
An estrogen antagonist.
What is Capecitabine?
A rationally designed 5-FU pro-drug developed to mimic continuous infusion of 5-FU.
What is the function of Bevacizumab (Avastin)?
It binds to vascular endothelial growth factor (VEGF) and inhibits its interaction with receptors.
During which phase are tumor cells usually most responsive to specific drugs?
During the specific phases indicated for Cell Cycle-Specific drugs.
What is the purpose of endocrine therapy in breast cancer treatment?
To block hormones that can promote the growth of cancer cells.
What is the PRN dosage of Metoclopramide?
10mg TID oral.
What is the follow-up therapy after trastuzumab for Ms. Wong?
Tamoxifen therapy, switching to an aromatase inhibitor for a total of 5-10 years.
What are some high-risk factors for breast cancer that Tamoxifen can help prevent?
Strong family history, prior non-malignant breast pathology, or inheritance of the BRCA1 or BRCA2 genes.
What medications were administered to Mr. Yu for colorectal cancer?
Ondansetron (Zofran) IV and dexamethasone IV.
What are Aromatase Inhibitors (AIs) used for?
To decrease estrogen-mediated cancer cell proliferation in hormone receptor-positive breast cancer.
What are some non-cancer uses of Methotrexate?
Rheumatoid arthritis and inflammatory bowel diseases.
What treatment did Mr. Yu receive and what is planned next?
He received surgery and is planned to start FOLFOX chemotherapy.
What does T0 signify in the TNM staging system?
The main tumor cannot be found.
What does FOLFOX stand for?
FOLFOX is a combination chemotherapy regimen that includes Folinic acid (leucovorin), Fluorouracil (5-FU), and Oxaliplatin.
What cancers is doxorubicin used to treat?
Hodgkin and non-Hodgkin lymphoma, myelomas, sarcomas, and breast, lung, ovarian, and thyroid cancers.
What characterizes locally advanced breast cancer?
T3 tumour without nodal involvement (T3N0).
What is a significant adverse reaction (ADR) of alkylating agents?
They can cause long-term damage to the bone marrow.
How do hormones play a role in cancer treatment?
They can be used to block or lower the amount of hormones in the body that fuel certain cancers.
How can the side effects of chemotherapy be managed?
Through medications, lifestyle changes, and supportive care.
What is the tenth most common cancer in Hong Kong?
Kidney cancer.
What is the overall classification of Stage IIIA?
It indicates locally advanced colorectal cancer.
What is the maintenance dose of trastuzumab after the loading dose?
6 mg/kg.
What is the required cardiac ejection fraction to proceed with Doxorubicin treatment?
Must be greater than 50%.
How long does the total trastuzumab treatment last?
One year.
What is the dosage of Chlorpheniramine administered on Day One of Paclitaxel cycles?
10 mg intravenous.
Where can one find chemotherapy protocols and tools?
Cancer Institute NSW Australia website.
What is the dose of Calcium Leucovorin (folinic acid) on Day 1?
300 mg.
What is the clinical stage of early-stage breast cancer?
Clinical stage I, IIA (T2N1).
What types of cancer is Capecitabine used to treat?
Colorectal cancer, gastric cancer, and breast cancer.
What did the colonoscopy reveal?
A 6-cm mass in the ascending colon, which was diagnosed as adenocarcinoma.
List two anti-tumor antibiotics used in chemotherapy.
Dactinomycin and doxorubicin.
What does RT represent in the context of breast cancer treatment?
Radiotherapy.
What does TX indicate in the TNM staging system?
The main tumor cannot be measured.
What is the dosage of Paclitaxel given during the infusion?
175 mg/m2 intravenous infusion in 500ml NS over 180 minutes.
What are some hormones used in cancer treatment?
Tamoxifen (antiestrogen), Flutamide (antiandrogen).
Which vitamin is also recommended for hand-foot syndrome?
Oral vitamin E.
Name an antiandrogen used in chemotherapy.
Flutamide.
What supportive care measures are recommended for Mr. Yu?
5FU, loperamide or codeine phosphate, maintain hydration, may require dose adjustment if severe.
Why is Oxaliplatin incompatible with saline?
It is a specific incompatibility noted in the treatment protocol.
What medications were administered to Ms. Wong for breast cancer?
Doxorubicin and trastuzumab.
Which cancer is the fifth most common in Hong Kong?
Hepatocellular carcinoma (liver cancer).
What is the role of Calcium Leucovorin (folinic acid)?
It enhances the efficacy of 5FU chemotherapy.
What is triple-negative breast cancer?
A type of breast cancer that does not have any of the three common receptors known to fuel most breast cancer growth.
Which chemotherapy drugs are included in the treatment regimen?
Doxorubicin (Adriamycin), Cyclophosphamide, and Paclitaxel (Taxol).
What do most targeted therapies attack?
Cells with mutant versions of certain genes or cells that express too many copies of a particular gene.
What symptoms did Mr. Yu present with?
Bloating, abdominal cramps, altered bowel habit, and unintentional weight loss.
What is the dosage of Dexamethasone for home use after oxaliplatin?
4mg BID for 3 days oral.
What is the dosage of Dexamethasone given on Day One?
20 mg intravenous.
What is the role of Doxorubicin in the CAV regimen?
It acts as an anthracycline antibiotic that interferes with DNA replication.
What type of cancer is oxaliplatin primarily used for?
Advanced colon cancer.
What are the two main treatment options for early-stage breast cancer?
Breast-conserving therapy (surgery plus radiation therapy) or mastectomy (with or without radiation therapy).
Name three examples of platinum drugs used as alkylating agents.
Cisplatin IV, carboplatin IV, and oxaliplatin (Eloxatin) IV.
What type of therapy is used for hormone receptor-positive breast cancer?
Endocrine therapy.
What are examples of targeted therapy in chemotherapy?
Gefitinib, erlotinib, bevacizumab, trastuzumab.
What are some adverse drug reactions (ADRs) associated with Tamoxifen?
Headache, hot flushes, fluid retention and oedema, thromboembolism, arthralgia and myalgia, endometrial changes, and uterine malignancies.
What are antiestrogens used in chemotherapy?
Tamoxifen.
How do alkylating agents affect DNA?
They alkylate nucleophilic groups on DNA bases, damaging DNA directly.
How long should reactions be observed in subsequent infusions of Trastuzumab?
2 hours.
How can the toxic effects of Methotrexate be reduced?
By administering Folic acid (5 mg weekly, 4 days after Methotrexate).
What type of corticosteroids can be used orally for hand-foot syndrome?
Oral corticosteroids.
On which day should Folic acid be administered?
Fridays.
How might liposomal formulations of doxorubicin differ from standard formulations?
They may be less cardiotoxic.
What is a common side effect of tamoxifen for Ms. Wong?
Hot flushes.
Why are case studies important in cancer research?
They provide insights into real-world applications of treatment modalities and help identify best practices.
What evaluation should be performed if needed before administering Doxorubicin?
Baseline LVEF (Left Ventricular Ejection Fraction) evaluation.
What types of data are typically included in a cancer case study?
Patient demographics, treatment protocols, outcomes, and follow-up results.
What is Mr. Yu's past medical history?
Hypertension (on losartan) and hyperlipidaemia (on atorvastatin).
What is the management plan for Mrs. Chong?
Surgery + chemotherapy based on molecular testing.
How much Famotidine is administered on Day One?
20 mg oral, once only.
What role do case studies play in understanding specific cancers like colorectal and breast cancer?
They help in identifying unique characteristics, treatment responses, and patient experiences related to these cancers.
What is the dosage of Metoclopramide on Day One?
10 mg oral or intravenous.
What is the cell cycle specificity of anthracyclines?
Cell Cycle-Nonspecific.
What is the significance of HER-2 positive in Ms. Wong's diagnosis?
It indicates a specific type of breast cancer that may respond to targeted therapies.
What is the take-home medication for Metoclopramide?
10 mg three times a day when required, oral (for 21 days).
What are some hormones used in cancer treatment?
Tamoxifen (antiestrogen), Flutamide (antiandrogen).
What do T1, T2, T3, and T4 represent in the TNM system?
They refer to the size and/or extent of the main tumor, with higher numbers indicating larger tumors or more growth into nearby tissues.
What is the primary effect of alkylating agents on cancer cells?
They prevent the cancer cell from reproducing.
Why are Aromatase Inhibitors ineffective in premenopausal women?
In the absence of ovarian suppression, compensatory physiological responses induce ovarian estrogen production.
What is the most distinctive adverse effect of doxorubicin?
Cardiotoxicity.
What cancer type is ranked fourth in Hong Kong?
Prostate cancer.
Did anastrozole work well for Ms. Wong, a premenopausal woman?
No, anastrozole (AIs) did not work well in premenopausal women.
How do antimetabolites interfere with cellular processes?
By substituting the normal building blocks of RNA and DNA.
What is the brand name of Doxorubicin?
Adriamycin.
How is Capecitabine converted to its active form?
Enzymatically in the GI tract to active 5-FU.
What is a significant risk associated with the administration of Doxorubicin?
Risk of extravasation.
What does MSI refer to in colon cancer treatment?
Microsatellite instability.
What are some plant-derived anti-tumor drugs?
Vinblastine, vincristine, vinorelbine, paclitaxel, docetaxel.
What is FOLFOX?
A combination of fluorouracil plus oxaliplatin.
Can you name some anti-tumor antibiotics?
Dactinomycin, bleomycin, doxorubicin.
Is mannitol infusion given during cisplatin infusion for Mr. Yu?
No, mannitol infusion is given pre- and post-cisplatin infusion only.
What do antimetabolites do?
They interfere with DNA and RNA synthesis by mimicking the building blocks of these molecules.
What are common adverse drug reactions (ADRs) of Methotrexate?
Bone marrow suppression, toxic effects on skin and gastrointestinal mucosa (mucositis).
What side effects are associated with CAPOX?
More grade 3 diarrhoea and hand-foot skin reactions.
Which cancer ranks second in prevalence in Hong Kong?
Lung cancer.
What is the purpose of neoadjuvant systemic therapy?
To treat locally advanced breast cancer before surgery.
What stage is referred to as distant metastases in breast cancer?
Stage IV (around 5% at diagnosis).
What side effect did Ms. Wong experience from paclitaxel?
Grade 1 peripheral neuropathy; continue chemotherapy.
What is the sixth most prevalent cancer in Hong Kong?
Stomach cancer.
What are the two major types of targeted therapies?
Monoclonal antibodies and small molecules.
How does Vincristine work in cancer treatment?
It inhibits microtubule formation, preventing cell division.
What do monoclonal antibodies target?
Cell surface or shed antigens, such as growth factor receptors or receptor ligands.
What ointments are recommended for erosions in hand-foot syndrome?
Petroleum/lanolin-based ointments.
What are the side effects associated with FOLFOX?
More neutropenia and venous thrombotic events.
What are examples of targeted therapy in chemotherapy?
Gefitinib, erlotinib, bevacizumab, trastuzumab.
On what date was Mr. Yu's treatment scheduled for Day 3?
3 April.
What is the dose of 5 Fluorouracil administered as a bolus?
400 mg/m² over 5 minutes.
Why is 5FU used in Mr. Yu's treatment?
To enhance 5FU cytotoxic effects.
What topical treatment contains 99% dimethylsulfoxide (DSMU)?
Topical 99% dimethylsulfoxide (DSMU).
What does N0 indicate in the TNM staging system?
There is no cancer in nearby lymph nodes.
What do N1, N2, and N3 signify in the TNM system?
They refer to the number and location of lymph nodes that contain cancer, with higher numbers indicating more affected lymph nodes.
What type of cancer is the eighth most common in Hong Kong?
Pancreatic cancer.
What is the typical regimen for administering Bevacizumab?
5-10 mg/kg every 2-3 weeks in 100ml NS over 90 mins IV infusion.
What is a consideration for patients with bone metastases or osteoporosis in breast cancer treatment?
Endocrine therapy may be used to manage these conditions.
How do Aromatase Inhibitors work?
They inhibit the enzyme aromatase, blocking the conversion of androgens into estrogens.
What is the role of anti-tumor antibiotics in chemotherapy?
They inhibit DNA and RNA synthesis in cancer cells.
What are common adverse drug reactions (ADRs) of doxorubicin?
Bone marrow suppression, gastrointestinal distress, severe alopecia, and red urine.
On which day should Methotrexate be administered?
Mondays.
Which cancer is associated with the highest mortality rate in Hong Kong?
Lung cancer.
What does M1 indicate in the TNM staging system?
Cancer has spread to other parts of the body.
What oral supplement is suggested for hand-foot syndrome?
Oral vitamin B6 (Pyridoxine) 400 mg.
What is the treatment approach for triple-negative breast cancer?
Adjuvant chemotherapy.
How does the risk of endometrial changes and uterine malignancies relate to Tamoxifen therapy?
The risk increases with the duration of Tamoxifen therapy.
What was the date for the next treatment for Mr. Yu?
15 April.
What can result from lifetime cumulative doses of doxorubicin?
Dose-dependent cardiomyopathy and heart failure.
What is a common side effect of doxorubicin in Ms. Wong?
Urine discoloration (red) is a normal effect.
What does M0 signify in the TNM staging system?
Cancer has not spread to other parts of the body.
Which cancer ranks seventh in Hong Kong?
Esophageal cancer.
What are some adverse drug reactions (ADRs) associated with Trastuzumab?
Cardiotoxicity, acute respiratory distress syndrome, infusion-related effects.
What are plant-derived anti-tumor drugs?
Chemotherapy agents derived from plants that inhibit cancer cell growth.
What is the most common cancer in Hong Kong?
Colorectal cancer.
Why are Aromatase Inhibitors effective in postmenopausal women?
Because the aromatase pathway is the primary source of estrogen in postmenopausal women.
What does NX mean in the context of regional lymph nodes?
Cancer in nearby lymph nodes cannot be measured.
What type of cancer is the third most common in Hong Kong?
Breast cancer.
What is an example of a TNM staging classification?
T3N1M0.
What is a significant side effect of oxaliplatin?
Dose-limiting neurotoxicity.
What are aromatase inhibitors used in cancer treatment?
Anastrozole, exemestane, letrozole.
What are aromatase inhibitors used in chemotherapy?
Anastrozole, exemestane, letrozole.
What are some common adverse drug reactions (ADRs) associated with Aromatase Inhibitors?
Headache, hot flushes, hyperlipidaemia, hypercholesterolaemia, fluid retention, edema, arthralgia, myalgia, and vaginal atrophy.
What does MX indicate regarding distant metastasis?
Metastasis cannot be measured.
What is the significance of constructing systemic chemotherapies for colorectal and breast cancer?
It allows for tailored treatment plans that improve patient outcomes.
Which cancer is ranked ninth in Hong Kong?
Non-Hodgkin lymphoma.