early late effects of cancer treatment

... epidemiology of cancer pain and of its treatments, the quality of analgesic-drug therapy and the effect of alternative analgesic strategies in a large, prospective, unselected cohort of cancer patients ... describe the characteristics of a large sample of cancer patients in terms of case mix (patients characteristics), pattern of care (pharmacological and non-pharmacological treatments) and relevant ... effectiveness of treatment regimens on pain intensity and patient-reported quality of life - To evaluate the effect of treatment regimens on patientreported satisfaction - To evaluate the safety profile...

Ngày tải lên: 20/06/2014, 15:20

... benefit One of the challenges of cancer treatment is to use the various treatment modalities alone and together in a fashion that maximizes the chances for patient benefit Cancer treatments are ... considered local treatments, though their effects can influence the behavior of tumor at remote sites Chemotherapy and biologic therapy are usually systemic treatments Oncology, the study of tumors ... treatment approaches, is a multidisciplinary effort with surgical-, radiotherapy-, and internal medicine–related areas of expertise Treatments for patients with hematologic malignancies are often...

Ngày tải lên: 07/07/2014, 01:20

... Principles of Cancer Surgery Surgery is used in cancer prevention, diagnosis, staging, treatment (for both localized and metastatic disease), palliation, and rehabilitation Prophylaxis Cancer can ... lightmicroscopic inspection of a tumor for pattern of growth, degree of cellular atypia, invasiveness, and morphologic features that aid in the differential diagnosis, sufficient tissue is of value in searching ... incisional biopsy is the procedure of second choice A wedge of tissue is removed, and an effort is made to include the majority of the cross-sectional diameter of the tumor in the biopsy to minimize...

Ngày tải lên: 07/07/2014, 01:20

... information for treatment planning and may determine the extent and nature of primary cancer treatment Treatment Surgery is the most effective means of treating cancer Today about 40% of cancer patients ... source of angiogenesis inhibitors and mass-related growth regulators in the tumor In selecting a surgeon or center for primary cancer treatment, consideration must be given to the volume of cancer ... have effects on metastatic tumor growth If resection of the primary lesion takes place in the presence of metastases, acceleration of metastatic growth may occur, perhaps based on the removal of...

Ngày tải lên: 07/07/2014, 01:20

... perception of successful therapy Plastic and reconstructive surgery can correct the effects of disfiguring primary treatment Principles of Radiation Therapy Physical Properties and Biologic Effects ... uses radiation to treat cancer Radiation is a physical form of treatment that damages any tissue in its path; its selectivity for cancer cells may be due to defects in a cancer cell's ability to ... placement of appropriate infusion portals Surgery may correct other treatment- related toxicities such as adhesions or strictures Rehabilitation Surgical procedures are also valuable in restoring a cancer...

Ngày tải lên: 07/07/2014, 01:20

... effective treatment volume is small X-rays and gamma rays are the forms of radiation most commonly used to treat cancer They are both electromagnetic, nonparticulate waves that cause the ejection of ... some fashion to a site of tumor Teletherapy is the most commonly used form of radiation therapy Radiation from any source decreases in intensity as a function of the square of the distance from ... are generated from decay of atomic nuclei in radioisotopes such as cobalt and radium These waves behave biologically as packets of energy, called photons Particulate forms of radiation are also...

Ngày tải lên: 07/07/2014, 01:20

... number of diseases, including breast cancer, Hodgkin's disease, head and neck cancer, prostate cancer, and gynecologic cancers Radiation therapy can also palliate disease symptoms in a variety of ... relief of bone pain from metastatic disease, control of brain metastases, reversal of spinal cord compression and superior vena caval obstruction, shrinkage of painful masses, and opening of threatened ... radiation source after a period of time precisely calculated to deliver a chosen dose of radiation to the tumor This approach is often used to treat brain tumors and cervical cancer The difficulty with...

Ngày tải lên: 07/07/2014, 01:20

... mild symptoms not requiring treatment; PS2, symptoms requiring some treatment; PS3, disabling symptoms, but allowing ambulation for >50% of the day; PS4, ambulation

Ngày tải lên: 07/07/2014, 01:20

... metastatic cancers If a tumor is localized to a single site, serious consideration of surgery or primary radiation therapy should be given, as these treatment modalities may be curative as local treatments ... Chemotherapy may be employed after the failure of these modalities to eradicate a local tumor or as part of multimodality approaches to offer primary treatment to a clinically localized tumor In ... Chemotherapy agents may be used for the treatment of active, clinically apparent cancer Table 81-1, A lists those tumors considered curable by conventionally...

Ngày tải lên: 07/07/2014, 01:20

... least an increased time to further progression of disease Active efforts are being made to quantitate effects of anticancer agents on quality of life Cancer drug clinical trials conventionally use ... correlation of host toxicity while achieving an "optimal biologic dose" becomes a more relevant endpoint for Phase I and early Phase II trials with targeted agents Valuable cancer drug treatment ... and it recapitulates the necessary cell death observed during the ontogeny of the organism Anoikis refers to the death of epithelial cells after removal from the normal milieu of substrate, particularly...

Ngày tải lên: 07/07/2014, 01:20

... novel mechanisms of action, combinations of drugs and targeted agents may maximize the chances of affecting critical pathways in the tumor Chemotherapeutic Agents Used for Cancer Treatment Table ... but regulate the action of particular pathways For example, the p210bcr-abl fusion protein tyrosine kinase drives chronic myeloid leukemia (CML), and HER-2/neu stimulates the proliferation of certain ... understanding of the relationship of cell death and cell survival mechanisms is needed Resistance to chemotherapy drugs has been postulated to arise either from cells not being in the appropriate phase of...

Ngày tải lên: 07/07/2014, 01:20

... Diarrhea: "early Prodrug mg/m2 onset" with cramping, requires enzymatic IV over 90 flushing, vomiting; "late clearance to active q3–4 onset" weeks after several drug "SN 38" doses Early diarrhea ... 665 mg/m2 Diarrhea bid Prodrug 5FU due of to Hand-foot continuous; intratumoral syndrome 1250 mg/m metabolism bid weeks on/ off; 829 mg/m2 bid weeks on/ off + 60 mg/d leucovorin Cytosine arabinoside ... mL/min and tolerate fluid push Carboplatin 365 mg/m2 Marrow platelets IV > WBCs q3–4 weeks Reduce dose according to CrCl: to AUC of 5–7 mg/mL Nausea as adjusted Renal (high dose) dose/(CrCl +...

Ngày tải lên: 07/07/2014, 01:20

... Busulfan can cause profound myelosuppression, alopecia, and pulmonary toxicity but is relatively "lymphocyte sparing." Its routine use in treatment of CML has been curtailed in favor of imatinib (Gleevec)or ... that covalently modify bases in DNA This leads to cross-linkage of DNA strands or the appearance of breaks in DNA as a result of repair efforts "Broken" or cross-linked DNA is intrinsically unable ... coadministration of mesna to prevent bladder injury Central nervous system (CNS) effects, including somnolence, confusion, and psychosis, can follow ifosfamide use; the incidence appears related to low...

Ngày tải lên: 07/07/2014, 01:20

... preparations of the drug has led to the practice of administering a test dose of 0.5– unit before the rest of the dose The most feared complication of bleomycin treatment is pulmonary fibrosis, which increases ... with p53 and Rb pathway lesions as the result of defective checkpoint mechanisms in cancer cells Owing to the role of topoisomerase I in the procession of the replication fork, topoisomerase I poisons ... 50–75% in the presence of liver dysfunction Daunorubicin is closely related to doxorubicin and was actually introduced first into leukemia treatment, where it remains part of curative regimens...

Ngày tải lên: 07/07/2014, 01:20

... particularly in the adjuvant treatment of breast cancer While chemotherapy-associated leukemia is generally of the acute myeloid type, APL arising in the setting of prior mitoxantrone treatment had the ... breakpoints of the translocation appeared to be at topoisomerase II sites that would be preferred sites of mitoxantrone action, clearly linking the action of the drug to the generation of the leukemia ... reflecting the action of a DNA damage checkpoint Prominent clinical effects include myelosuppression, nausea, and transient hypotension related to the speed of administration of the agent Etoposide...

Ngày tải lên: 07/07/2014, 01:20

... motile and secretory processes occur Microtubules are composed of repeating noncovalent multimers of a heterodimer of α and subunits of the protein tubulin Vincristine binds to the tubulin dimer ... infusions Leucovorin augments the activity of 5FU by promoting formation of the ternary covalent complex of 5FU, the reduced folate, and TS Less frequent toxicities include CNS dysfunction, with prominent ... formation of ara-CTP, resulting in S-phase–related toxicity Continuous infusion schedules allow maximal efficiency, with uptake maximal at 5–7 µM Ara-C can be administered intrathecally Adverse effects...

Ngày tải lên: 07/07/2014, 01:20

... adjuvant treatment of breast cancer in postmenopausal patients with estrogen receptor–positive tumors Letrozole treatment affords benefit following tamoxifen treatment Adverse effects of aromatase ... approximately the same degree of activity in primary hormonal treatment of breast cancers that have elevated expression of estrogen receptor protein Estrogen is not used often owing to prominent cardiovascular ... pharmacologic effect is a mirror or parody of the normal effects of the agent acting in nontransformed tissue, although the effects on tumors are mediated by indirect effects in some cases Glucocorticoids...

Ngày tải lên: 07/07/2014, 01:20

... notable response rates to withdrawal of tamoxifen itself or to subsequent addition of an aromatase inhibitor or progestin Likewise, initial treatment of prostate cancers with leuprolide plus flutamide ... understanding of cancer cell biology has suggested many new targets for cancer drug discovery and development These include the products of oncogenes and tumor-suppressor genes, regulators of cell ... for discovery of the candidate drug is the a priori importance of the target in the biology of the tumor, rather than the initial detection of drug candidates based on the phenomenon of tumor cell...

Ngày tải lên: 07/07/2014, 01:20

... degradation of the inhibitory subunit of the NFκB transcription factor by the proteosome Bortezomib inhibits this process and can prevent activation of NFκB-dependent genes, among other growth-related effects ... superior to interferon plus chemotherapy in the initial treatment of the chronic phase of this disorder It has lesser activity in the blast phase of CML, where the cells may have acquired additional ... is an inhibitor of the proteasome, the multi-subunit assembly of protease activities responsible for the selective degradation of proteins important in regulating activation of transcription...

Ngày tải lên: 07/07/2014, 01:20

... Complications of Cancer Chemotherapy Myelosuppression The common cytotoxic chemotherapeutic agents almost invariably affect bone marrow function Titration of this effect determines the MTD of the agent ... schedule The normal kinetics of blood cell turnover influence the sequence and sensitivity of each of the formed elements Polymorphonuclear leukocytes (PMNs; t1/2 = 6–8 h), platelets (t1/2 = 5–7 days), ... agents The nadir count of each cell type in response to classes of agents is characteristic Maximal neutropenia occurs 6–14 days after conventional doses of anthracyclines, antifolates, and antimetabolites...

Ngày tải lên: 07/07/2014, 01:20