Metastatic Cancer – Flashcards
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What is angeogenesis
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The development of new blood vessels
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Role of angeogenesis and metastasis (cancer moving to new places in the body)
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wound healing causes new vessels to form to help the wound... can actually aid in causing metastasis
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Prostate Cancer spreads to what organs, most common to least common
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Bone Marrow Liver Brain Lungs BLBL
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Breast cancer spreads to what organs, most common to least common
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Bone Lungs Liver Brain
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Colon cancer spreads to what organ, most common to least common
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Liver (mainly) lungs=bone
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Pancreas cancer spreads to what organs, most common to least common
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Liver (mainly) Lungs
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Which type of Capillary would likely involve metastasis
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Sinusoidal capillaries
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Bevacizumab (Avastin) used mainly for what? not used for what
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mainly used for Colon Cancer not used for breast cancer
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How does Avastin work?
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inhibits VEGF
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what does VEGF do
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causes angeogenisis
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Black box warning of Avastin
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Gastrointestinal Perforations Surgery and would healing problems hemorrhage
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Major side effect of Avastin?
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Hypertension in 35% of patients 20% of those are stage 3 or 4 hypertension
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What to do Stage 3 Thromboembolic event?
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withhold avastin for 2 weeks
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When to start Avastin back?
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once anti-coagulants given and patient is stable
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When to permanently discontinue Avastin?
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Stage 4 event
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how many days after surgery to start Avastin?
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28 days (4 weeks)
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Avastin should not be administered within ___ days of a catheter
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7
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What is the most common cancer world wide?
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liver cancer
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What is the most common cause of liver cancer
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Hep B or Hep C
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What is the standard treatment for HCC
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there is not one treatment shows little survival rate
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Where do HCC patients receive their blood from to the liver?
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Hepatic Artery
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what is PIAF
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Doxorubicin Cisplatin Inteferon 5 FU
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how does Sorafenib work?
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oral multikinase inhibitor
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Sorafenib has ____ targets
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multiple
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having multiple targets allows it to
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reduce proliferation and angeogenesis
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how long did Sorafenib increase survival?
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3 months
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what is the new reference standard for HCC?
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Sorafenib
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Side effects of Avastin (Bev)
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Hypertension ProteinUria Gastrointestinal perforations increased risk of myocardial infarction increase risk of thromboembolic events BLEEDING FROM THE NOSE dizziness and depression
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Sorafenib Side Effects
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decrease levels of phosphate Diarrhea and nausea fatigue wound healing problems hypertension skin rash HAND FOOT REACTION
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___ patients may need decreased dose of Sorafenib
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Asian
