Final Exam: Chemotherapy Concepts
What is the ultimate goal of oncological treatments? - Answer Kill every cancer cell and
produce a cure
If a cancer cannot be cured, what are the alternative goals? - Answer -control growth
-offer palliation
Why is the cell cycle important to the discussion of chemotherapy? - Answer Some
anticancer drugs only work in specific parts of the cell cycle.
What is the proliferation rate of cancer cells early in the disease process compared to
late? - Answer Early
-more cancer cells are in the active phase, in other words there is a high growth fraction
Late
-as they grow and age, more cells go into the rest phase.
Which phase is the rest phase of the cell cycle? - Answer G0
What is the growth fraction? - Answer The ratio of proliferating cells to cells at rest.
What is an example of a high growth fraction? - Answer 3:1
Means there are more cells actively dividing
What does it mean when there is a low growth fraction? - Answer There are more cells
at rest
With which growth fraction does chemotherapy work best? - Answer High growth
fractions, because they are able to target the growth cycle.
A patient that has been recently diagnosed with stage IV metastatic melanoma. The
treatment team rounded this morning to explain the diagnosis. Following their visit, the
patient is very distraught because of the difficulty associated with late stage, aggressive
cancer. What specific part of the pathophysiology of cancer - Answer
Why is cancer harder to treat as it progresses? - Answer Over time, more cells go into
G0, the drugs are less effective, and many times there are necrotic cores, which
prevents the treatment from accessing the site
As tumors increase in size, the rate of proliferation ___________ - Answer decreases
What are characteristics of large tumors? - Answer -have a necrotic core
-decreased nutrient supply at core
, -more cells in resting phase, so more time to recover
-**hard to treat**
What are the barriers to successfully treating cancer? - Answer -100% kill required
-chemotherapy is the most toxic drug group
-late detection presents a myriad of problems (necrotic core, more G0)
-cancer cells continuously mutate
-the mutated cells add drug resistance to the table
-cell heterogenicity
Why does the need for a 100% kill rate present a barrier to success? - Answer It only
takes one cell to survive to continue the cancer
How do toxic effects of chemotherapy present a barrier to success? - Answer Chemo =
Most Toxic Drug Group
-so sometimes patients can't tolerate sustained high doses
How does chemotherapy have to be dosed throughout treatment? - Answer Must use
the same dose throughout treatment for a 100% kill
--however, much of the time, the patient cannot tolerate the dose, so they have to back
off on the dose.
Why do cancer treatments have to be the same dose? - Answer Variable doses are not
as effective at 100% killing the cancer cells.
You cannot kill the _______ to cure the ______ - Answer patient; cancer
What are the consequences of late detection? - Answer -metastasis
-less responsive d/t mutation
-patient is more debilitated by the disease so they cannot treatment
Why do solid tumors respond poorly to treatment? - Answer -low growth fraction
-limited blood supply
What is drug resistance? - Answer -cancer cells mutate constantly
-natural selection allows the most drug-resistant mutants to flourish
What is heterogeneity? - Answer The ongoing mutations of the cancer cells means that
despite having one tumor, the cells within may differ greatly from each other.
These mutations only increase as the tumor ages.
What are the strategies for successful chemotherapy? - Answer -intermittent chemo
-combo therapy
-optimal dosing
-regional therapy
What is the ultimate goal of oncological treatments? - Answer Kill every cancer cell and
produce a cure
If a cancer cannot be cured, what are the alternative goals? - Answer -control growth
-offer palliation
Why is the cell cycle important to the discussion of chemotherapy? - Answer Some
anticancer drugs only work in specific parts of the cell cycle.
What is the proliferation rate of cancer cells early in the disease process compared to
late? - Answer Early
-more cancer cells are in the active phase, in other words there is a high growth fraction
Late
-as they grow and age, more cells go into the rest phase.
Which phase is the rest phase of the cell cycle? - Answer G0
What is the growth fraction? - Answer The ratio of proliferating cells to cells at rest.
What is an example of a high growth fraction? - Answer 3:1
Means there are more cells actively dividing
What does it mean when there is a low growth fraction? - Answer There are more cells
at rest
With which growth fraction does chemotherapy work best? - Answer High growth
fractions, because they are able to target the growth cycle.
A patient that has been recently diagnosed with stage IV metastatic melanoma. The
treatment team rounded this morning to explain the diagnosis. Following their visit, the
patient is very distraught because of the difficulty associated with late stage, aggressive
cancer. What specific part of the pathophysiology of cancer - Answer
Why is cancer harder to treat as it progresses? - Answer Over time, more cells go into
G0, the drugs are less effective, and many times there are necrotic cores, which
prevents the treatment from accessing the site
As tumors increase in size, the rate of proliferation ___________ - Answer decreases
What are characteristics of large tumors? - Answer -have a necrotic core
-decreased nutrient supply at core
, -more cells in resting phase, so more time to recover
-**hard to treat**
What are the barriers to successfully treating cancer? - Answer -100% kill required
-chemotherapy is the most toxic drug group
-late detection presents a myriad of problems (necrotic core, more G0)
-cancer cells continuously mutate
-the mutated cells add drug resistance to the table
-cell heterogenicity
Why does the need for a 100% kill rate present a barrier to success? - Answer It only
takes one cell to survive to continue the cancer
How do toxic effects of chemotherapy present a barrier to success? - Answer Chemo =
Most Toxic Drug Group
-so sometimes patients can't tolerate sustained high doses
How does chemotherapy have to be dosed throughout treatment? - Answer Must use
the same dose throughout treatment for a 100% kill
--however, much of the time, the patient cannot tolerate the dose, so they have to back
off on the dose.
Why do cancer treatments have to be the same dose? - Answer Variable doses are not
as effective at 100% killing the cancer cells.
You cannot kill the _______ to cure the ______ - Answer patient; cancer
What are the consequences of late detection? - Answer -metastasis
-less responsive d/t mutation
-patient is more debilitated by the disease so they cannot treatment
Why do solid tumors respond poorly to treatment? - Answer -low growth fraction
-limited blood supply
What is drug resistance? - Answer -cancer cells mutate constantly
-natural selection allows the most drug-resistant mutants to flourish
What is heterogeneity? - Answer The ongoing mutations of the cancer cells means that
despite having one tumor, the cells within may differ greatly from each other.
These mutations only increase as the tumor ages.
What are the strategies for successful chemotherapy? - Answer -intermittent chemo
-combo therapy
-optimal dosing
-regional therapy
