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a daganat-terápia alapjai. Diagnosis Histopathology Tumor markers Cell surface markers (CD20, CD34…) Genetic markers (BRCA-1,Philadelphia chromosome) Tumor markers in the blood α-FP (testis, HCC), β-HCG (testis, trophoblastic neoplasia PSA CEA (colorectal, breast, lung),

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a daganat ter pia alapjai
a daganat-terápia alapjai
  • Diagnosis
    • Histopathology
    • Tumor markers
      • Cell surface markers (CD20, CD34…)
      • Genetic markers (BRCA-1,Philadelphia chromosome)
      • Tumor markers in the blood
        • α-FP (testis, HCC),
        • β-HCG (testis, trophoblastic neoplasia
        • PSA
        • CEA (colorectal, breast, lung),
        • CEA125(ovary),
        • CA199(pancreas),
        • thyroglobulin (thyroid)
        • Lactic dehydrogenase, LDH .
slide2

a daganat-terápia alapjai

  • Staging
    • TMN staging: (for solid tumors)
      • T: tumor size
      • N: node involvement
      • M: metastases
      • Ex: T2N1M0
a daganat ter pia alapjai1
a daganat-terápia alapjai
  • Modalities of Treatment
    • Surgery
    • Radiation
    • Chemotherapy
a daganat ter pia alapjai2
a daganat-terápia alapjai
  • Immunotherapy (melanoma, Bladder cancer, renal cell carcinoma)
      • BCG Vsaccine (local regional bladder cancer)
      • Monoclonal antibody
        • Trastuzumab
        • rituximab
  • Hormonal therapy (breast cancer, prostate cancer)
  • Drugs inducing differentiation
    • all-tans retinoic acid (ATRA)
  • Hematopoietic stem cell transplantation
a daganat ter pia alapjai3
a daganat-terápia alapjai
  • Criteria for Response
    • Cure: patient is entirely free of disease and has the same life expectancy.
    • Complete response (CR): complete disappearance of all cancer and no evidence of new disease for at least 1 month.
    • Partial response (PR) : 50% or greater decrease in the tumor size or other disease markers, and no evidence or any new disease for at least 1 month.
    • Stable disease: tumor size neither grows nor shrinks significantly.
    • Progression of disease: 25% increase in the tumor size or the development of and new lesions while receiving treatment.
a daganat ter pia alapjai4
a daganat-terápia alapjai
  • Management of treatment-related toxicity
    • Infections
    • Hematological reactions
    • Nausea and vomiting
    • Oral complications
    • Pulmonary complications
    • Cardiac toxicities
    • Gonadal dysfunction
    • Second cancers
    • Neurotoxicity
    • Nephrotoxicity
    • Hepatotoxiity
paraneoplastic syndrome
Paraneoplastic syndrome
  • Chronic adrenocortical insufficiency
    • Adrenal, lymphoma
  • Dermatomyositis and polymyositis
    • Lung, stomach, ovary
  • Hypercalcemia:
    • Lung, breast, prostate
  • DIC : Acute promyelocytic leukemia
  • SIADH: Lung, esp. SCLC
  • Thrombophlebitis:
    • lung, breast, ovary, Prostate
summary
Summary
  • Cancer is not a single disease entity.
  • Cancer biology is the most important aspect in treating or preventing cancers
  • Chemotherapy pharmacy service or oncology pharmacy service
  • Know the general concepts of cancers, focus on the drug-related problems.
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