A daganat ter pia alapjai
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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 .


A daganat ter pia alapjai

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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