12. Malignant tumors of the gastrointestinal tract (stomach, pancreas, colorectal cancer) - clinical picture, classification, staging and complex treatment.
Covers hormonal drug treatment of breast cancer, including oestrogen receptor blockers, aromatase inhibitors and typical sequencing schedules, then androgen deprivation therapy for prostate cancer with LHRH agonists and anti-androgens. Moves on to renal cancer, contrasting surgical and ablative options with first- and second-line targeted drugs, and ends with bladder cancer management by stage, from watchful waiting and intravesical BCG to cystectomy and cisplatin-based chemotherapy.
Inside: 2 sections · 15 flashcards · 2 min
Topic 45 of 50 in the MU Sofia syllabus for Nuclear Medicine (Medicine, Year 4). The free AceMed note covers it in 2 sections, about 272 words (2 min of reading), with 15 flashcards.
In this note
Drug treatment of hormone-dependent tumors - breast cancer, prostate cancer.
Approaches for treatment of common excretory system
Drug treatment of hormone-dependent tumors - breast cancer, prostate cancer.
Breast cancer
Some breast cancers are affected by hormones in the bloodstream. ER- and PR-positive breast cancer cells have estrogen receptors that trigger growth. Hormone therapy blocks these receptors to limit tumour growth
Examples: Tamoxifen (blocks estrogen receptors), Toremifene (used for metastatic tumours), Fulvestrant (blocks and damages estrogen receptors), Aromatase inhibitors (drugs that stop estrogen production, only work pre menopause examples include Letrozole, Anastrozole)
Common schedules:
Tamoxifen 2 years, followed by AI for 5 years
Tamoxifen 5 years, followed by AI for 5 years
Chemotherapeutics can also be used for adjuvant therapy
Prostate cancer
Also known as androgen deprivation therapy - goal is to reduce androgens which stimulate growth of prostate cancer (main androgens are testosterone and dihydrotestosterone).
Used in cases where surgery and radiation would not work due to spread, or as neo adjunctive therapy.
Examples: Luteinizing hormone-releasing hormone agonists (LHRH analogs) lower the amount of testosterone made by the testicals (e.g. Leuprolide, Goserelin). Anti androgens (block androgen receptors e.g. Flutamide, Bicalutamide)
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