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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
• a-FP (testis, HCC),
• ß-HCG (testis, trophoblastic neoplasia
• PSA
• CEA (colorectal, breast, lung),
• CEA125(ovary),
• CA199(pancreas),
• thyroglobulin (thyroid)
• Lactic dehydrogenase, LDH .

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a daganat-terápia alapjai

• Staging
• TMN staging (for solid tumors)
• T tumor size
• N node involvement
• M metastases
• Ex T2N1M0

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a daganat-terápia alapjai

• Modalities of Treatment
• Surgery
• Radiation
• Chemotherapy

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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

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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.

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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

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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

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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.