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CHEMOTHERAPY

Group 8
DEFINITION:

Chemotherapy “chemical" and "treatment."


• The treatment of cancer using specific chemical agents or
drugs that are destructive to malignant cells and tissues.
• Treatment to stop the growth of cancer cells, either by killing
the cells or by
stopping them from dividing (NCI)

Cytotoxic
‘toxic to cells’
GOAL OF CHEMOTHERAPY

1) Cure : eradication
2) Control: stop the growing and spreading
3) Palliation:
when cure and control are not possible
 - relieve symptoms caused by cancer
- improve QoL
GOAL OF CHEMOTHERAPY

 Must be realistic
 The primary focus of chemo :
preventing cancer cells from multiplying,
invading adjacent tissue or developing metastasis.
 Objective of chemo :
Destroy all malignant cells without excessive
destruction of normal cells
POTENTIAL PATIENT RESPON

 Complete response (CR)


complete disappearance of the disease.

 Partial response (PR)


decrease in size or number of the lesions by 30% or more.

 Stable disease (SD)


disease has unchanged in size and number of lesions.
Generally, a less than 50% decrease or a slight increase in s
ize would be described as stable disease.

 Progressive disease (PD)


Disease has increased in size or number on treatment.
CANCER CELLS AND NORMAL CELLS

CANCER CELLS NORMAL CELLS


Frequent
mitoses

Normal
cell

Nucleus
Few
mitoses
Blood vessel

Abnormal
heterogeneous cells

Loss of contact inhibition Oncogene expression is rare


Increase in growth factor secretion Intermittent or coordinated
Increase in oncogene expression growth factor secretion

Loss of tumor suppressor genes Presence of tumor suppressor


genes 10
NORMAL CELL CHARACTERISTICS:

 Metabolism. Strictly controlled &


predictable
 Maturation & Differentiation Strictly
controlled.
 Reproduction = Cell death
 Contact Inhibition. Mechanism for
switching off division when in contact
with different cells
 Recognition
CANCER CELL CHARACTERISTICS:

 Unchecked & Uncontrolled Growth


 Loss of contact inhibition
 Loss of capacity to differentiate
 Increased growth fraction
 Chromosomal Instability
 Capacity to metastasise
 Altered biochemical properties
• Clone of cells overgrows due to
accumulation of mutations controlling
proliferation.
• Disseminates through bloodstream to
other parts of body
• Forms tumor
TYPES OF CHEMOTHERAPY

• Cell cycle dependent


– Cell cycle phase specific

• Cell cycle independent


– Cell cycle phase non-specific

23
CHEMOTHERAPY AND CANCER CELLS

Cell Cycle specific :


Most active against cells in a specific
phase therefore need prolonged exposure
or repeated doses.

Cell Cycle Non-specific:


Most effective against actively dividing
cells but also effective in G0.
CLASSIFICATION OF
CHEMOTHERAPEUTIC
AGENTS

25
1. Toxic  limited dose
2. Likely to Resistance
3. 1 cycle of treatment  kills < 99,9 %
cancel cells

 Combination
 Repeated Cycle of treatment
Combination of Chemotherapy

 To get synergistic effect


 To minimalize side effect
 To kill cancer cell in any
different steps of cycle cell
 To delay the onset of drug
resistant