G1: Most variable period of cell cycle. Growth factors act here.

Radiation therapy:

  • M phase most sensitive

  • Most effective w/high O2 levels

  • Higher energy = less skin damage

  • Path: obliterative endarteritis; decrease healing due to impaired fibroblasts

Extremity Sarcoma biopsy:

  • Excisional if < 3cm, otherwise longitudinal incision
  • Incisional biopsy (less lymphatic disruption, easier to excise scar if biopsy positive).
  • Postop RT if high grade sarcoma, close margins or tumor > 5 cm


  • Generally spread hematogenously, not to lymphatics
  • Staging based on histological grade, not size/nodes

Li Fraumeni syndrome:

  • p53 Mutation
  • Sarcomas, breast CA, brain tumors, leukemia.

Colon CA: associated with:

  • Loss of tumor suppressor genes such as:
    • APC gene, p53, DCC (deleted in colon CA)
  • Or Activation of a proto-oncogene:
    • K-ras

Breast CA: associated with:

  • Loss of tumor suppressor genes such as:
    • p53, bcl-2, c-myc, c-myb, her-2-neu

c-myc: associated with:

  • Small cell lung CA
  • Neuroblastoma
  • Burkitt's lymphoma

Regulators of Apoptosis: Bcl-2 gene; p53 and c-myc

sis oncogene: is homologous to PDGF

erb B:

  • Codes for epidermal growth factor receptor
  • Associated with decrease survival in breast CA

K ras proto-oncogene: encodes for GTP protein

  • 90% of pancreatic CA
  • 50% of colon CA
  • Also in lung CA

Ret proto-oncogene:

  • Diagnostic for Medullary Thyroid Cancer
  • Patient with family history of MEN who has Ret proto-oncogene should have total thyroidectomy

Tamoxifen (binds Estrogen Receptor)

  • Shown to decrease breast CA in high risk patients
  • Increased Risk of DVT
  • Increased risk of endometrial CA

Bleomycin and Busulfan:

  • Both have pulmonary fibrosis as complication

Vincristine, Cisplatin: both cause neurotoxicity

Levamisole: immune-stimulant (is an antihelminthic agent)

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