Blue Book: Approach to cancer patient Flashcards
Presenting complaints: The 4 main categories are
- Lumps
- Bleeding
- Pain
- Change in function.
Give examples of each
Lumps: Breast lump, change in moles, node/nodules and musculoskeletal lumps
Bleeding: haemoptysis, rectal bleeding, haematuria, post-menstrual or intermittent bleeding.
Pain: chest or abdominal pain
Change in function: change in bowel habit, new cough, dyspnoea, weight loss, fever, acute confusional state.
What technique is used to diagnose the mass?
Biopsy and histological assessment.
What modern staging system is used to grade cancer?
TNM: Tumour, Node, Metastasis
Staging is based on the TNM score.
Explain the T.
Tx: Primary Tumour cannot be assessed.
T0: No evidence of primary tumour
Tis Carcinoma in situ
T1, T2, T3, T4: increasing size and or local extent of primary tumour.
Explain the N.
NX: Regional lymph nodes cannot be assessed.
NO: No regional lymph node metastasis
N1, N2, N3 increasing involvement of regional lymph node.s
Explain the M
MX presence of distant metastasis cannot be assessed.
M0 No distant metastasis
M1 Distant metastasis
What is a grade?
A grade is the extent the tumour resembles normal tissue or has a bizarre appearance.
Explain GX G1 G2 G3
GX: Grade of differentiation cannot be assessed.
G1: Well differentiated: similarities remain to normal tissue of the organ.
G2: Moderately differentiated
G3: Poorly differentiated: Bizarre cells.
High grades have a higher risk of what?
Recurrence locally
High stage
Development of secondaries
Lymph node metastases is a powerful indicator of what?
Systematic blood borne metastases.
Staging is important in determining cancer treatment.
In breast cancer/colorectal cancer if the cancer has spread to the lymph nodes, which type of chemotherapy will be used? Why?
Adjuvant chemotherapy.
High risk of distant metastases.
