Cancer Management And Patient Care

Question 1

Signs and symptoms of breast cancer?

Answer 1

Breast and axilla lump

• change in breast shape or size
• skin change
• nipple change-inverted or discharge

Question 2

What is fungation?

Answer 2

Necrosis of the tissue

Ulcer open wound

Question 3

What is peaud orange?

Answer 3

Pickering of the skin very much looks like orange skin

Question 4

Patient setup for breast ?

Answer 4

Stable comfortable
Reproducible
Most common - supine in immobilisation devices-breast board
Arms outside beam-reduces cardiac dose
Sternum horizontal-reduce lung tissue
Reduce folds in breast

Question 5

Why do we want to reduce folds in breast?

Answer 5

To reduce skin irritation

Question 6

If subclav field is used do you need to check skin folds?

Answer 6

Yes

Question 7

Prone equipment?

Answer 7

Slings

Breast boards

Question 8

Critical structures of the breast?

Answer 8

Heart
Lung
Contralateral breast
Spinal cord
Depending on field arrangement for SCF

Question 9

What are the staging of skin irritation to the breast?

Answer 9

1-erythema
2-dry desquamation
3-moist desquamation
4-exfoliative dermatitis

Question 10

What is desquamation?

Answer 10

Shedding of skin

Question 11

Side effects breast (acute)

Answer 11

Erythema

Desquamation

Question 12

What is the common breast fractionation?

Answer 12

50gy in 25 but with an extra 10 gym in 5 fraction to the surgical site

Question 13

Late changes of breast?

Answer 13

Fibrosis
Telangiectasia-dilation of capillaries of face
Breast shrinkage

Question 14

What are acute changes?

What are late changes?

Answer 14

During treatment

Well after treatment

Question 15

What is a skin reaction?

Answer 15

Side effect of radiation

Question 16

Patient care treatment?

Answer 16

Avoid abrasion to skin
Use soap alternative
Wear loose garments
Gentle arm exercises started after surgery
Aqueous cream use frequently

Question 17

What is better meplilex film or aqueous cream?

Answer 17

Depends but mepilex

Question 18

What is palliative care?

Answer 18

Quality rather quantity of care
Symptomatic relief
Reduce tissue size
Restore normal function

Question 19

Palliative examples?

Answer 19

SVC obstruction
Spinal cord compression
Osteoltytic bone metastasis
Brain metastases

Question 20

Symptoms and treatment of spinal cord compression?

Answer 20

Pain in local area to another location
Motor deficits, sensory deficits
Autonomic dysfunctions
Surgical interventions 
Beware of other psychosocial needs and dignity

Question 21

Palliative spinal cord dose compression

Answer 21

8gy in 1 fraction- emergency situation
12 gy in 2 fraction a week apart
20gy in 5 given in one week
30gy in 10 given in 2 weeks

Question 22

Hyperfraction doses?

Answer 22

For pain relief

Question 23

Side effects of spinal cord compression?

Answer 23

Nausea
Cramping
Diahhroea
Erythema
Flatulence
Fatigue

Question 24

Management for palliative treatment?

Answer 24

Stable and reproducible positions pillows, soft tops and foam wedges
Field size larger for movement and margin greater for PTV

Question 25

Prostate management?

Answer 25

Biopsy
TRUS biopsy
Increased urinary obstruction
Elevated PSA
Sacral, sciatic and perineal pain

Question 26

Clinical management treatments

Answer 26

Watchful waiting
Surgery
Hormone therapy- testosterone and androgen
Ultrasound
Cryotherapy
Radiation therapy

Question 27

Prostate preparation?

Answer 27

Bladder and bowel preparation

Empty bowel full bladder 500-600 ml

Question 28

Radiation induced procitis?

Answer 28

Talengictasia of rectum

Question 29

Two types of surgery for prostate?

Answer 29

Radical retro pubic prostatectomy
Robotic surgery
Potency rates of 80% can survive