Cancer Management And Patient Care Flashcards
Signs and symptoms of breast cancer?
Breast and axilla lump
- change in breast shape or size
- skin change
- nipple change-inverted or discharge
What is fungation?
Necrosis of the tissue
Ulcer open wound
What is peaud orange?
Pickering of the skin very much looks like orange skin
Patient setup for breast ?
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
Why do we want to reduce folds in breast?
To reduce skin irritation
If subclav field is used do you need to check skin folds?
Yes
Prone equipment?
Slings
Breast boards
Critical structures of the breast?
Heart Lung Contralateral breast Spinal cord Depending on field arrangement for SCF
What are the staging of skin irritation to the breast?
1-erythema
2-dry desquamation
3-moist desquamation
4-exfoliative dermatitis
What is desquamation?
Shedding of skin
Side effects breast (acute)
Erythema
Desquamation
What is the common breast fractionation?
50gy in 25 but with an extra 10 gym in 5 fraction to the surgical site
Late changes of breast?
Fibrosis
Telangiectasia-dilation of capillaries of face
Breast shrinkage
What are acute changes?
What are late changes?
During treatment
Well after treatment
What is a skin reaction?
Side effect of radiation
Patient care treatment?
Avoid abrasion to skin Use soap alternative Wear loose garments Gentle arm exercises started after surgery Aqueous cream use frequently
What is better meplilex film or aqueous cream?
Depends but mepilex
What is palliative care?
Quality rather quantity of care
Symptomatic relief
Reduce tissue size
Restore normal function
Palliative examples?
SVC obstruction
Spinal cord compression
Osteoltytic bone metastasis
Brain metastases
Symptoms and treatment of spinal cord compression?
Pain in local area to another location Motor deficits, sensory deficits Autonomic dysfunctions Surgical interventions Beware of other psychosocial needs and dignity
Palliative spinal cord dose compression
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
Hyperfraction doses?
For pain relief
Side effects of spinal cord compression?
Nausea Cramping Diahhroea Erythema Flatulence Fatigue
Management for palliative treatment?
Stable and reproducible positions pillows, soft tops and foam wedges
Field size larger for movement and margin greater for PTV
Prostate management?
Biopsy TRUS biopsy Increased urinary obstruction Elevated PSA Sacral, sciatic and perineal pain
Clinical management treatments
Watchful waiting Surgery Hormone therapy- testosterone and androgen Ultrasound Cryotherapy Radiation therapy
Prostate preparation?
Bladder and bowel preparation
Empty bowel full bladder 500-600 ml
Radiation induced procitis?
Talengictasia of rectum
Two types of surgery for prostate?
Radical retro pubic prostatectomy
Robotic surgery
Potency rates of 80% can survive
