Oncology Flashcards
Colonic cancer staging
Colonic cancers are staged with CT scanning of the chest, abdomen and pelvis.
Rectal cancer staging
MRI of rectum and CT of chest, abd and pelvis.
Goldstandard for Colorectal Ca
Colonoscopy is the gold standard,
What is NHS BOSS flexible sigmoidoscopy screening?
The NHS BOSS flexible sigmoidoscopy screening comprises a single flexible sigmoidoscopy to patients aged 55 years
what signs warrant a referral for rectal ca
Essentially the following patients need referral:
- Altered bowel habit for more than six weeks
- New onset of rectal bleeding
- Symptoms of tenesmus
Tumor marker for Colorectal Ca
Carcinoembryonic antigen (CEA) is the main tumour marker in colorectal cancer.
Most hypervascular metastatic cancer
Renal metastases have a tendency to be hypervascular.
TUmours that spread to bone
The typical tumours that spread to bone include:BBRTP
Breast
Bronchus
Renal
Thyroid
Prostate
What is Mirel scoring system
Mirel Scoring system for fracture
Score pointsSiteRadiographic appearanceWidth of bone involvedPain1Upper extremityBlasticLess than 1/3Mild2Lower extremityMixed1/3 to 2/3Moderate3PeritrochantericLyticMore than 2/3Aggravated by function
chemotherapy in breast Ca
Patients with grade 3 lesions or axillary nodal disease
*To downsize the tumor
Endocrine therapy in Breast Ca
*Postmenopausal :Aromatase inhibitor like letrozole.
*Perimenopausal:Tamoxifen for 3years then switchto letrozOlle
*Premenopausal: Exemestane over tamoxifen.
Chemotherapy for Breast Ca
FEC regime is most commonly used (Fluorouracil, epirubicin and cyclophosphamide).
Raised CEA levels in non malignant situations
Cirrhosis
IBS(Thus not used for screening of Ca in colitis patients)
Diseases which require Colorectal Ca screening
*Familial adenomatous polyposis
*Hereditary non polyposis colorectal cancer
* Peutz Jegher Syndrome
*Acromegaly
*IBD
*Ureteosigmoidostomy
Most common osteolytic bone metastatic in children
Neuroblastoma
site of Bone# in Ca
The commonest bone sites affected are:
Vertebrae (usually thoracic)
Proximal femur
Ribs
Sternum
Pelvis
Skull
What to do in doxorubicin extravasation
cold compresses is indicated in doxorubicin extravasation
Hyaluronidase is indicated in the extravasation of???
Hyaluronidase is indicated in the extravasation of
contrast media
TPN
vinca alkaloid
FNAC can’t diagnose which thyroid tomer
Follicular Tumor
Mainside effect of arthracyclines(doxorubicin)
Cardiotoxicity
Breast ca drugs
Class. Example. Mode of action
Antimetabolites. 5 FU. S Phase specific drug, mimics uracil and is incorporated into RNA
Anthracyclines.* Doxorubicin. Inhibits DNA and RNA synthesis by intercalating base pairs
Topoisomerase inhibitors.** Etoposide. Inhibits topoisomerase II, prevents efficient DNA coiling
Platinum. Cisplatin. Crosslinks DNA, this then distorts molecule and induces apoptosis (similar to alkylating agents)
Alkylating agent. Cyclophosphamide. Phosphoramide mustard forms DNA crosslinks and then cell death
Taxanes. Docetaxal. Disrupts microtubule formation
Drugs for pain in CKD patient
Alfentanil, buprenorphine and fentanyl are preferred
Contraindication to Iung cancer excision
Assess general health
Stage IIIb or IV (i.e. metastases present)
FEV1 < 1.5 litres is considered a general cut-off point
Malignant pleural effusion
Tumour near hilum
Vocal cord paralysis
SVC obstruction
Criteria of adrenalectomy
if the tumor is producing excess hormones or is large in size (more than 2 inches or 4 to 5 centimeters).
