Oncology Flashcards
Management of stages of NSCLC
Stage I and II - surgical resection
Stage II and III - adjuvant chemotherapy following resection
Stage III and IV - chemoradiotherapy if non-resectable
Adverse effects - tamoxifen in breast cancer
Hot flushes
Thromboembolism
Endometrial cancer
Adverse effects - aromatase inhibitors (eg. letrozole) in breast cancer
Osteoporosis and bone loss
Arthralgia
(Use in post-menopausal women only)
Colorectal cancer - NHMRC screening guidelines for average risk
No history or family history of cancer OR 1 1st/2nd degree relative diagnosed age 55 or older
- FOBT 2 yearly for over age 50
- Sigmoidoscopy 5 yearly over age 50
Colorectal cancer - NHMRC screening guidelines for moderate risk
2 1st degree relatives OR 1st degree relative diagnosed less than age 50
- Colonoscopy 5 yearly from age 50 or 10 years prior to family member diagnosis age
- Flexi-sigmoidoscopy and barium enema, if unable to do colonoscopy
Colorectal cancer - NHMRC screening guidelines for high risk
Confirmed FAP - Sigmoidoscopy yearly from age 15 til development of polyposis
HNPCC - Colonoscopy 1-2 yearly from age 25 or 5 years prior to family member diagnosis age
Hereditary non-polyposis colon cancer (HNPCC) - clinical features
Age less than 50 Proximal (Right sided colon predominantly) Microsatellite instability Poorly differentiated Mucinous Lymphocytic infiltrate
Extravasation injury - vesicants (potential to cause tissue necrosis)
Anthracyclines (eg. doxorubicin - most significant) Vinca alkaloids (eg. vincristine)
Extravasation injury - irritants (inflammatory reaction at site)
Platinum analogues (eg. cisplatin) Taxanes (eg. paclitaxel)
Cancer associated with Streptococcus bovis
Colorectal cancer
Chemotherapy adverse effects - cardiotoxicity
Anthracycline (doxorubicin)
- arrhythmias, myocardial necrosis, vaso-occlusion or vasospasm - dose dependent, reversible on cessation
- cardiac failure - dose dependent, irreversible
5-Fluorouracil
- coronary vasospasm
Chemotherapy adverse effects - neuropathy
Vincristine Oxaliplatin Taxol Cisplatin/carboplatin Bortezomib TNF alpha blockers
Chemotherapy adverse effects - infertility
Permanent
- Cyclophosphamide
Reversible
- Doxorubicin
- 5-fluorouracil
- Taxanes
Tumour markers - AFP
Nonseminomatous germ cell tumour
Hepatocellular carcinoma
Tumour markers - B-HCG
Testicular germ cell tumour (elevation more than 10000 IU/L)
Tumour markers - Ca 15-3
Breast cancer (metastatic)
Tumour markers - Ca 19-9
Pancreatic cancer
Gall bladder cancer
Cholangiocarcinoma
Tumour markers - Ca 125
Ovarian cancer
Endometrial cancer
Tumour markers - CEA
Colorectal cancer
Breast cancer (metastatic)
Smoking
Paraneoplastic antibodies - anti-Hu
ANNA-1, anti neuronal nuclear Ab
- SCLC
Encephalomyelitis, cerebellar degeneration, sensory neuropathy, autonomic dysfunction
Paraneoplastic antibodies - anti-Yo
PCA-1, Purkinje cell Ab
- Ovarian
- Breast
(Cerebellar degeneration)
Paraneoplastic antibodies - anti-Ri
ANNA-2, anti neuronal nuclear Ab 2
- Breast
- Ovarian
- SCLC
(Cerebellar degeneration, myoclonus, brainstem encephalitis)
Paraneoplastic antibodies - anti-Tr
- Hodgkin lymphoma
Cerebellar degeneration
Multiple endocrine neoplasia 1 (MEN1) - presentation
Parathyroid tumours
Pituitary adenomas
Pancreatic islet cell tumours
(“3 Ps”, due to MEN1 gene)
Multiple endocrine neoplasia 2 (MEN2) - presentation
Medullary thyroid carcinoma
Phaeochromocytoma
- MEN2A - w/ primary hyperparathyroidism
- MEN2B - w/ mucosal neuroma, intestinal ganglioneuroma, Marfanoid
(due to RET gene)
