Oncology Flashcards
what are adjuvant and neoadjuvant treatments?
neoadjuvant = before Tx e.g. neoadj. chemo shrinks tumour pre-surg
adjuvant = “alongside”
what 4 important categories/ topics should you cover in a chemo [or other] consent ?
- pros [benefits]
- cons [SEs/risks]
- logistics [what it involves]
- alternatives
why might cancer pt be hypoalbuminaemic
using proteins to make CA
liver not working [CA/mets] to make proteins
not eating well
what do low and high grade mean in tumour grading
low grade = well-differentiated [good prog]
high grade = poorly differentiated [bad prog]
why causes tumour lysis syndrome, what are the consequences, and what are some complications?
chemo for rapidly proliferating tumours [leukaemia, lymphoma, myeloma] leads to cell death
^urate, ^K+, ^phosphate, low calc
arhythmia, renal failure
Mx for tumour lysis syndrome
prevent w/ hydration
uricolytics [allopurinol]
give 4 examples of paraneoplastic syndromes
hypercalc siADH cushings neuropathy lambert-eaton myasthenic syndrome dermatomyositis/polymyositis acanthosis nigricans pemphigus hypertrophic osteoarthropathy
paraneoplastic hypercalc occurs when tumour secretes parathyroid hormone-related protein. Give some e.g.s of tumours
lung oesoph skin cervix breast kidney
cancers ass. w/ SIADH
prostate
lung
pancreas
lymphoma
what causes cushings to happen as a paraneoplastic syndrome
tumour secretes ACTH or CRF
SEs of radiotherapy
acute - inflammatory e.g. prostatitis [^urinary Sx]
chonic - scar tissue
secondary CA
Mx of spinal cord compression in CA
dex +PPI
neurosurg/ortho R/F
radio
Ix in spinal cord compression in CA
MRI whole spine
causes of SVC obstruction in oncology
lung CA most common lymphoma node node mets thymoma germ cell rarer: venous thrombosis
clinical features of SVC obstruction
oedema [face, arms] SOB, stridor plethora/cyanosis visual dist [papilloedema] engorged neck/chest wall veins cough headache
in a pt with known HF, how could you differentiate their HF from new SVC obstruction
JVP will be fixed raised in SVC ob
but pulsatile raised in hf
Mx of SVC obstruction in oncology
dex \+/- anticoag stent treat CA [radio/chemo] O2 if hypoxic
Ix for SVC obstruction
CT
Mx of paraneoplastic hypercal?
fluids
bisphos
(calcitonin [rapid])
treat underlying CA
what ways can CA patient have bleeding
thrombocytopenic from bone marrow dysfn. from CA or chemo Ca invades vessel liver mets = not making clotting factors tumour itself bleeds steroids-GI bleed
within what time period of recieving chemo should you suspect neutropenic sepsis in an unwell Pt
6 weeks
cancers most common for spinal cord comporession
breats prostate lung myeloma melanoma
what are the 2 ways in which cancer can cause spinal cord compression and whichj is more common?
direct invasion of CA [rarer]
collapse/compression of vertebra due to mets
most common cancers to metastasise to brain
lung
breast
colorectal
melanoma
signs and sx of brain mets
headache [worse in morning, coughing, bending] focal neuro signs ataxia fits nausea vomiting papilloedema
Mx of brain mets
dex to reduce cerebral oedema
radio
neurosurg
