Oncology Flashcards
Presentation of lung cancer
SVC obstruction
CXR
History of asbestos exposure and recent chest pain/SOB
Unexplained systemic symptoms with suspicious CXR
Presentation of upper GI cancer
Dyspepsia Chronic GI bleeding Dysphagia Weight loss Persistent vomiting Anaemia Epigastric mass Suspicious barium meal result Obstructive jaundice Isolated dysphagia Unexplained abdominal pain
Presentation of lower GI cancer
>40 yrs PR bleeding Bowel habit change Right lower abdominal mass Palpable rectal mass Unexplained iron deficiency anaemia
Presentation of breast cancer
Discrete hard lump with fixation
Nipple changes unresponsive to treatment
Spontaneous bloody unilateral nipple discharge
Nipple inversion
Presentation of gynae cancer
Exam suggestive of cervical cancer
Post-menopausal bleeding
Vulval lump or bleeding
Presentation of urological cancer
Hard irregular prostate Raised PSH and urinary symptoms Painless macroscopic haematuria Abdominal/testicular mass Ulceration or mass in penis
Presentation of CNS cancer
New onset CN palsy or unilateral sensorineural deafness
New onset headaches with signs of raised ICP
New and unexplained headache of progressive severity
Recent-onset seizures
Rapid progression of subacute focal deficit
Unexplained cognitive impairment or personality change with features indicative of tumour
Treatment approaches to cancer
intent, growth pattern, assessment
Intent:
Curative, palliative, radical, adjuvant, neoadjuvant, primary medical therapy, symptom control
Growth pattern:
Detectable tumours
Assessment:
Overall survival, disease-free survival, progression free survival, clinical benefit response, response rate
Modalities of cancer treatment
Physical: Surgery Radiotherapy Chemotherapy Immunotherapy
Physiology: Support Counselling Relaxation therapy CBT Group therapy
Surgical oncology
Surgical clearance and cure (clear margins)
Accurate diagnosis and grade
Accurate stage and prognosis (TNM)
Palliative surgeries
Radiation oncology
Direct/indirect DNA damage
External beam radiotherapy - can be focused on tumour so surrounding tissue receives lower dose
Side effects of radiotherapy
Acute
Epithelial damage (skin, mouth, pharynx and bowel mucosa - soreness, diarrhoea and nausea)
Oedema and erythema (steroids to reduce swelling)
Infertility (gonads susceptible to radiation)
Fibrosis and skin problems (inflammation, desquamousation, hyper-pigmentation, pruritis)
Hair loss
Dryness (mouth and eyes)
Foetal damage
Infection (due to immunocompromise)
Chemotherapy oncology
Inhibits cell division, non-selectively kill rapidly growing cells
Factors affecting chemotherapy efficacy
Rate of division of cancer
Number of cells actively dividing
Tumour size
Development of resistance
Side effects of chemotherapy
GI disturbance (N&V, diarrhoea, constipation) Alopecia Bone marrow suppression (anaemia, neutropenia, thrombocytopenia) Mucositis Peripheral sensory neuropathy Nephrotoxicity Infertility Cardiotoxicity Pulmonary fibrosis Secondary malignancies
