Oncology Flashcards
Which oncological emergency is associated with 5% of lung cancers?
SVCO
What are the symptoms of SVCO?
face swelling arm swelling (both if proximal obstruction) SOB headache fatigue injected conjunctiva visual disturbance distended veins
What is the most common cause of SVCO?
SCLC
Management of SVCO
general: dexamethasone, balloon venoplasty, stenting
small cell: chemotherapy + radiotherapy
non-small cell: radiotherapy
Symptoms of spinal compression
radicular pain (worse on lying down or coughing) constipation faecal incontinence weakness sensory changes
Immediate investigation of spinal cord compression
Urgent MRI
Management of spinal compression
high-dose oral dexamethasone
urgent oncological assessment for consideration of radiotherapy or surgery
Treatment of chemotherapy induced nausea and vomiting
Low risk - metclopramide
High risk - ondansetron (5HT3 blocker) + dexamethasone
What is tumour lysis syndrome?
TLS occurs from the breakdown of the tumour cells and the subsequent release of chemicals from the cell. It leads to a high potassium and high phosphate level in the presence of a low calcium. It should be suspected in any patient presenting with an acute kidney injury in the presence of a high phosphate and high uric acid level.
What should be given prior to chemotherapy to avoid tumour lysis syndrome?
high risk: IV allopurinol or IV rasburicase
low risk: oral allopurinol during chemotherapy cycles
treatment: IV rasburicase
note: do not give allopurinol with rasburicase
Example of 5HT3 antagonist
Ondansetron
CA19-9
Pancreatic Cancer
CA125
Ovarian Cancer
CA15-3
Breast Cancer
CEA
Colorectal Carcinoma
