Oncology and palliative care

Question 1

How do you treat spinal cord compression

Answer 1

ASAP! Dexomethasone, palliative radiothx. sometimes decompressive surgery.

Question 2

When does superior vena cava syndrome become an emergency?

Answer 2

causing obstruction with airway compromise. normally there is time to plan the right treatment

Question 3

Sx of SVC syndrome?

Answer 3

dyspnoea, orthopnoea, swollen face and arm, cough, headache and engorged veins.

Question 4

What is the prognosis for pts with malignancy-ass. hypercalcaemia (10-20% of pts and 40% of myeloma pts)

Answer 4

very poor. 75% pts dead within 3m of starting hypocalcaemic treatment

Question 5

Name 2 more oncological emergencies

Answer 5

Raised ICP, tumour lysis syndrome.

Question 6

Main principles of palliative care

Answer 6

VERY patient-centred - make them comfy
pain
nausea and vomiting - cyclyzine, metoclopramide, domperidone, ondensatron.
constipation - bisacodyl, glycerol suppository
breathlessness O2, morphine to dec. resp. drive
mouthcare
pruritus -cholestyramine, moisturiser..
venepuncture