Palliative Care Flashcards
Tumour marker: Ca15-3
breast
Tumour marker: Ca125
ovarian
Tumour marker: CEA
colorectal (and breast, lung)
Tumour marker: Ca19-9
pancreatic
Tumour marker: beta-hCG
testicular, gestational trophoblastic (molar pregnancy)
Tumour marker: LDH
leukaemia, myeloma, lymphoma, testicular and female germ cell tumours, melanoma
Tumour marker: AFP
testicular and female germ cell tumours, hepatocellular carcinoma
Abx for Neutropenic sepsis
Tazocin (piperacillin/tazobactam)
When does neutropenic sepsis present?
within 6wks of chemotherapy, classically 7-10 days after chemo
Mx of spinal cord compression
- 16mg dexamethasone STAT (and continue regular dex) + PPI cover
- MRI whole spine within 24h
- analgesia
- urgent Mx with radiotherapy or surgery within 24h of MRI
Mx of SVC obstruction
- prop up
- give oxygen if hypoxic
- 16mg dexamethasone stat (+ tapering regular dose)
- chemotherapy or radiotherapy
- rapid Sx relief: balloon venoplasty and SVC stentint
- anticoagulation
Mx of hypercalcaemia
- IV rehydration
- IV bisphosphonates (e.g. pamidronate, zolendronic acid)
Mx of brain mets
- urgent CT/MRI if needed
- 16mg dexamethasone to reduce cerebral oedema
- radiotherapy
- discuss with neurosurgery
What is tumour lysis syndrome?
occurs with chemotherapy for rapidly proliferative tumours (e.g. leukaemia, lymphoma, myeloma) when a large number of cells die, causing:
high urate, potassium and phosphate, and low calcium
risk of arrythmia and renal failure
Mx of tumour lysis syndrome
prevent with hydration and uricolytics e.g. rasburicase, allopurinol