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Flashcards in Cancer care Deck (79)
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1

S&S of small cell lung

S&S:
• Central
• ADH secretion --> Hyponatremia
• ACTH secretion --> Cushings syndrome:
○ bilateral adrenal hyperplasia
○ Leading to high levels of cortisol and hypokalaemic alkalosis
• Lambert-Eaton syndrome - Abs to Na VGCs --> myasthenic like syndrome

2

Tx of small cell

Tx:
• Usually metastatic by diagnosis
• If no mets consider surgery
• If mets, radio + chemo

3

S&S of spinal cord compression

S&S:
• Back pain - RED FLAGS:
○ New onset >55yrs
○ PMH of tumour
○ Thoracic pain
○ Systemically unwell
○ Etc
• Lower limb weakness
• Sensory changes
Autonomic dysfunction

Earliest and most common is back pain worse when coughing or strainining

4

Tx and ix of spinal cord compression

Tx:
• High dose dexamethasone
• Urgent assessment for radiotherapy or surgery

ix - MRI spine

5

RFs of oesophageal cancer

RFs:
• Smoking
• Alcohol
• GORD
• Barretts

6

ix of oesophageal cancer

Ix:
• Upper GI endoscopy
• CT staging

7

S&S of oesophageal cancer

S&S:
• Dermatological - acanthosis nigricans
• Dysphagia progressive
weight loss
chest pain
hoarseness

8

Tx of oesophageal cancer

Tx:
• Surgical resection
• Ivor-Lewis oeseophagectomy
• Adjuvant chemo
palliative stenting

9

What is neoadjuvant and adjuvant chemo

neoadj - before tx
adj - post tx

10

How describe skin lesions?

ABCDE Symptoms
A - Asymmetry
B - Border irregular
C - Colour
D - Diameter
E - Evolution
Symptoms - bleeding, oozing, itching, altered sensation

11

S&S of colorectal cancer

S&S:
• Rectal bleeding
• Change in bowel habit
• Weight loss
• Anaemia
• Palpable mass

Right vs left sided:
• Right presents later as blood is not as fresh, and there are less symptoms

12

Staging of colorectal ca

Staging - Dukes:
1. A - Within bowel wall
2. B - Through bowel wall
3. C - Lymph nodes involved
4. D - Distant mets

13

ix and tx of colorectal ca

Ix:
• Colonoscopy
• Staging CAP CT

Tx:
• Surgery +/- adjuvant chemo
○ Low rectal cancer - AP excision of rectum

14

S&S of stomach ca

S&S:
• Dyspepsia - >1 mth and >50
• Weight loss
• Vomiting
• Dysphagia
• Anaemia
• Enlarged vircows node.

15

Ix and tx of stomach ca

Ix:
• Gastroscopy
• Staging CT

Tx:
• Gastrectomy

16

Define neutropenic sepsis

Neutrophil count <0.5*10^9 + :
• Temp >38C
• OR Sx consistent with sepsis
in pts taking anticancer tx

17

S&S of neutropenic sepsis

S&S:
• Can be perfectly well
• Sx related to source of infection
• Tx history of cancer (often 5-10 days post chemo)
• Fever
• Drowsy
• Confused
• Hypotension - V urgent referral needed

18

SVCO causes

Causes:
• Extrinsic compression:
○ Right sided tumours
○ Superior mediastinal lymphadenopathy
• Intrinsic compression:
○ Thrombosis
○ Foreign body
Tumour

19

S&S of SVCO

S&S:
• Swelling of face, neck, arms
• Distended neck and chest wall veins
• SOB
• Headache
• Lethargy

20

Tx of SVCO and IX

Ix:
• CXR
• CT chest with contrast

Tx:
• Chemotherapy
• Radiotherapy
• Stent - palliative
• Consider anticoag

21

Patho of malignancy induced hypercalcemia. S&S

Occurs in 5-30% of cancers
Caused by tumour secretion of PTHrP

S&S:
• Dehydration
• Psychiatric manifestations + confusion
• Anorexia
• Constipation

22

Ix and tx of malig induced hypercal

Ix:
• Calcium
• U&E - dehydration
• PTH/PTHrP

Tx:
• IV access and bloods to check other electrolytes
• CXR and ECG
• IV fluids then IV bisphosphonates

23

S&S of tumour lysis and commonly caused by

Presentation:
• 3-7 days post chemo
• Cardiac arrhythmia
• Oligouria

Common cancers causing:
• Small cell lung
• Germ cell tumours
• Myeloma

24

Tx of tumour lysis and prevention

Tx:
• Prevention:
○ Prehydration
○ Monitoring of electrolytes and fluid balance
○ Allopurinol
• Tx:
○ Hydration throughout
○ Correct electrolytes and fluid balance
§ Hyperkalaemia - K+ lowering regimens
§ Hyperphosphatemia - phosphate binders (Ca carbonate)

25

ovarian tumour marker

ca 125

26

pancreatic tumour marker

ca19-9

27

breast tumour marker

ca15-3

28

prostate tumour marker

psa

29

hepatic tumour marker

alpha feto protein

30

colorectal tumour marker

CEA