Flashcards in Oncology Deck (47)
List the main oncological emergencies
Spinal cord compression
Superior vena cava obstruction
What are some causes of spinal cord compression?
Extra-cordal compression (tumour)
Vertebral body extension (osteophyte)
Osteoporotic crush fracture
List symptoms and signs of spinal cord compression
Radicular (band-like) pain
Pain worse on cough/straining
What investigations would you order for spinal cord compression?
Lumbar puncture if suspected meningeal involvement
How is spinal cord compression treated?
Acute: IV dexamethasone
List some causes of superior vena cava obstruction
Intrinsic: clot, foreign body, tumour
Extrinsic: mass/tumour, aneurysm, fibrosis
Thrombosis, ovarian hyper-stimulation
List symptoms and signs of superior vena cava obstruction
What is Pemberton's test for superior vena cava obstruction?
Lift arms over head
If causes facial plethora/cyanosis and raised JVP, obstruction is likely
How is superior vena cava obstruction?
Clot - streptokinase, anticoagulation
List causes of hypercalcaemia in oncological patients
Lytic bone mets
List symptoms and signs of hypercalcaemia
Moans, groans, aches and stones
How is hypercalcaemia treated?
Manage underlying malignancy
List symptoms and signs of raised ICP
Headache, worse in morning or straining
Focal neurological deficit
What investigations would you order for raised ICP?
Urgent CT/MRI head
How is raised ICP treated?
Mannitol may give symptomatic relief
What is meant by neoadjuvant chemotherapy?
Shrink tumour prior to surgery
Early control of metastasis
What is meant by primary chemotherapy?
Sole treatment for malignancy
What is meant by adjuvant chemotherapy?
Given post- surgery/radiotherapy to decrease risk of remission
What is meant by palliative chemotherapy?
Given for symptomatic relief and prolong survival, i.e. non-curative intent
What do antimetabolic chemotherapy agents do? Name some?
Inhibit processes that promote growth/synthesis
Methotrexate, 5-fluoroucil, azathioprine
What do anti-tumour antibody chemotherapy agents do? Name some?
Inhibit DNA transcription and replication via topiromase inhibitors
Doxorubicin, etoposide, actinomycin
What do antimicrotubule chemotherapy agents do? Name some?
Prevent separation of chromatids during replication
Vincristine, vinblastine, paclitaxel
What do alkylating chemotherapy agents do? Name some?
Alkylate functional groups to form covalent bonds
Cyclophosphamide, chlorambucil, cisplatin, busulfan
What do monoclonal antibody chemotherapy agents do? Name some?
Target tumour-specific antigens
Rituximab (CD20), cefuximab (EGFR1), bevacizumab (VEGF), imatinib (TK1)
List some side effects of chemotherapy
How does radiotherapy work?
Uses ionising radiation to produce free radicals that damage DNA
Why is radiotherapy delivered in fractions?
Gives normal cells time to recover
What is the difference between radical and palliative radiotherapy in terms of the doseage given?
Radical - 40-70Gy in 15-35 fractions
Palliative - 8-30Gy in 1-10 fractions
List some early side effects of radiotherapy
Mucositis, oral thrush