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Flashcards in Oncology Deck (16):
1

What are the features on metastatic spinal cord compression?

Back pain - may be worse lying down and coughing
lower limb weakness
Sensory changes
Neurological signs - these depend on the level of the lesion of the compression

2

How is metastatic spinal cord compression managed?

Urgent MRI whole spine
High dose oral dexamethasone
Urgen oncological assessment for radiotherapy or surgery

3

When is surgery indicated in MSCC?

Patients who have residual sensory or motor function and a good prognosis

4

What is SVC obstruction?

An oncological emergency caused by compression of the SVC.

5

What are the features of SVC obstruction?

Hx of lung cancer
Dyspnoea
Swelling of the face, neck, arms and possibly conjunctiva and orbit
Headache
Visual disturbance
Pulseless jugular venous distension

6

What malignancies commonly cause SVC obstruction?

NSCLC
lymphoma

7

How is SVC obstruction managed?

Balloon venoplasty
Dexamethasone
Stenting

SCLC = chemo and radiotherapy
NSCLC = radiotherapy

8

What is tumour lysis syndrome?

A condition caused by the breakdown of tumour cells and the subsequent release of the chemicals in the cell. This leads to a
HIGH K+
HGH URIC ACID
HIGH PHOSPHATE
(in the presence of a low calcium)

9

How does tumour lysis syndrome present?

AKI
cardiac arrhythmias
seizure

10

How is tumour lysis syndrome diagnosed in the lab?

uric acid >475umol/L or 25% increase

K+ >6mmol/l or 25% increase

phosphare >1.125mmol/l or 25% increase

calcium <1.75mmol/l or 25% decrease

11

How is tumour lysis syndrome managed?

prevention - give allopurinol or rasburicase and fluids

12

What is the definition of neutropenic sepsis?

WCC <0.5 and temp >38 (or other signs consistent with sepsis)

13

How is neutropenic sepsis treated?

Do NOT delay antibiotics
- Start Pip/Taz

If still febrile after 48 hours give meropenem +/- vancomycin

14

How is hypercalcaemia treated?

IV rehydration
IV bisohosphonates

15

What cancers commonly cause hypercalcaemia

Myeloma
Squamous cell carcinoma of the lung
Bone mets

16

How is a raised ICP in the context of malignancy managed?

Urgent MRI head
Dexamethasone 8-16mg/24 hours