Paediatric Oncology Flashcards
what is used to classify paeds tumours?
International Classification of Childhood Cancer (ICCC)
What are the 3 most common childhood cancers?
- Acute leukaemia
- CNS tumours
- Lymphomas
Why do kids get tumours?
Genes Environment -radiation -infection Iatrogenic -chemo + radiotherapy
who to be worried about -
immediate referral
unexplained petechiae, hepatosplenomegaly
who to be worried about - urgent referral
repeat attendance, same problem, no clear diagnosis
new numero symptoms, abdominal mass
who to be worried about - refer
rest pain, back pain and unexplained lump
lymphadenopathy
what can oncologists do to find out what a presentation is?
Scans
- gold standard = MRI but takes a long time so might do USS or CT
Biopsy
Tumour markers
What can oncologists do to find out where the tumour is?
staging e.g. scans
- CT of chest - for metastases
- bone marrow
PET scan
How do oncologists treat paeds cancer?
multimodal therapy based on specific disease and extent (plus patient factors)
MDT approach
Chemo
surgery
Radiotherapy
risks of CHEMO
Acute Hair loss Nausea & vomiting Mucositis Diarrhoea / constipation Bone marrow suppression – anaemia, bleeding, infection
Chronic
Organ impairment – kidneys, heart, nerves, ears
Reduced fertility
Second cancer
Risk of Radiotherapy
Acute Lethargy Skin irritation Swelling Organ inflammation – bowel, lungs
Chronic
Fibrosis / scarring
Second cancer
Reduced fertility
oncological emergencies
Sepsis / febrile neutropenia raised ICP spinal cord compression mediastinal mass tumour lysis syndrome
Management of raised ICP
Dexamethasone if due to tumour
Neurosurgery - urgent CSF diversion
Management of spinal cord compression for tumour
urgent mRI
start dexamethasone
definitive treatment with chemo
what do SVC syndrome and SMS stand for and mean?
superior vena cava syndrome and superior mediastinal syndrome
