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Oncology + Palliative > Management + staging > Flashcards

Flashcards in Management + staging Deck (12):
1

Why do you use a performance status + name 2 

Performance of patient during treatment.

Use Eastern Cooperative Oncology Group table (0 = fully active, 5 = dead)

Karnofsky 

2

Grade vs stage

Stage = how advanced cancer is in its progress Grade = what cells look like under microscope - how similar it is compared to normal cells

3

What cancers are TNM staging used for?

Used for solid tumour cancer (not applicable to leukaemia or CNS tumours)

4

What does the T in TNM mean?

Size or direct extent of primary tumour Tx: tumour cannot be assessed Tis: carcinoma in situ T0: no evidence of tumour T1, T2, T3, T4: size and/or extension of the primary tumour

5

What does the N in TNM mean?

Degree of spread to regional lymph nodes Nx: lymph nodes cannot be assessed N0: no regional lymph nodes metastasis N1: regional lymph node metastasis present; at some sites, tumour spread to closest or small number of regional lymph nodes N2: tumour spread to an extent between N1 and N3 (N2 is not used at all sites) N3: tumour spread to more distant or numerous regional lymph nodes (N3 is not used at all sites)

6

What does M mean in TNM?

Presence of distant metastasis M0: no distant metastasis M1: metastasis to distant organs (beyond regional lymph nodes)

7

What are the grades of cancer?

Grade 1 = cancer looks similar to normal cells, growing slowly 2 = cells look unlike normal cells + growing more quickly than normal 3 = cancer looks very abnormal, growing quickly

8

What causes paraneoplastic syndrome?

Caused by humoral factors (hormones + cytokines) released by tumour

9

What types of paraneoplastic syndrome are there?

Hypercalcaemia (from excess PTH release) 

Syndrome of inappropriate ADH secretion

ACTH release causing raised cortisol = Cushings

Serotonin release = peristalsis, diarrhoea, bronchoconstriction 

Lambert-Eaton = autoantibodies to Ca+ channels, proximal muscle weakness 

10

What is SIADH + how is it managed?

Syndrome of inappropriate ADH secretion Causes low sodium + low osmolarity

Give saline through central line

11

What causes hyponatraemia in cancer pts, and what are the S+S?

Caused by SIADH + medications (PPIs)

S+S: anorexia, headache, N+V, personality change, muscle cramps + weakness, confusion, ataxia, seizures, signs of hypervolaemia (pulmonary rales, S3 gallop, peripheral oedema)

12

What is APTT used for?

Measures extrinsic + intrinsic pathways Used to monitor heparin