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Tumour Markers
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Leukaemia
General Information Age Ranges Acute Leukaemia Symptoms Signs Diagnosis Treatment Note: Relapse of acute leukaemia often means imminent death unless bone marrow transplantation is successful. Mean 5-year survival rate: Chronic Myeloid Leukaemia (CML) Clinical Features Chronic Lymphocytic Leukaemia (CLL) Clinical Features Note: Most cases, especially early indolent CLL, require no…
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Common cancers and their 5-year survival rates (a collation of surveys)
Cancer % Testicular 98 Prostate 95 Thyroid 92 Breast (female) 91 Melanoma 91 Hodgkin lymphoma 87 Uterus 84 Bladder 77 Colon 72 Non-Hodgkin lymphoma 72 Ovary 41 Stomach 33 Liver 20 Lung 19 Pancreas 1 John Murtagh’s General Practice, 8th Edition > Malignant disease POTENTIALLY CURABLE MALIGNANT TUMOURS Several tumours…
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Colorectal Cancer
Risk Factors Age >45 years (accounts for 90% of Colon Cancer)Inflammatory Bowel Disease Ulcerative Colitis – Risk increases with duration since diagnosis (2% at 10 years of disease, 18% at 30 years of disease)Crohns Disease – Lifetime risk of Colorectal Cancer: 4-5% Adenomatous polyps >5mm (Confers RR of 2-3 times)Hamartomatous…
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Gastric Cancer
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Pancreatic cancer
epidemiology risk factors clinical presentation is related to location of tumour Signs diagnosis pathology treatment prognosis
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Pagets disease of the nipple
Symptoms pagets eczema Erythematous, scaly, crusty, and thickened plaque-like lesionerythematous patch is sharply demarcated and deeply infiltrated, unlike eczematous dermatitis Unilateral, persistentItching or burning sensation. Discharge and/or bleeding from the nipple.Ulceration.Destruction of the nipple.Inversion of the nipple.Sometimes palpable breast lump BilateralIrritation.Acute inflammation, weeping vesicles or blisters.Chronic problems with dry, thickened…
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Ovarian Cancer
Adnexal mass DDx Risk Factors Protective factors Presentation Genitourinary symptoms (frequency, urgency, prolapse) Examination Screening Investigations Management
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Endometrial Cancer
Postmenopausal Bleeding = Endometrial cancer until proven otherwise. ABNORMAL VAGINAL BLEEDING IN PRE- AND PERI-MENOPAUSAL WOMEN VAGINAL BLEEDING IN POST-MENOPAUSAL WOMEN A diagnostic guide for General Practitioners and Gynaecologists Peak incidence 50-70 years Fairly uncommon <45yo, including endometrial hyperplasia (supported by evidence) Risk Factors Symptoms Abnormal bleeding (80%). Be suspicious…
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Cervical Cancer
Risks Natural history of cervical dysplasia Presentation Management Cervical screening Refer immediately if Unsatisfactory Should have a co-test if Pregnancy Previous hysterectomy Self-collection Specific populations start early Previous hysterectomy Clinician-collected Cervical Screening Test – step-by-step instructions visualise the cervix. Ectropion HPV vaccination Human papillomaviruses
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Breast cancer
Risk Factors Screening Clinical features Examination Investigations Triple test Risk Factors Screening Redbook – ver 9 https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Red%20Book/Guidelines-for-preventive-activities-in-general-practice.pdf Risk Level Age Relatives Diagnosed Conditions What should be done? How often? Low Risk No age restriction No confirmed family history No diagnosed breast cancer in the family Mammogram + Breast awareness…
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Cancer Pain
Total/holistic approach – physical, psychological, spiritual, social Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques by François Mestdagh, Arnaud Steyaert and Patricia Lavand’homme – https://www.mdpi.com/1718-7729/30/7/500 Opioids in Cancer Pain Management: An Update of the Mainstay Approach Importance and Guidelines Weak Opioids Strong Opioids Comparative Efficacy and…
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Pharyngeal Cancers
Painful Swallowing + Ear Pain + Hoarseness = Pharyngeal Cancer Risk Factors: smoking (tobacco, marijuana, cigars), UV lights, EtOH, Betel nut chewing, HPV, EBV Presenting Symptoms Nasopharynx Cancer more common in African and East Asian populations, ay cause paresis of soft palate and nasal regurgitation on swallowing Laryngeal Cancer: stridor
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Testicular cancer
relatively rare and accounts for 1-1.5% of male cancers it is rare before puberty but is the most common tumour in young and middle aged men (usually in males between the ages of 15-49)
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Prostate cancer / Prostate cancer screening
Symptoms of prostate cancer History/Risk factors EXAMINATION PSA screening Key organisation’s positions on PSA testing: RED BOOK v10: target group Screening/Intervention frequency of Ix intervention 50–69 years at average* risk PSA testing Digital rectal examination – not recommended as a routine addition to PSA testing in asymptomatic men every 2…
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Thyroid Nodules and Cancers
Thyroid nodules are often picked up as incidental findings on clinical examination, or on imaging (usually carotid ultrasound) for another purpose. They can cause problems if they become large and compress the oesophagus / trachea. Causes of clinically detectable thyroid nodule: History Workup Treatment and Followup FNA Results FNA results…
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Bladder cancer
Follow up: Guided by urology but apparently those with non muscle invasive disease should have 3 monthly cystoscopy and urine cytology for 2 years and annually thereafter (? For how long)
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Lung Cancer
Lung cancer in Australia Causes Types Methods of spread Clinical: INVESTIGATIONS Treatment intent