• CANCER,  HAEMATOLOGY

    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…

  • CANCER,  COLORECTAL,  SURGICAL

    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…

  • CANCER,  GYNECOLOGY

    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…

  • CANCER,  GYNECOLOGY

    Ovarian Cancer

    Adnexal mass DDx Risk Factors Protective factors Presentation Genitourinary symptoms (frequency, urgency, prolapse) Examination Screening Investigations Management

  • CANCER,  GYNECOLOGY

    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…

  • CANCER,  GYNECOLOGY

    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 

  • CANCER,  GYNECOLOGY

    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…

  • CANCER,  PAIN MEDICINE,  PALLIATIVE CARE

    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…

  • CANCER,  ENT,  NECK

    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

  • CANCER,  MEN' HEALTH

    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)

  • CANCER,  MEN' HEALTH

    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…

  • CANCER,  ENDOCRINE,  THYROID

    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…

  • CANCER,  RENAL

    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)