Clinical Problems in Oncology

Edited bySing Yu Moorcraft, MB BCh, MRCP, Clinical Research Fellow in Medical Oncology, The Royal Marsden NHS Foundation Trust, London, UK Daniel L.Y. Lee, MB BCh, MRCP, Specialist Registrar in Medical Oncology, St James’ Institute of Oncology, Leeds, UK David Cunningham, MD, FRCP, FMedSci, Consultant Medical Oncologist, The Royal Marsden NHS Foundation Trust, London, UK

• List of contributors, ixPreface, xiAcknowledgements xiiList of abbreviations xiii1 Introduction to clinical problems in oncology 1Sing Yu MoorcraftGeneral approach to the management of oncology patients 2Performance status 6Tumour markers 62 Oncological emergencies 13Daniel L.Y. LeeAnaphylaxis and hypersensitivity reactions 13Bleeding 16Central airway obstruction and stridor 19Extravasation 23Febrile neutropenia 28Hypercalcaemia 30Non-neutropenic sepsis 34Raised intracranial pressure and seizures 36Spinal cord compression 41Superior vena cava obstruction 45Transfusion reactions 48Tumour lysis syndrome 503 Side effects and complications of cancer and its treatment 53Alexandra Pender, Sing Yu Moorcraft and Daniel L.Y. LeeOverview of toxicity management 54Abnormal liver function tests 57Alopecia 60Anaemia 62Anorexia and nutrition 66Ascites 69Bone metastases and osteoporosis 71Bowel obstruction 75Breathlessness 77Chest pain and other cardiac complications 81Confusion and decreased conscious level 86Constipation 91Dental disorders 93Diarrhoea 95Dysphagia 100Fatigue 104Fertility and pregnancy 106Haematuria 113Hearing loss 115Hiccups 117Hyperglycaemia and hypoglycaemia 119Hypertension and hypotension 123Lymphoedema 127Mucositis 129Nausea and vomiting 133Neuropathy 138Neutropenia 142Proteinuria 145Pruritus 146Psychiatric disorders 149Rash 154Renal failure and hydronephrosis 163Sexual dysfunction 166Thrombocytopenia 170Thromboembolism 173Vaccinations and immunoglobulin 178Visual symptoms 1804 Introduction to radiotherapy 185Emma Dugdale, Alexandra Gilbert and Robin PrestwichIntroduction to radiotherapy 185Methods of delivery of radiotherapy 1865 Radiotherapy side effects and their management 193Alexandra Gilbert, Emma Dugdale and Robin PrestwichOverview of radiotherapy toxicity 193Overview of radical radiotherapy treatment and side effect management by anatomical treatment site 195Brain 195Head and neck 196Breast 200Thorax 200Abdomen 204Pelvis 205Skin toxicities 211Total body irradiation 2146 Endocrine therapy, immunotherapy and targeted therapies 215Samantha TurnbullEndocrine therapy 215Immunotherapy 218Targeted therapies 2207 Electrolyte abnormalities 225Sing Yu MoorcraftHypocalcaemia 225Hyperkalaemia and hypokalaemia 227Hypermagnesaemia and hypomagnesaemia 231Hypernatraemia and hyponatraemia 234Hyperphosphataemia and hypophosphataemia 2378 Palliative care and pain management 241Karen NeohPain management 241Overview of pain management 241Opioid prescribing in palliative care 245Opioid toxicity 251Syringe pumps 252End-of-life care 2539 Oncology procedures and their complications 257Juanita LopezAscitic drains (paracentesis) 257Biliary drains and stents 259Central venous access devices 261Chemoembolisation 265Chest drains and pleurodesis 266Enteral feeding tubes 269Nephrostomies and ureteric stents 270Oesophageal stents and dilatation 272Radioembolisation (SIR-spheres®) 273Radiofrequency ablation (RFA) 27510 Cancer drug development and funding 277Sing Yu MoorcraftClinical trials 277Funding of cancer drugs 280Personalised medicine 282Appendices 287Sing Yu Moorcraft and Daniel L.Y. LeeChemotherapy regimes 287Drug toxicities 287Useful resources 296Index 301

“Clinical Problems in Oncology: A Practical Guide to Management is an easy–to–use, compact reference with essential, practical information on managing oncological emergencies, as well as the side effects and complications of cancer and its treatment.”  (Kingbook73's Medical Ebook and Video Collection, 7 October 2014)