ONCOLOGY CARTOONS OCT 2023

1. DR KANHU CHARAN PATRO
M.D, D.N.B[RT], MBA, FICRO, FAROI, PDCR,
CEPC
OCTOBER 2023 ISSUE/91st VOLUME
www.facebook.com/oncologycartoons/photos_albums
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5. 16th SEP 2023/STEREOTAXY
GRADING OF CHEST WALL TOXICITY IN LUNG SBRT
JIE-TAO MA/IJROBP/2018

6. 17th SEP 2023/CHEMOTHERAPY
HORMONE THERAPIES IN MALIGNANCY TREATMENT
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

7. 18th SEP 2023/IMMUNOTHERAPY
IMMUNO THERAPIES IN MALIGNANCY TREATMENT
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

8. 19th SEP 2023/STAGING
NAMED STAGING OF CARCINOMAS
GOOGLE /PINTREST
15. Durie-Salmon Staging Multiple myeloma
16. Arriaga Pittsburgh Staging External auditory canal
17.Ann Arbor staging/Lugano classification Lymphoma
18.Rai Staging CLL
19. Kadish staging Esthasioneuroblastoma

9. 20th SEP 2023/BMT
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL
THERAPY
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

10. 21st SEP 2023/BMT
6 STEPS OF CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL
THERAPY
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

11. 22nd SEP 2023/PAIN
COMMON OPOIDS UTILIZED IN ONCOLOGICAL PAIN
MANAGEMENT
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

12. 23rd SEP 2023/BSC
BREAKING THE BAD NEWS – SPIKES
PROTOCOL
ANTONIA DEAN/IJPN/2016

13. 24th SEP 2023/BSC
BREAKING THE BAD NEWS – ABCDE
PROTOCOL
FRANKLIN J/AM FAM PHYSICIAN/2018

14. 25th SEP 2023/BSC
BREAKING THE BAD NEWS – BREAKS
PROTOCOL
FRANKLIN J/AM FAM PHYSICIAN/2018

15. 26th SEP 2023/BSC
BREAKING THE BAD NEWS – PETER KAYE’S
PROTOCOL
INTERNATIONAL PARAMEDIC PRACTICE

16. 27th SEP 2023/BSC
HICCUPS MANAGEMENT IN ONCOLOGY
PRACTICE
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

17. 28th SEP 2023/BSC
TYPES OF CHEMOTHERAPY INDUCED NAUSEA AND
VOMITING
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

18. 29th SEP 2023/BSC
ADDITIONAL MANAGEMENT OF BREAKTHROUGH NAUSEA AND
VOMITING
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES
1. Breakthrough CINV. Breakthrough CINV is vomiting and/or nausea that occurs within five days of
chemotherapy administration after the use of guideline directed prophylactic antiemetic agents.
2. This type of CINV usually requires immediate treatment or requires “rescue” with additional antiemetic

19. 30th SEP 2023/BSC
Please avoid lactose diet during 5FU
therapy
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES
Fluorouracil causes
osmotic diarrhea due
to the decreasing
expression of lactase
Please avoid lactose
diet , FODMAP rich
food during 5FU
therapy
Doctor asked to
stop milk product
, but why?

20. 1st OCT 2023/BSC
Constipation in cancer patients
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

21. 2nd OCT 2023/BSC
HYPERVISCOSITY SYNDROME IN
CANCER
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES
1. Hyperviscosity syndrome is an oncologic emergency characterized by a triad of
neurologic deficits, vision changes, and mucosal bleeding resulting from increased
blood viscosity created by elevated levels of paraproteins.
2. Hyperviscosity syndrome is most found in patients with Waldenstrom
macroglobulinemia (10‒30% of patients), leukemia, and multiple myeloma (2‒6%).
3. Hydration, plasmapheresis and cancer directed chemotherapy is the mainstay of
treatment.
4. Hyperviscosity syndrome is worsened with dehydration.

22. 3rd OCT 2023/BSC
CANNULATE LOWER LIMB FOR VENOUS
ACCESSES IN SVCO
KAPIL CHAUDHARY/J ANAESTHESIOL CLIN PHARMACOL/2012
An IV line in the upper extremity is contraindicated in view of long and unpredictable
circulation time and as blood return from the upper body can be interrupted by SVCO.

23. 4th OCT 2023/BSC
GARDING AND SCORING IN
SVCO
Alexandre Pont/FRONTIERS IN CARDIOVASCULAR MEDICINE/2021

24. 5th OCT 2023/BSC
CANCER RELATED DIARRHEA AND
MANAGEMENT
* Most known to cause diarrhea.
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES

25. 6th OCT 2023/BSC
IS THERE A NEED OF TRACHEOSTOMY IN
SVCO?
Google
In severe cases patient may
present with stridor, due to
laryngeal edema and not relieved
by steroids

26. 7th OCT 2023/BSC
MENTAL AND VISUAL ALTERATION IN IN
SVCO
Pulse notes
1. Breathlessness, because of swelling around the windpipe (trachea)
2. Headaches, which get worse when you lean forward or bend over.
3. Facial swelling, with changes to your complexion.
4. Changes in your eyesight.
5. A Swollen neck.
6. Swollen arms and hands.
7. Visible swollen blue veins on the chest.
8. Feeling dizzy and headache or feeling of fullness in the head,
made worse by bending or lying down, all due to venous
congestion

27. 8th OCT 2023/BSC
How to unclog the blocked feeding tube?
Pulse notes
1. Remember to flush the tube: before and after each feed before, after and between each
medication.
2. Milking the tube-Use your thumb and forefinger to squeeze and roll along the length of the tube
until the blockage is cleared.
3. Push and pull technique-Fill a 50ml syringe with warm water from the kettle (which has been
boiled and left to cool for 20 minutes). Connect it to the tube. Push and pull on the syringe (like
using a bicycle pump) to try to dislodge the blockage. It may take up to 30 minutes before the tube
becomes unblocked. Never force the syringe as this may damage the tube.
4. Soda water-If the blockage persists, try flushing the tube with soda water. Leave it for 20 to 30
minutes to help dissolve the blockage. Then using the push pull technique, flush the tube with
warm water (follow the instructions above). Never flush with sugary drinks such as cola or
lemonade as these may cause the tube to breakdown and make the blockage worse.
5. Submerge in warm water-Submerging the blocked part of the outer tubing in a bowl of warm
water for 10 minutes may soften the blockage and enable one of the methods above to work more
effectively.
6. Attempt 1 Water is the best choice for the initial attempt: use a 30- or 60-mL syringe with a gentle
back and forth flushing of warm water allowing the water to sit five minutes between flushes.
Studies have shown meat tenderizing powder, carbonated beverages, and juice to be ineffective
and may cause protein precipitation in tube worsening the clog.
7. Attempt 2 Use enzymatic declogging agent: crush two tabs of pancrealipase/ creon 4200-unit
tablets and 1 tab of 325 mg sodium bicarbonate and combine with 10 cc warm water. Shake to mix
it up. Insert solution into feeding tube and leave it for 1 hour. Attempt to flush. If still unable to flush
add more enzymatic solution and wait another hour before attempting to flush.
8. Attempt 3 If tube still does not flush consultation with specialist GI, IR for tube replacement.

29. 9th OCT 2023/RCC
Stauffer’s Syndrome
https://www.urologynews.uk.com/

30. 10th OCT 2023/BSC
Paraneoplastic syndromes secondary to
neuroendocrine tumours
Gregory Kaltsas/Endocrine-Related Cancer (2010)

31. 11th OCT 2023/BSC
Wikipedia
Types of paraneoplastic syndrome

32. 12th OCT 2023/BSC
Wikipedia
Neurolomuscular paraneoplastic syndrome

33. 13th OCT 2023/BSC
https://clinicalgate.com/
ENDOCRINE PARANEOPLASTIC SYNDROMES

34. 14th OCT 2023/BSC
https://clinicalgate.com/
HEMATOLOGIC PARANEOPLASTIC SYNDROMES

35. 15th OCT 2023/PUBLIC
Google
CANCER IS NOT CONTAGIOUS – ENJOY SHARING
Close contact or things like sex, kissing,
touching, sharing meals, or breathing the
same air cannot spread cancer.