This lecture covers surgical oncology, including the epidemiology, definitions, biology, etiology, screening, diagnosis, staging, treatment, and palliation of cancer. The objectives are discussed including carcinogenesis, the work-up process involving screening, diagnosis and staging of cancer, as well as treatment options and palliative care. Treatment may involve surgery, chemotherapy, radiation therapy, hormone therapy, targeted therapy, or immunotherapy depending on the cancer type and stage. The goal of treatment is cure through wide resection of the tumor and draining lymph nodes when possible or palliation to relieve symptoms for advanced or metastatic disease.
Breast cancer is a malignancy originating from breast tissue. This chapter
distinguishes between early stages, which are potentially curable, and
metastatic breast cancer (MBC), which is usually incurable.
Uterine Cancer Recurrence: All You Need To Knowbkling
t's not uncommon for uterine cancer survivors to worry about recurrence.
Whether you've had a recurrence or want to become more informed, join Dr. Susan C. Modesitt, Director of Gynecologic Oncology at UVA Cancer Center, to learn more information about uterine cancer recurrence as well as available treatment options.
This is a general overview of options available to patients with liver dominant metastatic disease as well other focal areas of disease which may benefit from services provided by an interventional radiologist
This is a presentation that discusses the principles of the use of tumour markers in surgical practice. It further discussed the advantages and disadvantages of tumour markers. Finally, the limitations of tumour markers were highlighted.
Breast cancer is a malignancy originating from breast tissue. This chapter
distinguishes between early stages, which are potentially curable, and
metastatic breast cancer (MBC), which is usually incurable.
Uterine Cancer Recurrence: All You Need To Knowbkling
t's not uncommon for uterine cancer survivors to worry about recurrence.
Whether you've had a recurrence or want to become more informed, join Dr. Susan C. Modesitt, Director of Gynecologic Oncology at UVA Cancer Center, to learn more information about uterine cancer recurrence as well as available treatment options.
This is a general overview of options available to patients with liver dominant metastatic disease as well other focal areas of disease which may benefit from services provided by an interventional radiologist
This is a presentation that discusses the principles of the use of tumour markers in surgical practice. It further discussed the advantages and disadvantages of tumour markers. Finally, the limitations of tumour markers were highlighted.
background of enteric fistula, causes of enteric fistula, presentation of enteric fistula, investigation of enteric fistula, conservative management and stabilization in patients with enteric fistula and selection of definitive management of enteric fistula
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Objectives of the lecture
• Epidemiology
• Definition of relevant terms
• Carcinogenesis and biology
• Etiology
• Work-up for cancer (screening, diagnosis, staging)
• Treatment
• Palliation
8. Oncogenes & TSGs
Gene Function
HER-2 Membrane mitosis signal receptor
p53 Prevents the accumulation of oncogenic mutations
kRas Intracellular signaling for mitosis and response to growth inhibitors
C-myc master regulator of cellular metabolism and proliferation
Bcl 2 Mediates apoptosis
MMRs Repair mismatched neuclotides (leads to MSI*)
10. Screening
• Risk stratification
• Gail model for ca breast: age,(menarche, first live birth), relatives with ca breast, previous
biopsy , atypical ductal hyperplasia)
• Mammography
• PSA/DRE
• FOBT or FIT
• Pap smear
• UGI and LGI scope
11. Diagnosis
• History and physical examination
• Definitive diagnosis by tissue biopsy
• Endoscopic, incisional, punch, excisional, core(image guided)*, ?FNA
• Enables grading and histochemistry
• Ensure consistency between histology and clinical picture
• Excisional Bx is aimed at curative intent
• Orient incision to allow for later scar excision if necessary
• Direct access to tumor to preserve planes and limit spread
• Lymph nodes should be excised whole to allow architectural assessment
*risk of sampling error ~20%
12. Tumor markers
• Present in high amounts in certain cancers: predictive vs prognostic
• Can be in the serum or in the tissue
• Serum markers:
• PSA
• CEA - colon
• AFP - liver
• Cancer Antigens (CA) 19-9 (colon, pancreas), 15-3 (breast), 27-29(breast,colon,stomach)
• Tissue markers
• HER-2, E2, P2, Ki67, p23, p53, oncotype DX
13. Staging
• Assesses anatomical extent – can be clinical cTNM
• Assists in: Prognostication, evaluation of treatments, exchange of information, treatment
selection
• Incorporates pre-op radiological assessment of lesion, nodes &
distant organs rTNM
• US, XR, CT, MRI, PET, Bone scan
• Post excisional assessment gives a pathological staging pTNM
• Distant staging for patients at high risk for mets
• T evaluates size/extent of primary tumor, N – nodal mets*, M - distant
14.
15. Surgical treatment
• Goal is to achieve cure – wide negative margins, removal of draining nodes
• Optimal margins varies among tumors
• Role of sentinel node biopsy to determine LND
• Patient performance status/fitness for surgery
• Operability MUST be determined pre-op
• Multiple distant metastases
• Bulky disease with extensive nodal spread
• Encasement of vital structures preventing en bloc resection
• Role of palliative resections
• Metastasectomy
16. Chemotherapy
• Adjuvant vs neoadjuvant
• Goals
• Eradication of micrometastatic disease
• Decrease local/distance recurrence
• Achieve/improve operability
• Reduce (or eradicate) disease burden and prolong survival
• Assessment of response
• Complete
• Partial
• Stable
• Progression
• Choice and combination of CTA
Shrink tumor for better/lesser surgery
Treatment of micromets without delay of
post op recovery
Assess effectiveness of CTA
18. Administration/combination
• Systemic IV or enteral vs direct delivery (e.g. TACE)
• Intermittent vs continuous administration
• Anticipate toxicity and mitigate
• Pulsing or reduce dose
• Combination of agents
• Coadminister cytoprotectants, CSF, EPO
• Combination
• Maximum cell kill within toxicity range for each drug
• Broader range of coverage
• Prevents or delays the emergence of drug-resistance
19. Radiotherapy
• External beam or internal (probes/implants/liquid isotope)
• Mostly for primary post-op clearance of remnant micro mets
• Can be used for isolated distant mets
• Used in combination with chemo in neo-adjuvant setting
• Fractionation is used to minimize toxicity (Total Gy/# sessions)
• Operate within the limits of
• Repair
• Reoxygenation
• Repopulation
• Redistribution
• Radiosensitivity (and role of radiosensitizers)
20. Other therapy
• Hormonal therapy
• For hormone dependent malignancies: breast, prostate
• Tamoxifen, leuprolide, DES
• Targeted therapy
• Inhibits angiogenesis or points of aggressiveness
• Anti VEGF (Bevacizumab), anti HER2 (Trastuzumab), anti c-kit (Imatinib)
• Immunotherapy
• Potentiate inherent antitumor immunity
• Gene therapy
• Aims to replace/repair mutated TSG
21. Follow-up and tumor markers
• Outcome measures
• Overall survival
• Progression/Disease free survival
• Interval of follow ups
• Indicators of recurrence
• Signs and symptoms
• Radiology/scope
• Tumor markers; PSA, CEA, Ca 125, 19-9, 13-3
22. Palliation
• Relieving symptoms without aim of cure
• In metastatic or bulky unresectable disease
• Low performance score (for the type of surgery)
• Ideally should be as minimally invasive as possible
• Analgesics
• Cytoreductive chemo to reduce mass effect
• Palliative recanalization of blocked lumens (stents, lasers, cryoablation)
• Palliative interventions to control mass effect, bleeding (APC, embolization)
• Palliative bypasses, resections for infection or bleeding, decompression
23. Review
• Epidemiology
• Definition of relevant terms
• Carcinogenesis and biology
• Etiology
• Work-up for cancer (screening, diagnosis, staging)
• Treatment
• Palliation