Oncology
Browse 60 topics in oncology.
Acute Leukaemia
Epidemiology: AML: Median age 68 years, incidence 4.3 per 100,000 in adults ALL: Bimodal distribution (peak ages 2-5 years and 50 years), incidence 1.7 per 100,000 Male predominance in both subtypes (M:F ratio...
Basal Cell Carcinoma
While BCC has an exceptionally low metastatic rate (less than 0.1%), it remains a significant clinical challenge due to its high incidence, potential for local invasion and tissue destruction, and substantial...
Bladder Cancer
Recent advances in molecular characterization have identified distinct molecular subtypes (luminal and basal) with differential responses to therapy, enabling precision oncology approaches. The treatment landscape for...
Breaking Bad News (SPIKES)
Breaking bad news is one of the most challenging and important communication tasks in clinical medicine. It refers to the process of conveying information that adversely and seriously affects an individual's view of...
Breast Cancer
Triple assessment—comprising clinical examination, imaging (mammography/ultrasound), and tissue diagnosis (core biopsy)—remains the diagnostic gold standard. Management is multimodal, integrating surgery...
Cancer Surgery and Anaesthesia
What is it? Anaesthesia for cancer surgery requires specialized knowledge of cancer biology, immunosuppression effects, optimal surgical timing, and perioperative considerations that differ significantly from...
Carcinoid Syndrome
Key Facts Tumour Origin : Midgut NETs (Appendix, Ileum) most common to cause syndrome. Syndrome Appears : Usually only after Liver Metastases (Hepatic first-pass metabolism bypassed). 10% of NET patients develop the...
Carcinoid Syndrome and Neuroendocrine Tumours
Neuroendocrine tumours (NETs) represent a heterogeneous group of neoplasms arising from neuroendocrine cells distributed... MRCP exam preparation.
Cervical Cancer
The overwhelming majority (99.7%) of cervical cancers are caused by persistent infection with high-risk Human Papillomavirus (hrHPV) , particularly types 16 and 18. The disease typically develops over 10-15 years...
Cervical Intraepithelial Neoplasia
CIN is typically asymptomatic and detected through organized cervical screening programmes using HPV testing and/or cervical cytology. The introduction of HPV-based primary screening has significantly improved...
Chondrosarcoma (Adult)
Chondrosarcoma is a malignant bone tumour producing cartilaginous matrix and represents the second most common primary bone malignancy after osteosarcoma, accounting for approximately 20% of primary bone malignancies....
Colorectal Cancer
The disease demonstrates significant geographical variation in incidence, with highest rates observed in developed countries, reflecting the impact of dietary factors, sedentary lifestyle, and increased longevity....
Cushing's Syndrome
The pathophysiology involves systemic dysregulation of protein and fat metabolism, creating a catabolic state characterized by proximal muscle wasting, skin thinning, and paradoxical central obesity. Diagnostic...
End of Life Care (Last Days of Life)
End of Life Care encompasses the multidimensional care provided during the last days to hours of life when a person is recognised as approaching death. This critical phase represents a transition from...
Endometrial Cancer
This aphorism encapsulates the fundamental pathophysiology of Type I endometrial cancer, where prolonged exposure to estrogen without adequate progesterone opposition drives malignant transformation.
Ewing's Sarcoma
Histologically, Ewing's sarcoma belongs to the Ewing sarcoma family of tumours (ESFT) , characterized as a "small round blue cell tumour" with a pathognomonic molecular signature: the EWSR1-FLI1 fusion gene resulting...
Gastric Cancer
The strongest modifiable risk factor is chronic infection with Helicobacter pylori , classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC). Other significant risk factors include...
Hepatocellular Carcinoma (HCC)
The major risk factors are chronic viral hepatitis (hepatitis B virus [HBV] and hepatitis C virus [HCV]), alcohol-related liver disease, and increasingly non-alcoholic steatohepatitis (NASH), now termed metabolic...
Hodgkin Lymphoma
The disease exhibits a bimodal age distribution with peaks at 15-35 years (young adults) and 55 years (older adults). Patients typically present with painless lymphadenopathy , often cervical or supraclavicular, with...
Human Papillomavirus (HPV) Infection
Human Papillomavirus (HPV) is a double-stranded DNA virus of the Papillomaviridae family, representing the most common sexually transmitted infection (STI) worldwide . Over 200 HPV genotypes have been identified, with...
Hyperviscosity Syndrome
Key Facts Cause : IgM paraprotein (Waldenström's 85%), IgA/IgG3 (myeloma 10-15%), cellular (polycythaemia less than 5%) Classic triad : Neurological (70%) + visual (60%) + bleeding (50%) symptoms Diagnosis : Serum...
Lambert-Eaton Myasthenic Syndrome (LEMS)
Lambert-Eaton Myasthenic Syndrome (LEMS) is a rare autoimmune disorder of the neuromuscular junction characterized by pr... MRCP exam preparation.
Lambert-Eaton Myasthenic Syndrome (LEMS)
The clinical hallmark is proximal muscle weakness , predominantly affecting the lower limbs, producing the characteristic complaint of "heavy legs" and difficulty rising from a chair or climbing stairs. The...
Leukaemia (Adult)
Leukaemia represents a heterogeneous group of clonal haematological malignancies characterised by the uncontrolled proliferation of abnormal white blood cells (WBCs) in the bone marrow and peripheral blood. These...
Lung Cancer
Comprehensive, evidence-based guide to Lung Cancer covering epidemiology, molecular pathophysiology, TNM 8 staging with detailed substaging, EGFR/ALK/ROS1 molecular subtypes, immunotherapy (PD-L1 testing), LDCT...
Lymphadenopathy
The generalist's challenge is to filter the "benign majority" from the "malignant minority". While less than 1% of primary care patients with lymphadenopathy have malignancy, this rises to 40-60% in specialist...
Lymphoma (Adult)
Lymphomas are a heterogeneous group of malignancies arising from lymphoid tissue, representing the fifth most common cancer in developed countries. They are broadly classified into Hodgkin lymphoma (HL) and...
Malignant Melanoma
Global Burden : Over 324,000 new cases diagnosed annually worldwide, with melanoma representing the 17th most common cancer globally. Incidence Variation : Highest in Australia/New Zealand (50-60 per 100,000),...
Malignant Mesothelioma
This malignancy is intrinsically linked to asbestos exposure, with a characteristic latency period of 20-50 years between first exposure and clinical presentation. Due to peak asbestos utilization in the...
Melanoma
A comprehensive guide to Malignant Melanoma covering epidemiology, molecular pathophysiology (BRAF/NRAS/KIT mutations), AJCC 8th edition staging, sentinel lymph node biopsy, and modern immunotherapy/targeted therapy...
Meningioma
Comprehensive evidence-based guide to meningiomas - the most common primary intracranial tumour. Covers WHO grading, molecular classification, the pathognomonic 'dural tail' sign, Simpson grading for surgical...
Metastatic Bone Disease
The "Big 5" primary carcinomas responsible for over 80% of bone metastases are Breast, Prostate, Lung, Kidney (Renal), and Thyroid - remembered by the mnemonic "Pb KTL" (Lead Kettle). Bone metastases are classified by...
Metastatic Spinal Cord Compression
Metastatic spinal cord compression (MSCC) is an oncological emergency occurring in 5-10% of cancer patients where spinal... MRCP, FRACP exam preparation.
Metastatic Spinal Cord Compression (MSCC)
The cardinal presenting symptom is pain (present in 83-95% of cases), which characteristically precedes neurological deterioration by weeks to months. This pain is often nocturnal (worse at night due to venous...
Molar Pregnancy (Hydatidiform Mole)
A molar pregnancy (hydatidiform mole) is a form of gestational trophoblastic disease (GTD) characterised by abnormal pro... MRCOG exam preparation.
Multiple Endocrine Neoplasia Type 2 (MEN 2)
A comprehensive, evidence-based guide to Multiple Endocrine Neoplasia Type 2 syndromes (MEN 2A and 2B), focusing on RET proto-oncogene mutations, genotype-phenotype correlations, prophylactic thyroidectomy timing,...
Nausea and Vomiting in Palliative Care
Nausea and vomiting are among the most distressing and debilitating symptoms in palliative care, affecting 40-70% of patients with advanced cancer and up to 60% of patients in the terminal phase. Effective management...
Neuroblastoma
The clinical spectrum is remarkably heterogeneous, ranging from spontaneous regression in low-risk infants to aggressive metastatic disease in older children. This biological diversity reflects profound differences in...
Neurofibromatosis Type 1 (NF1)
NF1 is an autosomal dominant disorder caused by loss-of-function mutations in the NF1 tumour suppressor gene located on chromosome 17q11.2 . This gene encodes neurofibromin , a large cytoplasmic protein of 2,818 amino...
Neutropenic Sepsis
Neutropenic Sepsis (Febrile Neutropenia, FN) is a life-threatening oncological emergency defined by fever in the presenc... MRCP exam preparation.
Oesophageal Cancer (Adult)
Oesophageal cancer is a highly aggressive malignancy of the oesophagus with two distinct histological subtypes: adenocar... MRCP, FRCS exam preparation.
Osteosarcoma
Osteosarcoma is the most common primary malignant bone tumour, accounting for approximately 20% of all primary bone canc... MRCP, MRCS, FRCS Orth, FRACS Orth ex
Ovarian Cancer (Adult)
Ovarian cancer is the deadliest gynaecological malignancy and the fifth leading cause of cancer death in women in developed countries. Despite accounting for only 3% of all female cancers, it causes more deaths than...
Palliative & Oncological Emergencies
Oncological emergencies represent acute, life-threatening or function-threatening complications that can occur at any stage of malignancy, from initial presentation through to end-of-life care. These emergencies...
Palliative Pain Management
Effective pain management is the cornerstone of palliative care, affecting 70-90% of patients with advanced cancer and requiring systematic, evidence-based approaches. The principles are guided by the WHO Analgesic...
Pancreatic Cancer
Pancreatic Ductal Adenocarcinoma (PDAC) represents approximately 95% of all pancreatic malignancies and is the 4th leading cause of cancer-related mortality in Western countries, with a devastating 5-year survival...
Penile Cancer
Human papillomavirus (HPV), particularly high-risk types 16 and 18, is detected in 30-50% of penile cancers through molecular studies, establishing a viral oncogenic pathway analogous to cervical cancer. Chronic...
Plantar Fibromatosis
The hallmark of management is conservative first : surgery is fraught with extremely high recurrence rates (57-100% for simple excision), making non-operative modalities including custom orthotics, intralesional...
Prostate Cancer
Prostate cancer represents the most common non-cutaneous malignancy in men worldwide, with an estimated 1.4 million new ... MRCP, FRCS(Urol) exam preparation.
Prostate-Specific Antigen (PSA) Testing in Adults
Prostate-Specific Antigen (PSA) is a serine protease glycoprotein produced almost exclusively by prostatic epithelial cells. It functions physiologically to liquefy the seminal coagulum, but its clinical utility lies...
Renal Cell Carcinoma (RCC)
A comprehensive guide to RCC, covering molecular pathophysiology, histological subtypes, Von Hippel-Lindau association, paraneoplastic syndromes, nephron-sparing surgery, and contemporary targeted biological therapies...
Retinoblastoma
The disease typically presents before the age of 5 years, with a median diagnosis at 18 months in bilateral cases and 24 months in unilateral disease. The critical clinical challenge lies in achieving the optimal...
Squamous Cell Carcinoma (Skin)
Cutaneous Squamous Cell Carcinoma (cSCC) is a malignant neoplasm arising from epidermal keratinocytes, representing the second most common skin cancer after basal cell carcinoma. Unlike basal cell carcinoma, cSCC...
Superior Vena Cava Obstruction
Superior vena cava obstruction (SVCO) represents compression, invasion, or thrombosis of the superior vena cava (SVC), i... MRCP exam preparation.
Superior Vena Cava Syndrome
Superior vena cava syndrome (SVCS) is a clinical syndrome resulting from obstruction of blood flow through the superior ... MRCP exam preparation.
Testicular Cancer
The fundamental clinical distinction is between Seminomas (slow growing, radiosensitive, elderly men) and Non-Seminomatous GCTs (NSGCTs - aggressive, early metastasis, young men).
Thyroid Cancer
The vast majority ( 90%) of thyroid cancers are differentiated thyroid cancers (DTC) , comprising papillary and follicular subtypes, which originate from thyroid follicular epithelial cells and retain the ability to...
Tumour Lysis Syndrome
Key Facts Timing : Usually 12-72 hours after chemotherapy initiation; can be spontaneous High-risk tumours : Burkitt lymphoma, ALL, high-grade NHL, AML with hyperleukocytosis Metabolic tetrad : ↑K+, ↑uric acid,...
Vestibular Schwannoma
The classic clinical triad comprises: Unilateral progressive sensorineural hearing loss (95% of cases) Tinnitus (unilateral, typically high-pitched) Vestibular dysfunction (imbalance more common than true vertigo)
Vulval Cancer
HPV-dependent pathway (30-40%): Affects younger women (40-60 years), associated with High-Risk HPV infection (types 16, 18), characterized by usual-type Vulval Intraepithelial Neoplasia (uVIN), and demonstrates...