20230905-FINAL MBBS mbbs class CLASS 4.pptx

Mbbs

1. How MBBS graduates can help a Cancer Patient – Oncologist Perspective Dr. P. Srinivasan Professor & HoD Dept of Radiation Oncology RMC/GGH, Kakinada E- Mail: [email protected] Mob: [phone]

2. S.No Date Day Topic 1 22-08-2023 Tue Radiation-Definition, Mechanism of Action and Types 2 25-08-2023 Fri Radiation-Definition, Mechanism of Action and Types 3 29-08-2023 Tue Classification & Staging of Tumours 4 01-09-2023 Fri Classification & Staging of Tumours 5 05-09-2023 Tue Radiation Management in Common Malignancies 6 08-09-2023 Fri Radiation Management in Common Malignancies 7 12-09-2023 Tue Radiotherapy for Benign diseases 8 15-09-2023 Fri Acute & Late effects of Radiation –Supportive care 9 19-09-2023 Tue Oncological Emergencies 10 22-09-2023 Fri Palliative Care 11 26-09-2023 Tue Cancer Prevention, Screening, Vaccination & Registry

3. Class 4 Dr. P. Srinivasan Professor & HoD Dept of Radiation Oncology RMC/GGH, Kakinada E- Mail: [email protected] Mob: [phone]

4. Serratus Anterior Intercostal muscles Ribs Pectoralis Major is not included Ulceration Satellite Nodules Dermis not included peau d’orange 4a + 4b T4d - Inflammatory Carcinoma Erythema / Edema Growth  6 months 1/3 area

5. N1-Ipsilateral mobile ALN N2a –Ipsilateral matted ALN N2b - Ipsilateral IM N3a – Ipsilateral IC +/- Axilla N3b- Ipsilateral ALN + IM N3c- Supraclavicular pN1 – 1-3 Nodes pN2- 4-9 Nodes pN3-10 + Nodes

6. ANATOMIC STAGING GROUP T3N0M0 – II B CLINICAL / PATHOLOGICAL PROGNOSTIC STAGE GROUP T3N0M0 – G1 / HER2+ / ER+ / PR+ I B / IA T3N0M0 – G1 / HER2+ / ER+ / PR- IIA / IIB T3N0M0 – G1 / HER2+ / ER- / PR- II B / IIB T3N0M0 – G2 / HER2- / ER- / PR- III B / IIB T3N0M0 – G3 / HER2- / ER- / PR- III B / IIIA AJCC Anatomic Stage Groups

7. ER+ PR + HER2 - ve ER± PR± HER2 ± ve ER± PR ± HER2 + ve ER+ PR + HER2 - ve

8. Breast Cancer Early Stage Surgery : BCS/MRM RT CT, HT, Targeted Therapy Locally Advanced NACT Surgery  Adjuvant therapy Metastatic Carcinoma CT/HT/RT/TT Metronomic Antiangiogenic

9. RISK FACTORS FOR LOCAL RELAPSE Younger age Positive margins No systemic therapy – Chemo/ hormonal Extensive Intraductal Component ( - ve margins eliminate this risk) BRCA1/2 T/N Stage TNBC / HER2 Positive

10. BCS Mastectomy Vs BCS BCS Contraindicated in Pregnancy Diffuse / Suspicious Microcalcification Inflammatory Breast cancer Chemo RT

11. Efficacy of Chemotherapy in cancer treatment

12. Cell cycle non specific Alkylating agents Cell cycle phase specific- Antimetabolites – S Phase Antimitotic – M Phase Cell cycle phase non specific Alkylating agents ( more active on proliferating cells) Platinum ( more active in S) Dacarbazine

13. Cell growth kinetics – Gompertzian model

14. Chemotherapy Prescription Premedications Drugs- Dosages In what solution to mix? Route of administration Where to give – Peripheral veins? Central line? Speed of the infusion / duration of chemo Order in which it has to be given P

15. Radiation Treatment Volume

16. No wedge Wedge pair Dynamic Wedge