I. Introduction & Epidemiology II. Pathogenesis (Figure 1) CML is driven by a single genetic event — the formation of the BCR::ABL1 fusion gene. Understanding this mechanism explains the disease biology, clinical features, and treatment rationale. A. The Philadelphia Chromosome B. Translocation Variants The classic t(9;22) is present in >90% of cases, but variant forms…
Introduction Therapeutic phlebotomy—the controlled removal of blood for therapeutic purposes—is a cornerstone of management in Polycythemia Vera (PV) and is used for relieving symptoms in secondary polycythaemias. While the practice of bloodletting has ancient origins, modern therapeutic phlebotomy bears little resemblance to its historical predecessor. Historical bloodletting was rooted in humoral theory and applied indiscriminately…
The TNM cancer staging system often appears as a seemingly impossible maze to navigate. However, beneath the complex tables lies a clear clinical logic: matching the aggression of the treatment to the aggression of the disease. This guide provides a strategic framework for medical students to master cancer staging, moving beyond anatomical memorization to understand…
“If you slept through the Genomic Era, here is your wake-up call.” The Premise: The year is 1995. Dr. Rip Van Winkle, a hardworking Senior Resident in Medical Oncology, sits at the small, cluttered desk in his apartment. He has just returned from a punishing 14-hour shift of ward rounds, his feet throbbing, yet he…
The 60-Second Rounds 1. Introduction The idea of performance status began with Dr. David Karnofsky in 1948, who created the Karnofsky Performance Status (KPS) to measure a patient’s functional well-being alongside tumor response. He realized that tumor shrinkage alone did not reflect whether patients were actually improving — many felt worse even when X-rays looked…
The Clinical Dilemma: To Operate or To Observe? The Problem: You have a patient with a localised adnexal mass. Some will be malignant, but others will be benign. Distinguishing them is the central challenge of gynaecologic oncology. The Constraint: The Stakes: The Gap: Conventional tools—CA-125 and standard Ultrasound—have significant limitations. CA-125 has poor specificity (false…
A definitive clinical guide to tumor markers. Learn the 4 roles, the ‘trend-over-value’ rule, and the practical, guideline-based use of PSA, CEA, AFP, and more.
Introduction: The Logic Behind the Language You’ve encountered dozens of tumour names. Some are logical, but many feel like random, contradictory terms. Why is a glandular tumour called an adenoma (benign) but a melanocytic tumour is a melanoma (malignant)? They both end in “-oma”. Why is a mesothelioma always malignant, leaving no room for a…
A physician’s instinct, based on decades of medical training, is to remove the tumor. But what if the modern, evidence-based approach requires waiting? A paradigm shift in breast cancer treatment now shows that using systemic therapy before surgery can dramatically increase the chances of a cure.
Explore this doctor’s dilemma through a compelling conversation between a family physician facing her own diagnosis and the oncologist who explains the powerful, life-saving reasons behind this new standard of care.
The Conversation After the Consultation A 48-year-old software executive has just finished his consultation for hypertension management. As he’s about to leave, he pauses at the door. “Doctor,” he says, “my uncle was just diagnosed with cancer. Is there anything I should be doing to prevent it?” This question, often asked as an afterthought, is…