Patient age is one of the strongest predictors of the biology of an ovarian mass and should guide the differential diagnosis, tumour marker selection and management Learning Objectives After reading this article, you should be able to: Clinical Case A 17-year-old girl presented to her family physician with intermittent lower abdominal pain for three months….
Breast Cancer Risk Factors series – III The previous post covered the reproductive and hormonal factors, which are mostly non-modifiable. This post covers the second group —lifestyle risk factors for breast cancer. Several of these are modifiable, which makes them the targets of prevention and counselling. Many still act through the same final pathway introduced…
The reproductive and hormonal risk factors for breast cancer for MBBS students — menarche, menopause, parity, lactation, COCP and HRT — unified by cumulative oestrogen exposure.
Mrs. KM is a 45-year-old pre-menopausal woman who presents to the surgical OPD with a self-detected, painless lump in her left breast of two months’ duration. We will follow Mrs. KM throughout this series—through her workup, diagnosis, staging, treatment, and follow-up—to understand both the biology of breast cancer and the clinical approach to its management….
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…