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Tag Archives: resident

Fitness to drive in patients with brain tumours: the influence of mandatory reporting legislation on radiation oncologists in Canada

by Esther Chan, Michelle Hanna, Alex Louie MD, and David D’Souza MD 

 

List of Cases

1.  Generalized seizures
2.  Reporting and reinstating a revoked license
3.  Moderate neurosensory deficits secondary to low grade glioma
4.  Medical, ethical, and legal implications associated with license revocation in brain cancer patients

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Chronic lymphocytic leukemia and breast cancer as synchronous primary in a male— a rare combination

A Resident Education Article

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Case Study

by Biswajit Dubashi, MD, DM

A 69-year-old man with no comorbidities and a family history of cancer presented with a right breast lump of 1 month’s duration. On examination, a 3×2-cm right breast lump with ulceration, fixed to the pectoralis major muscle, was noted. A right axillary hard mobile lymph node was also found. Investigations revealed hemoglobin 8.2 g/dL and total leucocytes 63×109/L, with a differential count of neutrophils 13%, lymphocytes 2%, abnormal cells 85%, and platelets 75×109/L. Bone marrow aspiration and biopsy revealed cll with CD5+ and CD23+. Trucut biopsy from the breast lump revealed an infiltrating ductal carcinoma positive for the estrogen receptor and negative for the progesterone receptor. Staging work-up was normal. The patient had renal dysfunction (creatinine clearance: 30 mL/min) with 13% elevation in uric acid and normal serum calcium and potassium, suggestive of tumour lysis syndrome. The final diagnosis was synchronous primary with carcinoma right breast T4bN1M0 and cll Rai stage iv.

 

Questions:

  1. What are the Malignancies associated with Chronic Lymphocytic Lymphoma?
  2. What are the various theories associated with development of second malignancies in patients?
  3. Which malignancy will you treat initially?
  4. Outline the management of breast cancer in the above patient.
  5. Outline the management of cll in the above patient.

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A Journey Through The Information Fog

by Jonathan Klein, MD

There`s a lot of information out there.

As an opening statement, especially written for a website that seeks to facilitate deep thought about an intense topic like cancer, that sentence is quite banal. But it’s a thought that crossed my mind the other night while perusing Twitter, cycling through various hits that came up when I searched for “cancer.”

I am a resident and I feel constantly bombarded with information. I just began my first ever resident-level rotation in my specialty of choice – radiation oncology – and often just don`t know where to begin. There is so much to learn and not enough time to learn it. I knew residency would be like this, but experiencing the situation first-hand can be overwhelming.

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