Solid tumours, haematological malignancies, chemotherapy regimens, oncological emergencies, and palliative oncology.
Bladder cancer is the most common urinary tract malignancy, typically presenting with painless visible haematuria, with transitional cell carcinoma (urothelial) accounting for over 90% of cases.
Breast cancer is the most common cancer in the UK with approximately 56,000 new cases per year, managed with a multimodal approach including surgery, radiotherapy, systemic therapy, and increasingly guided by molecular subtype.
Cancer biology encompasses the molecular and cellular mechanisms underlying malignant transformation, characterised by the hallmarks of cancer as described by Hanahan and Weinberg.
Cancer pain affects approximately 70-80% of patients with advanced disease, requiring a systematic approach using the WHO analgesic ladder, with strong opioids being the mainstay for moderate-severe pain.
The NHS operates three national cancer screening programmes (breast, cervical, and bowel), with the aim of detecting cancer or pre-cancerous changes early to reduce mortality.
Cancer staging (TNM/FIGO) describes the anatomical extent of disease, while grading describes the degree of differentiation, both being essential for treatment planning and prognosis.
Cervical cancer is an HPV-driven malignancy managed with surgery for early-stage and concurrent chemoradiotherapy for locally advanced disease, with immunotherapy emerging for recurrent/metastatic cases.
Chemotherapy uses cytotoxic drugs to kill rapidly dividing cells, administered in various settings (neoadjuvant, adjuvant, palliative) with specific side effects requiring careful monitoring and supportive care.
Colorectal cancer is the fourth most common cancer in the UK with approximately 42,900 new cases per year, increasingly detected by the NHS Bowel Cancer Screening Programme and treated with surgery, chemotherapy, and targeted therapy.
Head and neck cancers encompass squamous cell carcinomas of the oral cavity, oropharynx, larynx, and hypopharynx, with smoking, alcohol, and HPV being the major risk factors.
Hepatocellular carcinoma is the most common primary liver cancer, arising almost exclusively in the context of chronic liver disease and cirrhosis, with surveillance AFP and USS being key for early detection.
Hypercalcaemia of malignancy is the most common metabolic emergency in oncology, affecting 10-30% of cancer patients, caused by PTHrP secretion or osteolytic metastases, and treated with rehydration and bisphosphonates.
Oesophageal cancer includes squamous cell carcinoma (upper/mid) and adenocarcinoma (lower/GOJ), with Barrett's oesophagus being the key precursor for adenocarcinoma and dysphagia the hallmark symptom.
Oncological emergencies are life-threatening complications of cancer or its treatment requiring immediate recognition and management, including neutropenic sepsis, spinal cord compression, SVCO, and tumour lysis syndrome.
Ovarian cancer is the most lethal gynaecological malignancy, predominantly high-grade serous carcinoma, treated with debulking surgery and platinum-based chemotherapy, with PARP inhibitors for BRCA-mutated disease.
Palliative chemotherapy aims to improve quality of life, control symptoms, and extend survival in patients with incurable cancer, requiring careful balance of benefit against treatment toxicity.
Pancreatic cancer has the worst prognosis of all common cancers, with only 10-20% of patients having resectable disease at diagnosis and overall 5-year survival approximately 7%.
Prostate cancer is the most common cancer in men in the UK, with a wide spectrum from indolent to aggressive disease, managed with active surveillance, surgery, radiotherapy, hormonal therapy, and novel agents.
Radiotherapy uses ionising radiation to damage DNA in cancer cells, delivered as external beam or brachytherapy, playing a curative or palliative role in approximately 50% of cancer patients.
Renal cell carcinoma is the most common primary renal malignancy, classically presenting with haematuria, loin pain, and a palpable mass, though increasingly detected incidentally on imaging.
Metastatic spinal cord compression (MSCC) is an oncological emergency requiring immediate dexamethasone and urgent MRI, with definitive treatment by radiotherapy or surgery within 24 hours to preserve neurological function.
Superior vena cava obstruction (SVCO) is caused by external compression or invasion of the SVC, most commonly by lung cancer or lymphoma, presenting with facial swelling and dyspnoea requiring urgent management.
Targeted therapy uses agents directed at specific molecular alterations driving cancer growth, including tyrosine kinase inhibitors, monoclonal antibodies, and PARP inhibitors, enabling personalised oncology.
Testicular cancer is the most common solid malignancy in young men aged 15-35, with cure rates exceeding 95% due to cisplatin-based chemotherapy, even in metastatic disease.
Tumour lysis syndrome is a potentially fatal metabolic emergency caused by rapid destruction of tumour cells, releasing intracellular contents and leading to hyperkalaemia, hyperuricaemia, hyperphosphataemia, and hypocalcaemia.