Radiation, Chemotherapy, and Oncological Emergencies

Vocabulary practice flashcards covering internal radiation (brachytherapy), chemotherapy administration, systemic toxicities, and oncological emergencies.

Brachytherapy

Internal radiation therapy where a radioactive source is placed temporarily or permanently inside the body, delivering treatment from the inside out.

High Dose Rate (HDR) Prostate Brachytherapy

A form of internal radiation where catheters are placed into the prostate using ultrasound and CT guidance, delivering radiation seeds over 15 to 20 minutes before all equipment is removed, leaving no residual radioactivity in the body.

Three Pillars of Radiation Safety

The primary safety principles used to minimize radiation exposure: time (limiting duration in the room), distance (staying as far away as possible, maintaining at least 6 feet), and shielding (using lead barriers or aprons).

Dosimeter Badge

A personal, non-shareable monitoring badge worn by healthcare staff that records cumulative radiation exposure over a specified period to ensure safe occupational exposure limits are not exceeded.

Dislodged Radioactive Seed Protocol

Emergency procedure requiring staff to never touch a fallen seed with bare hands or gloves, but instead retrieve it using tongs, deposit it into a lead-lined radioactive container, notify the healthcare provider, and document the change in implanted seed count.

Permanent Brachytherapy

The implantation of radioactive seeds that deliver low-level radiation over weeks or months, requiring radiation precautions at home and straining of all urine for the first 7 to 10 days to catch any inadvertently passed seeds.

Desquamation (Dry vs. Wet)

Skin breakdown resulting from radiation exposure; dry desquamation presents with cracked, red skin, whereas wet desquamation occurs when radiation damage extends deeper into the lower epithelial or dermal layers.

Mucositis (Stomatitis)

Inflammation, breakdown, and painful ulceration of the epithelial lining of the oral cavity and mucous membranes caused by the targeting of rapidly dividing cells by radiation or chemotherapy.

Vesicant

A medication, such as certain chemotherapy agents, that causes severe cellular damage, blistering, tissue necrosis, or destruction if it infiltrates outside of the blood vessel.

Extravasation

The accidental leakage of an infused vesicant drug (such as Doxorubicin) into the surrounding subcutaneous tissue, necessitating the immediate cessation of the infusion to prevent extensive tissue and muscle necrosis.

Huber Needle

A specially designed, non-coring needle used to access an implanted venous port through its self-sealing silicone septum without removing a core of silicon.

Megastrol

A pharmaceutical agent administered to cancer patients receiving chemotherapy to stimulate and increase appetite.

Chemotherapy-Induced Alopecia

Hair loss occurring 7 to 10 days after the initial chemotherapy treatment due to cell death in rapidly dividing hair follicles, with potential regrowth starting approximately one month after completing chemotherapy.

Engraftment

The phase following a stem cell transplant where infused donor or autologous stem cells take hold in the bone marrow and begin manufacturing new blood cells, usually occurring within 8 to 10 days.

Graft-versus-Host Disease (GVHD)

A severe immune-mediated complication occurring in 30% to 50% of allogeneic stem cell transplant recipients where the newly transplanted donor cells attack the recipient's tissues; managed primarily with corticosteroids.

Superior Vena Cava (SVC) Syndrome

An oncologic complication caused by external compression of the thin-walled SVC (typically from lung cancer [75%] or lymphoma [10%]), resulting in impaired venous drainage from the head, neck, and upper extremities.

Pemberton's Maneuver

A physical exam technique for SVC syndrome where the patient elevates both arms 180 degrees for one minute, which precipitates or worsens facial edema and plethora due to compromised venous return.

Tumor Lysis Syndrome (TLS)

An oncologic emergency triggered by the rapid destruction and lysis of massive quantities of malignant cells post-treatment, releasing excessive intracellular potassium, phosphate, and nucleic acids into the blood.

TLS Electrolyte Triad ('PUKE Calcium')

A clinical mnemonic reflecting the metabolic disturbances in Tumor Lysis Syndrome: elevated Phosphate, elevated Uric acid, elevated Potassium, and low Calcium.

Rasburicase

A recombinant urate oxidase enzyme administered in severe tumor lysis syndrome to metabolize and degrade existing uric acid directly into the more soluble compound allantoin.

Allopurinol

A hypoxanthine and xanthine oxidase inhibitor used in oncology to inhibit uric acid synthesis and protect the kidneys from urate-induced acute kidney injury.