Haematologist Health Dictionary

An drug used mainly to induce remission of acute myeloblastic LEUKAEMIA. A potent suppressant of myeloblasts, its use requires monitoring by a HAEMATOLOGIST. (See CYTOTOXIC.)... cytarabine

The management of MALIGNANT disease – a major health problem since successful management requires close liaison between the patient, surgeons, physicians, oncologists, haematologists, paediatricians and other specialists. Diagnosis may involve various investigations and often requires a BIOPSY. Once a diagnosis has been established, treatment may involve surgery, radiotherapy or chemotherapy (or various combinations as required) – see below, and main dictionary entries.

Surgery may be most common, and is often the only treatment, for some gastrointestinal tumours, soft-tissue tumours, gynaecological tumours and advanced cancers of the head and neck.

Radiotherapy uses ionising radiation to kill tumour cells. Radiation is by naturally occurring isotopes (see ISOTOPE) or arti?cially produced X-RAYS. Germ-cell tumours (see SEMINOMA; TERATOMA) and malignant lymphomas (see LYMPHOMA) appear to be particularly sensitive to irradiation, and many head and neck tumours, gynaecological cancers, and localised cancers of the PROSTATE GLAND and URINARY BLADDER are curable with radiotherapy. It is also a valuable means of reducing pain from bone metastases (see METASTASIS). Unpleasant side-effects are common: chie?y lethargy, loss of appetite and dry, itchy skin symptoms.

Chemotherapy is also an important treatment in germ-cell tumours (see above); in some forms of LEUKAEMIA and lymphoma; in ovarian cancer (following surgery – see OVARIES, DISEASES OF); and in small-cell lung cancer (although most patients die within 18 months – see LUNGS, DISEASES OF). It is also used in some breast cancers (see BREASTS, DISEASES OF); advanced myeloma (see MYELOMATOSIS); sarcomas (see under CANCER); and some childhood cancers (such as WILMS’ TUMOUR).

More than 20 substances are in common use, the major classes being ALKYLATING AGENTS (e.g. cyclophosphamide, chlorambucil, busul fan); ANTIMETABOLITES (e.g. methotrexate); VINCA ALKALOIDS (e.g. vincristine, vinblastine); and antitumour ANTIBIOTICS (e.g. actinomycin D). Choice of agent and the appropriate regimen requires expert guidance. Common side-effects include nausea and vomiting, bone-marrow suppression and ALOPECIA, with each substance having its own spectrum of unwanted effects.

Good doctor-patient communication, with the sharing of information and bringing the patient into the decision-making process, is vital even if time-consuming and exhausting.

Equally imortant treatment is PALLIATIVE, for example to ensure e?ective pain or nausea control. Common sources of pain in cancer may involve bone, nerve compression, soft tissue, visceral, myofascial, constipation, muscle spasm, low-back pain, joint pain (e.g. capsulitis) and chronic post-operative pain. Patients may be suffering from more than one pain, all of which should be identi?ed. The aim should be to eliminate pain.

There are three rungs of the analgesic ladder; if one rung fails, the next one should be tried:

(1) non-opioid drugs – for example, aspirin, PARACETAMOL, NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS); (2) weak opioids – for example, CODEINE, DIHYDROCODEINE, dextropropoxyphene; (3) strong opioids

– for example, MORPHINE, DIAMORPHINE, buprenorphine. Oral treatment is always preferable, unless prevented by severe vomiting. (See also CANCER; ONCOLOGIST; PAIN; PALLIATIVE CARE.)... oncology

The most common form of cancer throughout the world. Five year survival: 10 per cent. Its association with cigarette smoking is now established beyond doubt. Other causes include such occupational poisons as asbestos, arsenic, chromium, diesel fumes, etc. The squamous cell carcinoma is the most common of the four types.

Diagnosis is confirmed by sputum test, chest X-ray, bronchoscopy or biopsy. Earliest symptoms are persistent cough, pain in the chest, hoarseness of voice and difficulty of breathing. Physical examination is likely to reveal sensitivity and swelling of lymph nodes under arms.

Symptoms. Tiredness, lack of energy, possible pains in bones and over liver area. Clubbing of finger-tips indicate congestion of the lungs. Swelling of arms, neck and face may be obvious. A haematologist may find calcium salts in the blood. The supportive action of alteratives, eliminatives and lymphatic agents often alleviate symptoms where the act of swallowing has not been impaired.

Broncho-dilators (Lobelia, Ephedra, etc) assist breathing. Mullein has some reputation for pain relief. To arrest bleeding from the lesion (Blood root).

According to Dr Madaus, Germany, Rupturewort is specific on lung tissue. To disperse sputum (Elecampane, Red Clover). In advanced cases there may be swollen ankles and kidney breakdown for which Parsley root, Parsley Piert or Buchu may be indicated. Cough (Sundew, Irish Moss). Soft cough with much sputum (Iceland Moss). To increase resistance (Echinacea).

Alternatives. Secondary to primary treatment. Of possible value.

Teas. Violet leaves, Mullein leaves, Yarrow leaves, Gotu Kola leaves, White Horehound leaves. Flavour with a little Liquorice if unpalatable.

Tablets/capsules. Lobelia, Iceland Moss, Echinacea, Poke root.

Formula. Equal parts: Violet, Red Clover, Garden Thyme, Yarrow, Liquorice. Dose: Powders: 750mg (three 00 capsules or half a teaspoon. Liquid Extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Thrice daily, and during the night if relief is sought.

Practitioner. Tinctures BHP (1983). Ephedra 4; Red Clover 4, Yellow Dock 2; Bugleweed 2; Blood root quarter; Liquorice quarter (liquid extract). Mix. Start low: 30-60 drops in water before meals and at bedtime increasing to maximum tolerance level.

Aromatherapy. Oils: Eucalyptus or Thyme on tissue to assist breathing. Inhale.

Diet. See: DIET – CANCER.

Treatment by a general medical practitioner or hospital specialist. ... cancer - bronchial carcinoma

n. the study of blood and blood-forming tissues and the disorders associated with them. —haematological adj. —haematologist n.... haematology

(painful bruising syndrome, psychogenic purpura) a rare disorder, characterized by unexplained, recurrent, and painful bruising, typically arising after physical and/or psycho-emotional stress. Classically, ecchymoses spontaneously appear and are associated with a prodrome of warmth and pain at the sites. The condition, which is seen primarily in young to middle-aged women, is induced by trauma and associated with *personality disorders. Research into the syndrome is sparse but recent publications suggest that only a minority of patients experience a serious reduction in their quality of life, that the condition seems to be dermal rather than systematic in most patients, and that it seems to be associated with ongoing stress. [L. K. Diamond (1902–1999), US paediatrician; F. H. Gardner (1919–2013), US haematologist]... gardner–diamond syndrome