Oncology

I have bee spending this week in the oncology department. As in the UK, ALL is the most common diagnosis, and as stated before all their treatment is free. There are 14 oncology beds, and currently 6 overspilling to the adjacent cardiac ward. I'm under Dr Kailash who is responsible for half of those patients. So far I have seen patients will ALL, AML, NHL, ovarian cancer and one with Langerhan's-cell histiocytosis.

Following the ward rounds is not particularly informative as there is little explanation, but afterwards I have had some discussions with Dr Kailash and Dr Amit (clinical haematologist). I've seen quite a few intrathecal (ie into the lower spine) injections - methotrexate to protect the CNS, and the bravery of the children is quite remarkable. Some invariably cry, but this morning two boys aged 5 and 7 had the injection, and without any anaesethetic, save some lidocaine cream, only winced.

I've also seen some bone marrow biospies for diagnosis, and these have been posterior iliac crest, and one tibial biopsy in a month only baby. At least these have a local anaethetic! The mother of the baby was quite distressed and crying, and I later found although he probably only has an infection (?CMV leading to jaundice), as he had to go to the oncology ward for a biopsy she thought he had leukaemia. Despite some attempts at reassurance, I don't think she was that convinced!