Supportive Care & Safety
Managing the fallout — nausea, neutropenia, emergencies, pain, and safe handling.
Chemotherapy Nausea and Vomiting: Blocking the Trigger Zones
A generation ago, the word "cisplatin" meant days of relentless vomiting — the side effect patients feared more than the cancer. Today the same patient often drives home comfortable. What changed isn't the chemotherapy; it's that we learned exactly WHICH triggers the drug pulls, and we now block every one of them BEFORE the infusion starts. This is the story of serotonin, substance P, the trigger zone, and the winning trio.
Febrile Neutropenia: The Oncology Emergency Behind a Simple Fever
A patient on chemotherapy phones the clinic: "It's just a temperature." Those four words trigger the fastest protocol a cancer hospital runs — blood cultures drawn and powerful antibiotics running within the hour. Why? Because in a body stripped of its neutrophils, an ordinary bug that a healthy person would shrug off can be lethal by morning. This is febrile neutropenia, and knowing what to do in the first sixty minutes saves lives.
Oncologic Emergencies: When Cancer or Its Treatment Turns Acute
Most of oncology is measured in weeks and cycles. But a handful of situations are measured in hours — where the tumour, or the chemotherapy meant to shrink it, suddenly threatens the heart, the kidneys, the spinal cord, or the airway. Recognizing these six emergencies, and reaching for the right drug fast, is often the difference between a full recovery and a catastrophe. This is the pharmacology of the oncology 'crash call'.
Cancer Pain and Palliative Care: The WHO Ladder and Beyond
Cancer pain is rarely conquered by one heroic drug. It is layered — a steady background opioid, a top-up for breakthrough, an adjuvant tuned to the nerve or bone, and, never forgotten, a laxative to keep the bowel moving. This is the discipline of the WHO analgesic ladder and the humane logic of palliative care: relieve suffering, in proportion, by the mouth, by the clock, by the ladder.
Handling Chemotherapy Safely: Extravasation, Exposure and Fertility
The same molecule designed to kill a tumour will kill anything it touches: the tissue of a patient's arm if it leaks from the vein, the DNA of the nurse who prepares it, the future children of the young man receiving it. Chemotherapy safety is not paperwork — it is three sharp reflexes: stop a leak the moment it starts, wear the armour every time, and counsel about fertility before the first dose, not after.
