Date of note: April 15, 2005
Name: Jane Smith Age: 28
Date of tissue diagnosis of cancer: November 15, 2004
Diagnosis: Hodgkin’s disease
Stage of cancer: Clinical stage IIA
Pathologic findings: Classical Hodgkin’s disease
Initial treatment plan:
Surgery: Biopsy, left supraclavicular lymph note
Radiation therapy: 30 Gy radiation, to modified mantle field (i.e., bilateral supraclavicular and mediastinal), as consolidation after chemotherapy
Chemotherapy: Stanford V chemotherapy for 12 weeks
Treatment received (specify dates, location, and providers):
Stanford V chemotherapy 12/1/04–3/2/05; full doses, on schedule; Dr. Kay, Eastern University Medical Center
Radiation therapy 3/15/05–4/15/05; Dr. Smith, Eastern University Medical Center
Unusual or unexpected toxicities during treatment:
Expected short- and long-term effects of treatment:
Short term—partial alopecia, hospitalization for fever with neutropenia, 2/15/05 to 2/17/05—given granulocyte colony-stimulating factor and red blood cell transfusion.
Late toxicity monitoring needed:
Thyroid function tests, annually—thyroid-stimulating hormone (TSH) and free T4.
Pulmonary function tests and echocardiograms are not customary or recommended to perform routinely. In particular, it is established that pulmonary function tests within 12 months of thoracic radiation may show mild abnormalities which improve over time.
Careful auscultation of the heart is recommended during follow-up, particularly for patients receiving chest irradiation and anthracycline chemotherapy.
Assessment of fertility—birth control pills for at least 2 years. Monitoring of menstrual functioning. Referral to GYN if requested.