Oncological emergencies oncology for medical students. In addition, emergencies resulting from comorbid conditions also occur in cancer patients. Oncologic emergencies associated with multiple myeloma include myelosuppression anemia, neutropenia, and thrombocytopenia, bonerelated emergencies, and acute renal failure. Oncologic emergencies are becoming more common as cancer survival rates improve. Commonality of oncologic icu emergencies common neutropenic septic shock cytokine release syndrome. Table 1 lists the classic oncologic emergencies, the types of cancer associated with these conditions, late signs and symptoms, and appropriate interventions. Adverse effects of chemotherapy may also require urgent intervention eg, extravasation and anaphylactic reactions. A 60 year old woman on palliative chemotherapy for lung cancer arrives in. Oncologic emergency medicine conference md anderson. Oncological emergencies are a group of conditions that occur as a direct or indirect result of cancer or its treatment that are potentially lifethreatening these include. Although some of these conditions are related to cancer therapy, they are by no means confined to the period of initial diagnosis and active treatment.
Cancer patients are at risk of a wide array of medical emergencies that can present under different. Please stay tuned for hematologic and therapy oncologic emergencies in a future post. Hypercalcemia of malignancy is treated with aggressive rehydra. Oncologic emergencies brain metastases increased icp n presentation n history of cancer in most cases n symptoms range from focal to generalized n symptoms often subtle, gradual in onset n only 50% have headaches n may see seizures, symptoms of increased icp n. The knowledge of most hematological emergencies is crucial in daily practice. John foote university of torontos ccfpem residency program director and dr. Neck vein distention during inspiration, abnormal heart sounds, tachycardia, increased venous and vascular pressures, sob, weakness, chest pain, orthopenia, anxiety, diaphoresis, lethargy and. Initial manifestations of malignancy or late in disease process oncologic emergencies metabolic oncologic emergencies tumor lysis syndrome tls. The following are examples of ce offerings that apply in the category of oncologic. Oncologic emergencies may be seen in any emergency department and will become more frequent as our population ages and more patients receive chemotherapy. A guide to acute oncology emergencies london cancer. Oncologic emergencies chapter 15 pg 262 oncologic emergencies complications of cancer o lifethreatening o occur as the result of cancer or cancer treatment emergencies can be obstructive, metabolic and infiltrative obstructive emergencies primarily cause by tumor obstruction of an organ or blood vessel superior vena cava syndrome most common o.
Oncologic emergencies ilna points for continuing education courses the following are examples of ce offerings that apply in the category of oncologic emergencies. The comprehensive oncologic emergencies research network concern is comprised of over 20 us medical centers with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multicenter collaborations. Diagnosis and management of oncologic emergencies ncbi. An oncologic emergency may be defined as any acute potentially morbid or lifethreatening event directly or indirectly related to a patients tumor or its treatment. In this article we will cover neutropenic fever, tumor. Download pdf common psychiatric emergencies free online. Download common psychiatric emergencies ebook pdf or read online books in pdf, epub. Hematological emergencies are defined as acute lifethreatening conditions in hematological dis eases dueto benign blood disorders or hematological malignancies or as a result of its treatment. They were agreed, and a decision made to adopt them for the whole of london cancer until further notice, was taken at the london cancer acute oncology expert reference group meeting on tuesday 30th october 2012. Approach the new advances and developments in the field of oncological emergency treatments, for the benefit of oncology specialists. Each chapter is well written and generously endowed with useful charts and tables providing extensive data on differential diagnosis, incidence and etiology, and therapeutic regimens. This post will provide a brief overview of the local physical and biochemical oncologic emergencies.
The management of a medical emergency in the patient with suspected or known cancer requires clinical knowledge and skill as well as a sense of the patients prognosis. Emergencies in hematology and oncology mayo clinic proceedings. Oncologic emergencies are potentially lifethreatening conditions in a cancer patient that have developed, directly or indirectly, as a result of malignant disease or. Cancer patients presenting with acute emergencies should be approached in a similar way to those without cancer. Hypercalcemia of malignancy occurs in 20 to 30 percent of patients with cancer. Cancer patients often have immunologic, metabolic, and hematologic defects, which can lead to complex emergency conditions when they present to an emergency center. Most oncologic emergencies can be classified as metabolic, hematologic, structural, or side effects from. An infiltrative oncologic emergency when there is a gradual or acute onset of fluid in the pericardial space. Concern is an open scientific forum for oncology and emergency. For some oncologic emergencies, surgical interventions may be necessary for. An oncologic emergency is an acute, potentially life threatening condition that has developed directly or indirectly as a result of cancer or cancer treatment 1, 2. Oncologic emergencies in the icu rhonda agostino, anp bc, fccm np coordinator, critical care icupacurrt memorial sloan kettering cancer center.
A word about emergencies not all emergencies are created equal response and definitive treatment may be required within short minutes, hours, or even the next day treatment approach depends on the severity of the emergency and the prognosis of the disease learn to recognize, stabilize, and ask for help. Pdf identifying oncological emergencies researchgate. Most oncologic emergencies can be classified as metabolic, hematologic, structural, or side effects from chemotherapy agents. More recently, oncology patient admissions or transfers to the icu are usually due to lifethreatening emergencies such as respiratory or cardiac compromise, bleeding emergencies, sepsis. This is the 7th oncologic emergency medicine conference at the university of texas md anderson cancer center. A resource for nurses is a comprehensive yet practical guide to understanding and managing oncologic emergencies from the nursing perspective.
Oncological emergencies that may occur include hypercalcemia, superior venous caval obstruction, spinal cord compression and neutropenic sepsis. Oncologic emergencies can result from either the cancer or its treatment. Higdon, ltc, mc, usa, martin army community hospital family medicine residency program, fort benning, georgia jennifer a. Lifesaving interventions are available for certain oncologic emergencies if the diagnosis is made in a timely fashion. Thoroughly updated and expanded, the third edition of understanding and managing oncologic emergencies. Current management of surgical oncologic emergencies. These oncologic emergencies can be broken into four categories.
Oncologic emergencies juanita madison, rn, mn, aocn chi franciscan health oncologic emergencies lifethreatening medical emergencies caused by. This new resource on managing oncologic emergencies is directed at all health care professionals who care for patients with cancer or survivors. Oncologic emergencies is a compact, concise and comprehensive guide to the management of acute and emergency. Malignancy treatment of malignancy when do they occur. Mayo clinic college of medicine and science is accredited by. Ons prevention tls hydration iv normal saline or 5% dextrose begin 24 48 hours prior to therapy ensure urine output 150 200 mlhr diuresis if urine output no maintained by hydration.
Pdf prompt identification and treatment of lifethreatening oncological conditions is of utmost importance and should always be included in the. Treatment of oncologic emergencies american family physician. Quizlet flashcards, activities and games help you improve your grades. Our conference aims to continue to fill the knowledge gap in oncologic emergency medicine by providing information in an interactive forum that in turn enhances medical decision making by healthcare providers.