Articles:Oncological emergencies
Acute emergencies in oncology are a group of conditions caused by complications of cancer or its treatment, that are life-threatening or irreversibly disabling if clinical management is delayed. As a consequence of our ability to treat increasingly larger numbers of patients effectively, the knowledge to recognise and respond swiftly to such presentations has never been more important.
These emergencies may be encountered at any stage in the pathway of a patient's journey through cancer. This may be at presentation, during the course of treatment, or later in the disease process. Below reviews the most frequently encountered oncological emergencies. It may sound obvious, but it is worth bearing in mind that unrelated acute medical or surgical conditions may occur in patients with malignant disease. Generally, the management will be the same as that of a patient without known cancer.
The emergencies are grouped according to the causative system of origin.
Contents
- 1 Cardiovascular emergencies
- 2 Respiratory emergencies
- 3 Metabolic emergencies
- 4 Renal & Urological emergencies
- 5 Gastrointestinal emergencies
- 6 Neurological emergencies
- 7 Haematological emergencies
- 8 Ophthalmological emergencies
- 9 Musculoskeletal emergencies
- 10 Gynaecological emergencies
- 11 Dermatological emergencies
Cardiovascular emergencies
- Superior vena cava obstruction
- Cardiac tamponade (malignant pericardial effusion)
- Venous thromboembolism
- Extravasation injury
- Complications of central venous devices[1]
Respiratory emergencies
- Acute large airway obstruction
- Pulmonary haemorrhage
- Respiratory failure
- Intractable hiccups
- Radiation pneumonitis
- Pleural effusion (malignant)
Metabolic emergencies
- Tumour lysis syndrome
- Hypercalcaemia
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Hypomagnesaemia
Renal & Urological emergencies
- Obstructive uropathy
- Urate nephropathy (from TLS)
- Haemorrhagic cystitis[2]
Gastrointestinal emergencies
- Obstruction
- Perforation
- Gastrointestinal haemorrhage
- Nausea and vomiting (uncontrolled)
- Mucositis (uncontrolled)
- Diarrhoea (uncontrolled)
- Abdominal ascites (malignant)
- Neutropaenic enterocolitis
Neurological emergencies
- Spinal cord compression
- Cauda equina syndrome
- Raised intracranial pressure
- Seizures (fits)
Haematological emergencies
- Leukostasis
- Hyperviscosity
- Disseminated intravascular coagulation
- Thrombocytopaenia
- Febrile neutropaenia (neutropaenic sepsis)
Ophthalmological emergencies
- Ocular and orbital metastases
Musculoskeletal emergencies
- Metastatic bone pain
- Pathological fractures
Gynaecological emergencies
- Gynaecological haemorrhage
Dermatological emergencies
- Acute skin reactions