ONCOLOGY EMERGENCIES....KECEMASAN KANSER

ONCOLOGY EMERGENCIES

Oncologic emergencies can occur at any time during the course of a malignancy, from the presenting symptom to end-stage disease. 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. In the setting of recurrent malignancy, these events can occur years after the surveillance of a cancer patient has been appropriately transferred from a medical oncologist to a primary care provider. As such, awareness of a patient's cancer history and its possible complications forms an important part of any clinician's knowledge base. Prompt identification of and intervention in these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness

We have chosen to categorize emergencies as metabolic, cardiovascular, infectious, neurologic, hematologic, or respiratory to highlight their lack of disease specificity and to facilitate their recognition during system-by-system assessment of the patient. These conditions require prompt recognition and treatment.

METABOLIC EMERGENCIES

• Hypercalcemia
• Hyponatremia
• Hypoglycemia
• Tumor Lysis Syndrome 

CARDIOVASCULAR EMERGENCIES

• Pericardial effusion and Cardiac Tamponade
• Superior Vena Cava Syndrome

INFECTIOUS EMERGENCY

• Neutropenic Fever

NEUROLOGIC EMERGENCIES

• Malignant Spinal Cord Compression
• Increased intracranial pressure

HEMATOLOGIC EMERGENCIES

• Hyperviscosity syndrome
• Leukostasis

RESPIRATORY EMERGENCY

• Malignant airway obstruction

CHEMOTHERAPEUTIC  EMERGENCIES

• Extravasation of chemotherapy
• Anaphylactic reactions to chemotherapy 

Conclusions

Oncologic emergencies can threaten the well-being of almost any patient with a malignancy. Because these conditions span the chronologic spectrum of a disease's natural history, from initial presentation to late recurrence to end-stage disease, all clinicians should be familiar with the manner in which these conditions emerge, as well as understand the methods for their prompt assessment and treatment. This review is not intended to address these techniques in an entirely comprehensive fashion, but may provide a framework for the paramedic to process these alarming events from physiology to intervention, permitting room for exciting new advancements in radiology and pharmacology that should continue to improve the care of the cancer patient in their hour of greatest need.