Oncologic Emergencies

2021 ◽  
Vol 32 (3) ◽  
pp. 306-314
Author(s):  
Ninotchka Brydges ◽  
Garry J. Brydges
Keyword(s):  
Care Management ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
The United States ◽  
Newly Diagnosed ◽  
Increased Intracranial Pressure ◽  
Related Complication ◽  
Oncologic Emergencies ◽  
Different Types ◽  
Life Threatening

A new cancer diagnosis is expected to affect approximately 1.9 million people in the United States in 2021. A small percentage of these patients will experience an emergent cancer-related complication. Oncologic emergencies may be encountered in emergency departments or require intensive care management. Patients newly diagnosed with cancer are more likely to present with emergencies related to the underlying malignancies. Oncologic emergencies can have various manifestations, ranging from mechanical obstruction due to tumor growth to metabolic derangements due to abnormal secretions from the tumor. Therefore, early identification and treatment of life-threatening oncologic events is critical. Although there are several different types of oncologic emergencies, this article focuses on metabolic emergencies (tumor lysis syndrome and cytoreductive hyperthermic intraperitoneal chemotherapy) and structural emergencies (increased intracranial pressure and vena cava thrombus). The purpose of this article is to provide acute care clinicians with an overview of selected oncologic emergencies and their evidence-based management.

Oncologic Emergencies

2011 ◽  
Vol 22 (4) ◽  
pp. 337-348 ◽  
Author(s):  
Regan Demshar ◽  
Rachel Vanek ◽  
Polly Mazanec
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Hemodynamic Instability ◽  
Cord Compression ◽  
Current Evidence ◽  
Oncologic Emergencies ◽  
Life Threatening

The picture of oncologic emergencies in the intensive care unit has changed over the past decade. The classic emergencies, that is, superior vena cava syndrome, spinal cord compression, tumor lysis syndrome and life-threatening hypercalcemia, are now routinely managed on the general oncology unit or in an outpatient setting. Vigilant monitoring for early signs of complications, proactive interventions to prevent complications, and aggressive management account for this change. Currently, emergent conditions that necessitate intensive care unit admission or transfer in the patient with cancer include respiratory failure, cardiac emergencies, hemorrhagic events and coagulopathies, sepsis, and hemodynamic instability. This article will present the current evidence-based management of these conditions, a brief summary of classic oncologic emergencies, and the role of the critical care nurse in meeting the multidimensional needs of the patient and family during the life-threatening episode, based on Ferrell’s quality of life model.

Oncologic Emergencies (DRAFT)

2018 ◽  
Author(s):  
Harry S. Rafkin
Keyword(s):  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Initial Assessment ◽  
High Morbidity ◽  
Patients With Cancer ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Vena Cava Syndrome

Oncologic emergencies are potentially life-threatening syndromes that occur in patients with cancer, and are either directly or indirectly related to the patient’s tumor. The clinical progression of these syndromes is rapid and the initial assessment of the patient must be done quickly, as without immediate therapy, high morbidity and mortality results. The oncologic emergency may be due to the tumor, the treatment given to control the tumor, or it may be due to a previously existing condition. This chapter reviews the clinical presentation, treatment, and management of tumor lysis syndrome, hypercalcemia, hyponatremia, disseminated intravascular coagulation, hyperviscosity syndrome, spinal cord compression, and superior vena cava syndrome.

INTENSIVE CARE OF LIFE-THREATENING CONDITIONS IN PEDIATRIC ONCOHEMATOLOGY

2021 ◽  
Vol 100 (5) ◽  
pp. 138-144
Author(s):  
N.V. Matinyan ◽  
◽  
T.T. Valiev ◽  
K.I. Kirgizov ◽  
S.R. Varfolomeeva ◽  
...  
Keyword(s):  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Adverse Outcomes ◽  
Malignant Neoplasms ◽  
Neutropenic Enterocolitis ◽  
Compression Syndrome ◽  
Life Threatening ◽  
Spinal Cord Compression Syndrome

Malignant neoplasms of the blood system in children are represented by highly aggressive variants, which at the stage of diagnosis and program chemotherapy can be complicated by the development of life-threatening conditions. Understanding the risk of possible complications allows you to effectively carry out preventive and therapeutic measures, to minimize adverse outcomes. This article presents modern approaches to the diagnosis and treatment of the most common life-threatening conditions in pediatric oncohematology: acute tumor lysis syndrome, typhlitis and neutropenic enterocolitis, superior vena cava syndrome, malignant airway compression syndrome, acute impairment of consciousness, spinal cord compression syndrome, thrombosis, methemoglobinemia.

scholarly journals The Domino Effect-Treatment of Superior Vena Cava Obstruction Triggering Tumor Lysis Syndrome: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 44-50
Author(s):  
Suman Ghosh ◽  
Tilak TVSVGK ◽  
Venkatesan Somasundaram ◽  
Mutreja Deepti
Keyword(s):  
Superior Vena Cava ◽  
Lymphoblastic Leukemia ◽  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Potassium Phosphate ◽  
Successful Outcome ◽  
Superior Vena Cava Obstruction ◽  
Tumor Lysis ◽  
Life Threatening

Oncological emergencies present in a multitude of manners-structural, metabolic, hematologic, etc. affecting multiple systems, often. Urgent institution of therapy is often required for a successful outcome. Occasionally, the treatment of one emergency can initiate a related or unrelated emergency, necessitating management of all the complications simultaneously. Superior vena cava obstruction (SVCO) is a medical emergency and most often manifests in patients with a malignant disease process requiring immediate diagnostic evaluation and therapy due to its’ life threatening presentation. The management of the SVCO is usually with chemotherapy, radiotherapy or intervention. In cases of large tumor burden, management of SVCO can trigger other complications. Tumor lysis syndrome is an oncologic emergency, which is characterized by a massive release of intracellular potassium, phosphate, and nucleic acid metabolites into the systemic circulation, which can be life-threatening. We present the case of a T-cell acute lymphoblastic leukemia with superior vena cava syndrome, developing tumor lysis syndrome on instituting definitive chemotherapy in a young patient. Doi: 10.28991/SciMedJ-2021-0301-6 Full Text: PDF

Hematologic and Oncologic Emergencies

2019 ◽  
pp. 170-177
Author(s):  
James McCue
Keyword(s):  
Emergency Department ◽  
Standardized Tests ◽  
Tumor Lysis Syndrome ◽  
Clinical Effects ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
First Response ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Hematologic and oncologic emergencies are an uncommon reason for people to present to the emergency department (ED), but when they do, it is important to know how to diagnose and treat these conditions because many of them are life threatening. Whether it is bleeding due to conditions such as hemophilia, von Willebrand’s disease, warfarin use, or dangerous conditions related to cancer such as tumor lysis syndrome or neutropenic fever, knowing the basics will help you manage these patients and also ace the standardized tests. This chapter presents questions related to the diagnosis, clinical effects, best first response in the ED, and most appropriate treatment of a wide range of these hematologic and oncologic emergencies.

scholarly journals Superior vena cava syndrome

VASA ◽  
2020 ◽  
Vol 49 (6) ◽  
pp. 437-448
Author(s):  
Peter Franz Klein-Weigel ◽  
Saban Elitok ◽  
Andreas Ruttloff ◽  
Sabine Reinhold ◽  
Jessika Nielitz ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Upper Airway ◽  
Interventional Therapy ◽  
Increased Intracranial Pressure ◽  
Life Threatening ◽  
Vena Cava Syndrome ◽  
Brachiocephalic Veins

Summary: The superior vena cava syndrome (SVCS) is caused by compression, invasion, and/or thrombosis of the superior vena cava and/or the brachiocephalic veins. Benign SVCS is separated from malignant SVCS. SVCS comprises a broad clinical spectrum reaching from asymptomatic cases to rare life-threatening emergencies with upper airway obstruction and increased intracranial pressure. Symptoms are correlated to the acuity and extent of the venous obstruction and inversely correlated to the development of the venous collateral circuits. Imaging is necessary to determine the exact underlying cause and to guide further interventions. Interventional therapy has widely changed the therapeutic approach in symptomatic patients. This article provides an overview over this complex syndrome and focuses on interventional therapeutic methods and results.

scholarly journals Enterococcus hiraeBacteremia Associated with Acute Pancreatitis and Septic Shock

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Peter V. Dicpinigaitis ◽  
Manuel De Aguirre ◽  
Joseph Divito
Keyword(s):  
Septic Shock ◽  
Acute Pancreatitis ◽  
Care Management ◽  
Geographical Origin ◽  
The United States ◽  
Human Infection ◽  
Enterococcus Hirae ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Critical Care Management

Infection withEnterococcus hiraehas rarely been reported in humans but is not uncommon in mammals and birds. We describe a case ofEnterococcus hiraebacteremia associated with acute pancreatitis, acute cholecystitis, and septic shock responsive to antibiotic therapy and supportive critical care management. Unique aspects of this case ofEnterococcus hiraebacteremia are its association with acute pancreatitis and its geographical origin. To our knowledge, this is the first report ofEnterococcus hiraebacteremia occurring in a patient in the United States. Although human infection with this organism appears to be rare, all cases reported to date describe bacteremia associated with severe and life-threatening illness. Thus, physicians need to be cognizant of the clinical significance of this heretofore little recognized pathogen.

scholarly journals Androgen deprivation and immunotherapy for the treatment of prostate cancer

2017 ◽  
Vol 24 (12) ◽  
pp. T297-T310 ◽  
Author(s):  
Melissa Gamat ◽  
Douglas G McNeel
Keyword(s):  
Prostate Cancer ◽  
Immune System ◽  
Metastatic Prostate Cancer ◽  
The United States ◽  
Primary Treatment ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Recurrent Prostate Cancer ◽  
System A ◽  
Different Types

Prostate cancer is the most common newly diagnosed malignancy in men, and the second most common cause of cancer-related death in the United States. The primary treatment for recurrent prostate cancer is androgen deprivation, and this therapy is typically continued lifelong for patients with metastatic prostate cancer. Androgens and androgen deprivation have profound effects on the immune system, a finding that has become more appreciated in an era where immune-based treatments for cancer are being increasingly explored. Preclinical studies suggest that androgen deprivation could potentially positively or negatively affect the use of approved immunotherapies, or those that are being developed for the treatment of prostate cancer. In this review, we provide a brief overview of the different types of androgen deprivation treatments used in the management of prostate cancer, discuss their effects on prostate tumors and the immune system and how they are being explored in combination with immunotherapy. Finally, we address some of the critical questions in the field that must be answered to identify the best approaches to combine androgen deprivation with immunotherapy for the treatment of prostate cancer.

Pediatric Hematologic And Oncologic Emergencies

2018 ◽  
Author(s):  
Rebecca Milligan ◽  
Jenny Mendelson
Keyword(s):  
Emergency Medicine ◽  
Immune Thrombocytopenia ◽  
Pediatric Patients ◽  
Tumor Lysis Syndrome ◽  
Von Willebrand Disease ◽  
Emergency Physicians ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Von Willebrand

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.  This review contains 6 figures, 7 tables and 48 references Key words: hematology, hemophilia, immune thrombocytopenia, neutropenic fever, oncology, pediatric, sickle cell anemia, tumor lysis syndrome, von Willebrand disease

Pediatric Hematologic And Oncologic Emergencies

2018 ◽  
Author(s):  
Rebecca Milligan ◽  
Jenny Mendelson
Keyword(s):  
Emergency Medicine ◽  
Immune Thrombocytopenia ◽  
Pediatric Patients ◽  
Tumor Lysis Syndrome ◽  
Von Willebrand Disease ◽  
Emergency Physicians ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Von Willebrand

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.  This review contains 6 figures, 7 tables and 48 references Key words: hematology, hemophilia, immune thrombocytopenia, neutropenic fever, oncology, pediatric, sickle cell anemia, tumor lysis syndrome, von Willebrand disease

Sign in / Sign up

Export Citation Format

Share Document