An Overview of Oncologic Emergencies - What Family Physicians and their Patients Need to Know View PDF

^*Rumi Khajotia
Pulmonology, International Medical University, Hospital Tuanku Ja’afar Malaysia, International Medical University, Seremban, Malaysia

^*Corresponding Author:

Rumi Khajotia
Pulmonology, International Medical University, Hospital Tuanku Ja’afar Malaysia, International Medical University, Seremban, Malaysia
Email:kkhajotia94@yahoo.com

Published on: 2013-09-26

Abstract

Over the years, the number of cancer patients globally has increased exponentially, and the problem is now a growing one. Family Physicians take care of their patients on a day-to-day basis and are commonly the first to suspect and refer patients with malignancies. Consequently, early suspicion of a potential malignant process by the family physician is essential for prompt referral of the patient to a speciality centre, thereby resulting in early diagnosis and treatment, with a consequent reduction in both morbidity and mortality. Hence, it is imperative for family physicians to be well acquainted with the knowledge of potential oncological emergencies which they could commonly encounter in the course of their busy medical practice.

Keywords

Hypercalcaemia; Bisphosphonates; Lymphoma; Neutropenia; Dexamethasone

Introduction

The incidence for most cancers is decreasing in the United States and many other developed nations. However, in contrast, the incidence and mortality rates are increasing in the developing world because of an increasing incidence of smoking, adoption of a sedentary lifestyle and increased intake of a calorie-rich diet. Consequently, the incidence of lung and colon cancers in some developing nations is greater than those in the United States and other western countries. Worldwide, it was estimated that there were about 12.7 million new cancer cases and 7.6 million cancer deaths in 2008 alone [1]. However, cancer incidence amongst males and females varies widely across countries. Amongst men, lung cancer is the commonest cause of cancer in most parts of Eastern Europe and Asia; liver cance.

in West Africa; prostate cancer in North America, Australia, Western and Northern Europe, and South America; esophageal cancer in East Africa; bladder cancer in Egypt and Kaposi’s sarcoma in central parts of Africa. Amongst women, the most frequently diagnosed cancer is breast cancer in most parts of the world, including North America, parts of South America and Western Asia, Australia and North Africa; liver cancer in Vietnam and Mongolia; cervical cancer in Central America, South America, Sub-Saharan Africa, and India; and lung cancer in North Korea and China [2]. As malignancies become more common, it is imperative for cancer patients and their treating family physicians to be aware of the vital symptoms and signs and various emergency conditions that trigger the need for immediate medical attention. It has to be emphasized that cancer patients are at risk from a wide variety of medical emergencies. These may arise from the direct local effects of the tumour, from its metastases or from generalized effects associated with the disease known as paraneoplastic syndromes. Some medical emergencies can arise as a result of anti-neoplastic therapy, a treatment targeted at preventing the growth of malignant cancerous cells. Because such conditions may require specific emergency management, the recognition of these clinical emergencies by clinicians is critically important, as quite often they are predictable, and can be prevented or adequately managed if diagnosed early, thereby reducing morbidity.