Oncological Emergencies Overview
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Questions and Answers

What is a common symptom of hypercalcemia of malignancy?

  • Weight gain
  • Cardiac arrhythmias (correct)
  • Hypotension
  • Increased appetite
  • Which type of cancer is NOT commonly associated with causing hypercalcemia in patients with advanced cancer?

  • Colorectal cancer (correct)
  • Small cell lung cancer
  • Non-small cell lung cancer
  • Breast cancer
  • What is a common symptom of spinal cord compression?

  • Abdominal bloating
  • Weakness in the legs (correct)
  • Excessive thirst
  • Chest pain
  • Which treatment approach is NOT used for managing superior vena cava syndrome?

    <p>Cardiac catheterization</p> Signup and view all the answers

    What is a common primary cause of metastatic cancer leading to spinal cord compression?

    <p>Lung cancer</p> Signup and view all the answers

    Which medication may be used to control the extent of bone resorption in hypercalcemia of malignancy?

    <p>Calcitonin</p> Signup and view all the answers

    What is one of the metabolic disturbances associated with tumor lysis syndrome?

    <p>Hypercalcemia</p> Signup and view all the answers

    What are some risk factors for tumor lysis syndrome?

    <p>High tumor burden and large cell size</p> Signup and view all the answers

    Which type of malignancy is tumor lysis syndrome more commonly associated with?

    <p>Non-Hodgkin's lymphoma</p> Signup and view all the answers

    What is a common complication related to hypercalcemia of malignancy?

    <p>Renal stones</p> Signup and view all the answers

    Superior vena cava syndrome is a common oncological emergency that results from:

    <p>Compression of the vein that leads to the heart from the upper body</p> Signup and view all the answers

    What is a primary symptom of spinal cord compression, an oncological emergency?

    <p>Neurologic deficits like weakness or numbness</p> Signup and view all the answers

    Study Notes

    Oncological Emergencies

    Oncological emergencies are life-threatening complications that can occur during cancer treatment or stem from the underlying malignancy itself. These emergencies require prompt attention and often involve the collaborative efforts of an oncologist, emergency physician, and other specialists to manage effectively. Some of the most common oncological emergencies include tumor lysis syndrome, hypercalcemia of malignancy, spinal cord compression, and superior vena cava syndrome.

    Tumor Lysis Syndrome

    Tumor lysis syndrome (TLS) occurs when cancer cells are rapidly broken down by chemotherapy. This can lead to a rapid release of intracellular contents into the bloodstream, causing metabolic disturbances such as hyperkalemia, hyperphosphatemia, hypocalcemia, and acute kidney injury. The risk factors for TLS include high tumor burden, large cell size, and higher rates of proliferation. It is more commonly associated with hematologic malignancies like non-Hodgkin's lymphoma and leukemias but can occur in solid tumors as well.

    Management of TLS includes aggressive hydration, administration of allopurinol or rasburicase to prevent complications related to phosphate and uric acid elevations, and monitoring of electrolytes and renal function. In some cases, renal replacement therapy may be necessary if severe acidosis, hyperkalemia, or volume overload presents.

    Hypercalcemia of Malignancy

    Hypercalcemia in patients with cancer can result from multiple sources including increased bone resorption due to osteoclast activation, parathyroid hormone–related peptide production, or ectopic PTHrP secretion by breast or lung cancer cells. This condition can cause symptoms like fatigue, dehydration, nephrolithiasis, cardiac arrhythmias, and neurological issues. Non-small cell lung cancer, small cell lung cancer, and breast cancer are among the most frequent causes of hypercalcemia in patients with advanced cancer.

    The management of hypercalcemia involves restoring fluid balance, correcting any electrolyte imbalances, and addressing the primary source of calcium excess. Medications such as calcitonin, zoledronic acid, or denosumab may also be used to control the extent of bone resorption.

    Spinal Cord Compression

    Spinal cord compression (SCC) occurs when there is pressure on the spinal cord caused by a vertebral body fracture or neoplastic invasion by tumor cells. Symptoms can vary depending on the level of the spine affected but generally include pain that radiates down one or both legs, weakness, sensory loss, and bowel or bladder dysfunction. Metastatic cancer is the most frequent cause of spinal cord compression, with lung and breast cancers being the most common primary tumors.

    The management of SCC involves immediate stabilization of the spine, administration of corticosteroids to reduce edema around the spinal cord, and management of any neurological deficits. If possible, definitive treatment of the underlying malignancy should also be pursued.

    Superior Vena Cava Syndrome

    Superior vena cava syndrome (SVCS) occurs when the superior vena cava (SVC) is obstructed by a malignant process, often a lung cancer or lymphoma. This can lead to swelling of the face, neck, and upper extremities, as well as dyspnea and cough. Non-small cell lung cancer and lymphomas are the most common causes of SVCS.

    Management of SVCS involves symptomatic relief, such as diuretics for edema, and treatment of the underlying malignancy. In some cases, stent placement or radiation therapy may help relieve the obstruction.

    In conclusion, oncological emergencies are potentially life-threatening complications that can arise during cancer treatment or from the cancer itself. Prompt recognition and management of these emergencies are crucial for patient survival and quality of life. A multidisciplinary approach, involving oncologists, emergency physicians, and other specialists, is often required to effectively manage these complex cases.

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    Description

    Learn about life-threatening complications that can occur during cancer treatment or due to underlying malignancies, such as tumor lysis syndrome, hypercalcemia of malignancy, spinal cord compression, and superior vena cava syndrome. Discover the key features, risk factors, and management strategies for each oncological emergency.

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