Management of Oncological Emergencies

Oncological emergencies are medical conditions that require immediate attention and intervention in individuals with cancer. These emergencies can arise due to complications of the cancer itself or as a side effect of cancer treatments. Prompt recognition and management of these emergencies are crucial to prevent serious consequences and potentially save lives. Here are some examples of oncological emergencies:

1. Tumor Lysis Syndrome (TLS): TLS occurs when cancer cells break down rapidly, releasing large amounts of cellular contents into the bloodstream. This can lead to electrolyte imbalances, such as high levels of potassium, phosphate, and uric acid, which can cause kidney failure, cardiac arrhythmias, and other life-threatening complications.

2. Neutropenic Fever: Neutropenia refers to a low count of neutrophils, a type of white blood cell responsible for fighting infections. Cancer treatments, such as chemotherapy, can suppress the bone marrow and reduce neutrophil levels, making patients susceptible to infections. If a patient with neutropenia develops a fever, it is considered an oncological emergency due to the risk of severe infections.

3. Spinal Cord Compression: Some cancers, particularly those that metastasize to the spine, can compress the spinal cord, leading to neurological symptoms such as back pain, weakness, numbness, and in severe cases, paralysis. Immediate intervention is crucial to relieve the compression and prevent permanent damage.

4. Superior Vena Cava Syndrome (SVCS): SVCS occurs when a tumor or blood clot obstructs the superior vena cava, a major vein that carries blood from the upper body to the heart. This can result in swelling of the face, neck, and upper body, breathing difficulties, and other symptoms that require urgent intervention to relieve the obstruction.

5. Hypercalcemia: Some cancers, particularly those that involve the bones, can lead to high levels of calcium in the blood. Hypercalcemia can cause symptoms such as extreme thirst, frequent urination, nausea, confusion, and in severe cases, cardiac arrhythmias. It requires immediate treatment to lower calcium levels and address the underlying cause.

6. Bleeding and Coagulation Disorders: Certain cancers, such as leukemia or advanced-stage solid tumors, can disrupt the normal blood clotting mechanisms, leading to spontaneous bleeding or clotting problems. Severe bleeding or clotting episodes require urgent medical attention.

Dr. Arkoprovo Halder is well versed in dealing with the various oncological emegencies by virtue of his training in leading cancer teaching hospitals of India.