quote:Reasons for emergency room visits
Many cancer patients need some type of emergency care during the course of their illness and treatment. Neutropenic fever is one of the most common reasons, but there are a number of others as well. Oncologic emergencies are usually either compressive or obstructive, metabolic, or cytopenic in nature.
Obstructive or compressive complications can arise when tumors—either primary or metastatic—impinge on nearby organs or structures. Brain tumors or metastases can cause seizures, headaches, strokes, and a host of neurologic symptoms, for example. Spinal cord compression, deep vein thrombosis and pulmonary emboli, superior vena cava syndrome, and obstructed ureters, vessels, airways, and ducts are other examples of compressive or obstructive conditions. Some of these conditions—pleural and pericardial effusions and cardiac tamponade, for example—can result either from the cancer itself or from treatment effects, notably radiation.
Metabolic emergencies like hyperuricemia and hypercalcemia can arise when tumors secrete hormone-like peptides that can disrupt electrolyte balances. Tumor lysis syndrome is a metabolic crisis caused by the destruction of cancer cells. As neoplastic cells die in response to therapy, their intracellular contents are spilled into circulation, causing hyperuricemia and potentially severe disturbances in all of the major electrolytes.
Cytopenic crises in cancer patients who present for emergency care include thrombocytopenic bleeding, neutropenic fever, and acute autoimmune hemolytic anemia. Of these, neutropenic fever is the most common and is usually related to the immunosuppressive effects of chemotherapy, which render patients highly susceptible to potentially dangerous infections.
About 19,000 patients were treated in M. D. Anderson Cancer Center’s Emergency Center (EC) last year. Most were M. D. Anderson patients. About 86% of them presented with urgent or emergent conditions. Not all conditions were directly related to cancer; the focus of this facility is not limited to “oncologic emergencies” but rather to any urgent care needs of cancer patients.
Read the full article here.
Emergency Care for Cancer Patients