26 - Supportive care and management of oncologic emergencies

Abstract

This chapter provides an insight into the supportive care and management of oncologic emergencies. In past few decades, survival in children with cancer has increased due not only to advances in specific oncologic therapies, but also due to advances in supportive care and an ability to manage oncologic emergencies. Cancer therapy requires supportive care in the management of infectious complications, blood component therapy, hematopoietic growth factors, pain management, management of nausea and vomiting, nutritional support, and psychosocial support. The metabolic and oncologic emergencies are also discussed along with their clinical features and treatments. Metabolic and endocrine emergencies, oncologic emergencies by anatomic region, and neurologic emergencies are discussed with their etiology, clinical presentation, evaluation, and treatment. Several factors lead to the susceptibility of oncology patients to infections: underlying cancer, type of therapy, degree and duration of neutropenia, disruption of normal barriers, humoral immunity, cell mediated immunity, colonizing microbial flora, and foreign bodies. The management of various infectious complications is discussed and proposed treatments are described briefly.