Anaesthetic implications of chemotherapy

Abstract

Chemotherapy, radiotherapy, and surgery are the most common modalities used to treat a patient with cancer. Many established chemotherapy drugs are anti-proliferative agents, targeting rapidly dividing cancer cells but also damaging non-malignant dividing cells, leading to toxicity. Chemotherapy usually causes cell death via a drug –receptor interaction that stimulates a cascade of catastrophic events, usually resulting in apoptosis. Common toxicities include cardiac, pulmonary, renal, hepatic, GI, bone marrow, and neurological damage. Table 1 lists the common anticancer action of the frequently used chemotherapy drugs. Newer anticancer agents target other differences between cancer cells and normal cells in order to exert a differential effect but all still have significant toxicity. This article will focus on the challenges that cancer patients receiving chemotherapy present to the anaesthetist.