ONCOLOGIC EMERGENCIES - TREATING ACUTE PROBLEMS RESULTING FROM CANCERAND CHEMOTHERAPY

Oncologic emergencies can occur in cancer patients who have a good pro gnosis. In all of them, the challenge to the clinician is to diagnose and treat before irreversible complications occur. In febrile patients with neutropenia, cultures of body fluids should be obtained and ther apy should be stared immediately with broad-spectrum antibiotics. If s pinal cord compression is suspected, either magnetic resonance spectro scopy or complete myelography can be done to confirm the diagnosis. Pr ompt workup in cancer patients with headaches or seizures may avoid ne urologic consequences. For brain metastases, immediate treatment with dexamethasone (Decadron, Dexone, Hexadrol) is indicated. For hypercalc emia, a number of drugs that inhibit bone resorption, resulting in low er serum calcium levels, are now available. Malignant cardiac tamponad e is relatively rare but potentially lethal; emergency pericardiocente sis often results in marked improvement.