Oncologic emergencies and urgencies: A comprehensive review Review
| Authors: | Gould Rothberg, B. E.; Quest, T. E.; Yeung, S. C. J.; Pelosof, L. C.; Gerber, D. E.; Seltzer, J. A.; Bischof, J. J.; Thomas, C. R. Jr; Akhter, N.; Mamtani, M.; Stutman, R. E.; Baugh, C. W.; Anantharaman, V.; Pettit, N. R.; Klotz, A. D.; Gibbs, M. A.; Kyriacou, D. N. |
| Review Title: | Oncologic emergencies and urgencies: A comprehensive review |
| Abstract: | Patients with advanced cancer generate 4 million visits annually to emergency departments (EDs) and other dedicated, high-acuity oncology urgent care centers. Because of both the increasing complexity of systemic treatments overall and the higher rates of active therapy in the geriatric population, many patients experiencing acute decompensations are frail and acutely ill. This article comprehensively reviews the spectrum of oncologic emergencies and urgencies typically encountered in acute care settings. Presentation, underlying etiology, and up-to-date clinical pathways are discussed. Criteria for either a safe discharge to home or a transition of care to the inpatient oncology hospitalist team are emphasized. This review extends beyond familiar conditions such as febrile neutropenia, hypercalcemia, tumor lysis syndrome, malignant spinal cord compression, mechanical bowel obstruction, and breakthrough pain crises to include a broader spectrum of topics encompassing the syndrome of inappropriate antidiuretic hormone secretion, venous thromboembolism and malignant effusions, as well as chemotherapy-induced mucositis, cardiomyopathy, nausea, vomiting, and diarrhea. Emergent and urgent complications associated with targeted therapeutics, including small molecules, naked and drug-conjugated monoclonal antibodies, as well as immune checkpoint inhibitors and chimeric antigen receptor T-cells, are summarized. Finally, strategies for facilitating same-day direct admission to hospice from the ED are discussed. This article not only can serve as a point-of-care reference for the ED physician but also can assist outpatient oncologists as well as inpatient hospitalists in coordinating care around the ED visit. © 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society. |
| Keywords: | cancer chemotherapy; aged; antianemic agent; busulfan; review; sorafenib; bevacizumab; doxorubicin; erlotinib; fluorouracil; sunitinib; diarrhea; drug safety; skin toxicity; drug targeting; pathophysiology; capecitabine; cancer radiotherapy; rituximab; cancer diagnosis; neoplasm; neoplasms; palliative care; carboplatin; anemia; esophagitis; mucosa inflammation; nausea; vomiting; lorazepam; olanzapine; qt prolongation; cyclophosphamide; immunoglobulin; cancer pain; hypercalcemia; oncology; cetuximab; cancer therapy; ifosfamide; docetaxel; panitumumab; drug hypersensitivity; febrile neutropenia; tumor lysis syndrome; nonsteroid antiinflammatory agent; spinal cord compression; patient safety; vandetanib; blood transfusion; medical oncology; glucocorticoid; ondansetron; health care personnel; nausea and vomiting; clinical pathway; colitis; emergency care; hospital admission; hospital discharge; dermatitis; terminal care; idarubicin; taxane derivative; intestine obstruction; morphine; linezolid; vancomycin; axitinib; corticosteroid; trastuzumab; paraneoplastic syndrome; calcineurin inhibitor; tacrolimus; hand foot syndrome; quinoline derived antiinfective agent; hydromorphone; analgesia; prochlorperazine; cytopenia; hemorrhagic cystitis; outpatient care; hospice; echinocandin; cardiomyopathy; oral mucositis; thymocyte antibody; olaparib; nose obstruction; fentanyl; vasopressin; oxycodone; venous thromboembolism; colistin; internal medicine; codeine; hydrocodone; histamine h2 receptor antagonist; complication; breakthrough pain; spinal cord cancer; emergency medicine; hypophysitis; bronchodilating agent; emergency; propylthiouracil; thiamazole; cytokine release syndrome; daptomycin; oncologist; infliximab; aminoglycoside antibiotic agent; ofatumumab; nystatin; vemurafenib; thrush; emergencies; skin irritation; carbapenem derivative; tocilizumab; dabrafenib; histamine h1 receptor antagonist; mycophenolate mofetil; malignant pleura effusion; ibrutinib; regorafenib; niraparib; humans; human; palbociclib; fidaxomicin; pembrolizumab; polymyxin; obinutuzumab; ribociclib; ozogamicin; aztreonam; entrectinib; vedolizumab; chimeric antigen receptor t-cell immunotherapy; transitional care; hematology/medical oncology; vasopressin release |
| Journal Title: | CA - A Cancer Journal for Clinicians |
| Volume: | 72 |
| Issue: | 6 |
| ISSN: | 0007-9235 |
| Publisher: | Wiley-Blackwell |
| Date Published: | 2022-11-01 |
| Start Page: | 570 |
| End Page: | 593 |
| Language: | English |
| DOI: | 10.3322/caac.21727 |
| PUBMED: | 35653456 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 December 2022 -- Source: Scopus |
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