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Erschienen in:
01.12.2018 | Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)
New Cancer Therapies: Implications for the Perioperative Period
Erschienen in: Current Anesthesiology Reports | Ausgabe 4/2018
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Purpose of Review
Cancer is on the rise. Standing on verge of exciting discoveries,
research is being translated into therapies that are being widely administered
to patients. Providing a hope for cure, where none existed before. This new body
of knowledge has come from a better understanding of cancer genetics, molecular
and sub molecular behavior, and understanding of cancer-generated cellular
environments. These have led to development of immunotherapy and its many
sub-genres, improvement and introduction of new radiation technologies, and
decreasing toxicities of existing chemotherapies.
Recent Findings
The purpose of this review is to have a summary look at this huge
landscape of cancer therapy. Specially looking at toxicities that an
anesthesiologist should be familiar with while providing perioperative care for
these patients, complications like tumor lysis syndrome, cytokine release
syndromes, Kounis syndrome, myocarditis, encephalopathies, and pituitary failure
need to be kept in mind.
Summary
One should be knowledgeable about these therapies and approach these
patients with a high index of suspicion. Anesthesiologists will need to refine
preoperative assessment with appropriate testing and intraoperative and
postoperative management in collaboration with oncologists, while involving the
expertise of internists, cardiologist, and endocrinologists in helping assess
and manage these patients in the perioperative period.