[Anesthesia and Anti-cancer Therapeutic Agents]

An increasing number of cancer patients are treated with anti-cancer chemotherapy and may require not only elective but also emergency surgery. Anti-cancer agents may have adverse effects on various organs and negative effects on subsequent anesthetic management Anesthesiologists must therefore be aware of potential toxicity of anti-cancer agents. The common toxicities include cardiac, pulmonary, bone marrow, renal and hepatic effects. Cardiopulmonary toxicity caused by drugs such as anthracylines and bleomycin is of major concern for anesthesiologists. Other toxicities, however, also require special anesthetic considerations in anes- thesia. Toxicities can be cumulative and irreversible as with anthracyclines, and therefore, attention also has to be paid to the past history of chemotherapy. Preoperative assessment is key to consistent and uncomplicated management of anesthesia. Anesthesi- ologists should take a detailed history of cancer man- agement and understand precise chemotherapy regi- mens and specific side effects experienced by the patient.