New Cancer Therapies: Implications for the Perioperative Period
Tayab Andrabi1, Katy E French2, Muzaffar H Qazilbash3
11Anesthesiology and PeriOper Med, Margaret and Ben Love Clinic (R6.1365), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd.Unit 0409, Houston, TX 77030 USA.
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.
Insights
Advances in cancer therapy offer new hope. Anesthesiologists must understand potential toxicities like cytokine release syndrome and tumor lysis syndrome for optimal perioperative care.
Area of Science:
- Oncology
- Anesthesiology
- Translational Medicine
Background:
- Cancer incidence is increasing globally.
- Significant advancements in understanding cancer genetics and molecular behavior.
- Development of novel cancer therapies including immunotherapy, advanced radiation, and reduced chemotherapy toxicity.
Purpose of the Study:
- To review the evolving landscape of cancer therapies.
- To highlight key toxicities relevant to anesthesiologists in perioperative care.
- To emphasize the importance of awareness regarding specific complications.
Main Methods:
- Literature review of current cancer treatment modalities.
- Identification of perioperative risks associated with new cancer therapies.
- Synthesis of information on potential patient complications.
Main Results:
- Emerging cancer treatments present unique challenges.
- Anesthesiologists must be aware of potential toxicities such as tumor lysis syndrome, cytokine release syndromes, Kounis syndrome, myocarditis, encephalopathies, and pituitary failure.
- These complications require careful consideration during perioperative management.
Conclusions:
- Knowledge of novel cancer therapies and their toxicities is crucial for anesthesiologists.
- A high index of suspicion is necessary when managing patients undergoing cancer treatment.
- Multidisciplinary collaboration with oncologists, internists, cardiologists, and endocrinologists is essential for comprehensive perioperative assessment and management.
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