[Emergencies in patients with tumors]

Oncological emergencies are frequent, particularly in advanced cancer stages. Many situations can only be tackled successfully with the cooperation of a well organized team of specialists. Spinal cord compression caused by cancer requires particularly swift action. The diagnosis should include a careful neurological examination. Myelography, once a classical approach in this setting, is increasingly being replaced by nuclear magnetic imaging techniques. Steroids should be given immediately after a diagnosis has been made and further treatment includes surgery, radiotherapy and/or chemotherapy, depending on the type of tumour involved. Febrile patients with severe neutropenia due to myelosuppression by cytostatic drugs often require treatment with intravenous antibiotics. Although hematopoietic growth factors are now available to hasten neutrophil recovery, these drugs should not be given on a routine basis. Another relatively frequent emergency is the superior vena cava syndrome, which is almost always due to a malignant tumour. Any treatment plan prepared to deal with an oncological emergency in a particular patient should take into account the prognosis of the underlying disease, the prospects for further therapy, and the patient's attitude.