Perioperative issues in patients with cancer

Preoperative evaluation of the oncology patient

This review focuses on the unique perioperative concerns of patients with cancer undergoing surgery. Importantly, not all surgical procedures are intended as cures: some patients who have cancer also undergo surgery for noncancer issues. Also, many of these patients have undergone prior chemotherapy and/or radiation therapy that can introduce perioperative concerns. These previous treatments, unique to patients with cancer, can adversely affect their cardiovascular, pulmonary, gastrointestinal, renal, and endocrine systems. This article also summarizes many important effects of a wide variety of chemotherapy agents in use today.

Preoperative evaluation of the oncology patient

This review focuses on the unique perioperative concerns of patients with cancer undergoing surgery. Importantly, not all surgical procedures are intended as cures: some patients who have cancer also undergo surgery for noncancer issues. Also, many of these patients have undergone prior chemotherapy and/or radiation therapy that can introduce perioperative concerns. These previous treatments, unique to patients with cancer, can adversely affect their cardiovascular, pulmonary, gastrointestinal, renal, and endocrine systems. This article also summarizes many important effects of a wide variety of chemotherapy agents in use today.

Preoperative evaluation of the oncology patient

This article focuses on the unique perioperative concerns of patients with cancer undergoing surgery. Importantly, not all surgical procedures are intended as cures; cancer patients also undergo surgery for noncancer issues. Many of these patients have undergone prior chemotherapy or radiation therapy that can introduce perioperative concerns. These prior treatments, unique to cancer patients, can affect their cardiovascular, pulmonary, gastrointestinal, renal, and endocrine systems adversely, and this article summarizes many important effects of various chemotherapy agents in use today.

Chemotherapy and anaesthetic drugs: too little is known

A growing number of patients undergo surgical procedures with general anaesthesia soon after receiving chemotherapy; occasionally such treatment can be given during surgery. Therefore, it is worthwhile and prudent to consider the pharmacological interactions between anticancer and anaesthetic drugs. We review published data on the pharmacological interactions between antineoplastic and anaesthetic drugs, despite the fact that this specific topic is poorly represented in published work. This low coverage seems to be due more to a lack of knowledge and understanding rather than an absence of interactions between the two drug types. Since the number of individuals receiving chemotherapy in the perioperative period is rising, patients who might have potentially dangerous and unwanted effects are also due to increase in number. Thus, we should be vigilant in the careful surveillance of these interactions as well as broaden our knowledge of in-vivo and in-vitro findings and investigations. Classic cytostatic compounds and modern drugs should be extensively studied, and new anticancer therapies closely interacting with immunological responses need to be better understood, since their clinical effectiveness might be modified by anaesthetics that are currently used. More frequently, tumours are being managed in a multimodal integrated approach with medical, surgical, and radiotherapeutic aspects.