Oncological Emergencies

• Cause: Rapid tumor cell breakdown following chemotherapy or radiation, especially in high-grade lymphomas and leukemias.
• Features: Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, acute kidney injury.
• Management: IV fluids, allopurinol or rasburicase, correction of electrolyte abnormalities.

2. Hypercalcemia of Malignancy

• Cause: Common in cancers like breast, lung, and multiple myeloma due to bone metastasis or production of parathyroid hormone-related protein (PTHrP).
• Features: Nausea, vomiting, confusion, dehydration, constipation, and in severe cases, coma.
• Management: IV hydration, bisphosphonates (zoledronic acid), and calcitonin.

3. Febrile Neutropenia

• Cause: Low neutrophil count (<500/mm³) following chemotherapy increases the risk of infection.
• Features: Fever, signs of infection (though they can be subtle due to low immunity).
• Management: Immediate broad-spectrum antibiotics, granulocyte-colony stimulating factors (G-CSF) to stimulate WBC(absolute neutrophil count) production.

4. Spinal Cord Compression

• Cause: Compression of the spinal cord by a tumor, often from vertebral metastases in cancers like breast, prostate, and lung cancer.
• Features: Back pain, motor weakness, sensory loss, bladder/bowel dysfunction.
• Management: High-dose steroids (dexamethasone), surgical decompression, or palliative radiotherapy.

5. Superior Vena Cava (SVC) Syndrome

• Cause: Obstruction of the superior vena cava by a tumor, often seen in lung cancer or lymphoma.
• Features: Swelling of the face, neck, and upper arms; shortness of breath; distended neck veins.
• Management: Elevating the head, diuretics, steroids, radiation, or stenting of the SVC.

6. Pericardial Tamponade

• Cause: Accumulation of fluid in the pericardium, often due to metastatic disease from cancers like lung, breast, and lymphoma.
• Features: Hypotension, muffled heart sounds, distended neck veins (Beck’s triad).
• Management: Urgent pericardiocentesis to drain the fluid, intravenous fluids, pericardial window surgery in severe cases.

7. Acute Leukostasis

• Cause: High white blood cell count in leukemia (especially acute myeloid leukemia) causing blood viscosity.
• Features: Respiratory distress, confusion, headaches, and stroke-like symptoms.
• Management: Leukapheresis (removal of white cells from blood), hydroxy urea,  chemotherapy.

8. Acute Airway Obstruction

• Cause: Tumor blocking the airway (e.g., lung or head and neck cancers).
• Features: Stridor, respiratory distress, cyanosis.
• Management: Oxygen, bronchoscopy, stenting, radiation, or surgical intervention.

9. Increased Intracranial Pressure (ICP)

• Cause: Brain metastases, primary brain tumors, or hemorrhage.
• Features: Headache, nausea, vomiting, visual disturbances, altered mental status, seizures.
• Management: Steroids (dexamethasone), surgery or radiation for tumor control, anticonvulsants for seizure management.

10. Sepsis

• Cause: Cancer patients, particularly those with neutropenia, are at high risk of developing severe infections.
• Features: Fever, hypotension, tachycardia, confusion, organ dysfunction.
• Management: Immediate administration of broad-spectrum antibiotics, fluids, vasopressors if needed, and close monitoring in the ICU.