Oncological Emergencies & Treatment Modalities

1. Oncological Emergencies
&
Treatment Modalities
Prof. (Mr.) Asokan R.
HOD of Medical Surgical Nursing &
Incharge of Research & Development,
Kalinga Institute of Nursing Sciences,
KIIT Deemed to be University,
Bhubaneswar, Odisha.

2. Introduction

3. Overview of the presentation
• Definition
• Importance of oncological emergencies
• Types of oncological emergencies
• Different Oncological Emergencies conditions
• Diagnosis of oncological emergencies
• Treatment Modalities
• Palliative Care and End-of-Life Issues
• Nursing Considerations
• Importance of prompt recognition and treatment of oncological emergencies
• Importance of nursing assessment and intervention
• Importance of symptom management and supportive care

4. Oncological emergencies refer to medical situations that require immediate
attention and intervention due to complications resulting from cancer or its
treatment.
Oncological emergencies are defined as any acute possible morbid or life-
threatening events in patients with cancer either because of the malignancy or because
of their treatment.
Oncological emergencies can be life-threatening and require prompt
diagnosis and treatment to prevent serious consequences.

5. Importance of oncological emergencies

6. • Oncological emergencies are important because they are potentially life-
threatening conditions that require urgent medical attention. Delaying
treatment can lead to serious complications and may even be fatal. Therefore, it
is crucial for cancer patients and their caregivers to be aware of the signs and
symptoms of oncological emergencies.
• Additionally, prompt recognition and management of oncological
emergencies can improve the patient's overall outcome and quality of life.
• Oncological emergencies can also be a sign that the cancer is progressing or has
become more aggressive. Therefore, treating the underlying cancer and
preventing future oncological emergencies is an essential part of cancer care.

7. Types of Oncological emergencies

8. There are several types of oncological emergencies, including
metabolic, hematologic, neurologic, and mechanical emergencies.
Metabolic emergencies include hypercalcemia, tumor lysis syndrome, and
hyponatremia.
Hematologic emergencies can include thrombocytopenia, anemia, and
coagulopathy.
Neurologic emergencies may include seizures, spinal cord compression, or
cerebral edema.
Mechanical emergencies can include bowel obstruction or superior vena cava
syndrome.

9. Oncological
Emergencies

10. II. Oncological Emergencies
• Tumor Lysis Syndrome (TLS)
• Hypercalcemia
• Neutropenic Fever
• Spinal Cord Compression
• Superior Vena Cava Syndrome (SVCS)
• Other oncological emergencies include hemorrhage, acute respiratory distress
syndrome (ARDS), pericardial tamponade, and disseminated intravascular
coagulation (DIC).

11. A. Tumor Lysis Syndrome
• TLS is a condition that occurs when cancer cells break down rapidly and
release large amounts of potassium, phosphate, and uric acid into the
bloodstream. This can lead to kidney failure, cardiac arrhythmias, and
seizures.
• Tumor Lysis Syndrome (TLS) is a potentially life-threatening oncologic
emergency. This can cause an imbalance in the body's electrolytes, leading to
kidney failure, cardiac arrhythmias, seizures, and other serious complications.

12. Causes and Risk Factors:
Commonly occurs in patients with hematologic malignancies such as
leukemia, lymphoma, or multiple myeloma. However, it can also occur in
solid tumors that are particularly sensitive to chemotherapy, radiation
therapy, or immunotherapy.
Risk factors for developing TLS include high tumor burden, rapid
tumor growth, and impaired renal function.

13. Signs and Symptoms:
Symptoms of TLS typically appear within 24-48 hours of initiating
treatment for cancer and may include:
1.Weakness or fatigue
2.Nausea, vomiting, or diarrhea
3.Decreased urine output or dark-colored urine
4.Muscle cramps or spasms
5.Irregular heartbeat or chest pain
6.Seizures or confusion

14. • Prevention: Identifying patients who are at risk and implementing
prophylactic measures such as hydration, alkalinization of urine, and the use of
medications such as allopurinol or rasburicase to prevent the buildup of uric acid
in the bloodstream.
• Treatment: Managing the electrolyte imbalances that occur as a result of
tumor lysis. This may involve correcting imbalances in potassium, calcium, and
phosphate levels, as well as monitoring renal function and providing dialysis if
necessary. In severe cases, patients may require admission to the intensive care
unit for close monitoring and aggressive management of complications.

15. B. Spinal Cord Compression
• Spinal cord compression is a medical emergency that occurs when a tumor
presses on the spinal cord. This can lead to paralysis, loss of sensation, loss
of bladder and bowel control and other neurological symptoms.
Causes and risk factors:
1.Cancer that has metastasized to the spine or nearby tissues
2.Spinal tumors, either primary or metastatic
3.Radiation therapy to the spine or nearby tissues
4.Chemotherapy, which can cause bone marrow suppression and weaken the vertebrae
5.Previous spinal surgery or spinal injury

16. Signs and symptoms:
1.Severe pain in the neck or back, which may worsen at night or with
movement
2.Weakness, numbness, or tingling in the limbs
3.Loss of sensation or ability to move limbs
4.Difficulty walking or loss of balance
5.Loss of bladder or bowel control
6.Sexual dysfunction

17. Treatment modalities:
1.Emergency medical attention: If you suspect spinal cord compression, seek medical
attention immediately, as prompt treatment can help prevent permanent damage to the
spinal cord.
2.High-dose steroids: Steroids are often prescribed to reduce swelling and inflammation
around the spinal cord.
3.Radiation therapy: This can help shrink tumors that are compressing the spinal cord
and alleviate symptoms.
4.Surgery: If other treatments are ineffective, surgery may be necessary to relieve
pressure on the spinal cord.
5.Chemotherapy: This may be used to treat cancerous tumors that are causing the spinal
cord compression.

18. C. Superior Vena Cava Syndrome
• SVCS is a condition that occurs when a tumor compresses the superior vena
cava, which is the large vein that carries blood from the upper body to the heart.
This can lead to swelling in the face, neck, and arms, shortness of breath, and
other symptoms.
• Superior vena cava (SVC) syndrome is a medical emergency & commonly
seen in cancer patients, particularly those with lung cancer, lymphoma, and
metastatic cancers, due to the tumor's involvement in the superior vena cava.

19. Causes: The most common cause is the obstruction of the superior vena cava by a
tumor or a blood clot. Other causes may include benign or malignant diseases that
lead to inflammation or compression of the vein.
Risk factors for SVC syndrome include a history of cancer or blood clots, a
family history of thrombosis or cancer, and the use of central venous catheters.
Signs and Symptoms:
• Swelling of the face, neck, and arms
• Shortness of breath, Chest pain
• Cough, Hoarseness
• Headache, Dizziness, Fainting
• Bluish discoloration of the skin.

20. Treatment Modalities:
• Chemotherapy or radiation therapy to shrink the tumor
• Anticoagulation therapy to prevent or treat blood clots
• Surgery to remove the tumor or insert a stent to open the blocked vein
• Supportive care, including oxygen therapy and medications to manage
symptoms such as pain and swelling.
The management of SVC syndrome is usually multidisciplinary,
involving oncologists, interventional radiologists, and other specialists to
provide comprehensive care.

21. D. Neutropenic Fever
• Neutropenic fever is a medical emergency condition that occurs when a
cancer patient's white blood cell count drops, leaving them vulnerable to
infection. This can lead to a fever, chills, and other signs of infection.
• It is a common complication of cancer treatment, particularly
chemotherapy, and is considered a medical emergency because it can
quickly progress to life-threatening sepsis.

22. Causes: The most common cause is the suppression of bone marrow activity by
chemotherapy or radiation therapy, leading to a decrease in white blood cells,
including neutrophils.
Risk factors for neutropenic fever include a low white blood cell count, recent
chemotherapy or radiation therapy, and the presence of a central venous catheter.
Signs and Symptoms:
• Fever of 100.4°F (38°C) or higher, Chills or shivering
• Rapid heartbeat, Low blood pressure, Shortness of breath
• Pain or soreness in the mouth, throat, Cough
• Abdominal pain or discomfort, Confusion or disorientation.

23. Treatment Modalities: Prompt administration of broad-spectrum antibiotics to
prevent or treat bacterial infections.
• Intravenous antibiotics to treat or prevent bacterial infections
• Antifungal or antiviral medications if there is suspicion of fungal or viral
infections
• Supportive care, including fluid and electrolyte replacement, oxygen therapy,
and pain management
• Granulocyte colony-stimulating factor (G-CSF) to stimulate the production of
neutrophils.

24. Hypercalcemia
• Hypercalcemia occurs when there is too much calcium in the bloodstream.
This can lead to confusion, dehydration, kidney damage, and heart problems.
• This condition is considered a medical emergency because it can cause severe
symptoms and potentially life-threatening complications.

25. Causes:
The most common cause of hypercalcemia in oncological
emergencies is cancer that has spread to the bone, as this can lead to the
release of calcium from the bones into the bloodstream.
Other causes may include the production of parathyroid hormone-
related protein (PTHrP) by cancer cells, which can cause the bones to
release calcium, and kidney problems that prevent the body from excreting
calcium properly.

26. Risk factors include advanced-stage cancer, cancers that are more likely to
spread to the bones (such as breast, lung, and prostate cancer), and treatment
with certain cancer medications (such as bisphosphonates).
Signs and Symptoms
• Fatigue and weakness
• Nausea and vomiting
• Loss of appetite, Constipation, Dehydration
• Confusion and disorientation
• Muscle weakness and bone pain
• Increased urination and thirst

27. Treatment Modalities: The primary goal is to lower the calcium level in the blood
as quickly as possible to prevent further complications.
• Intravenous fluids: This can help to flush excess calcium out of the bloodstream and
improve hydration.
• Medications: Drugs such as bisphosphonates or calcitonin may be used to reduce
the amount of calcium in the blood and prevent its release from the bones.
• Corticosteroids: These drugs can help to reduce inflammation and swelling in the
body, which can be a contributing factor to hypercalcemia.
• Chemotherapy: If hypercalcemia is caused by an underlying cancer, treating the
cancer with chemotherapy may help to lower calcium levels.
• Hemodialysis: In severe cases of hypercalcemia, hemodialysis may be required to
remove excess calcium from the blood.

28. E. Other oncological emergencies
• Sepsis
• Disseminated intravascular coagulation (DIC)
• Cardiac tamponade

29. Sepsis
Sepsis is a potentially life-threatening condition that occurs when the
body's immune response to an infection becomes dysregulated and causes
inflammation throughout the body.
Causes and Risk Factors:
• The primary cause is bacterial infections, which can occur due to weakened
immune systems, surgical procedures, and invasive devices such as
catheters.
• Chemotherapy and radiation therapy can also weaken the immune system
and increase the risk of infections that can lead to sepsis.

30. Signs and Symptoms:
• Fever or hypothermia, Rapid heart rate, Rapid breathing
• Confusion or altered mental status
• Low blood pressure, Decreased urine output, Skin rash or discoloration
Treatment Modalities:
• The first line of treatment is prompt administration of antibiotics.
• In addition to antibiotics, supportive care is necessary, including fluid
resuscitation, oxygen therapy, and management of organ dysfunction.
• In severe cases, patients may require admission to the intensive care unit for
close monitoring and advanced interventions.

31. Disseminated intravascular coagulation (DIC)
• Disseminated intravascular coagulation (DIC) is a serious condition
characterized by abnormal clotting of blood within the small blood
vessels, leading to the formation of small blood clots that can block
blood flow to vital organs.
DIC can occur in oncological emergencies, which are critical
situations in patients with cancer that require urgent medical attention.

32. Causes and risk factors:
DIC can be caused by a wide range of conditions, including cancer,
sepsis, trauma, obstetric complications, and certain medications.
In oncological emergencies, the most common cause of DIC is cancer
itself, particularly in patients with advanced-stage disease or malignancies
that are associated with high levels of pro-coagulant factors, such as acute
promyelocytic leukemia (APL - aggressive type of acute myeloid leukemia).

33. Signs and symptoms:
• Abnormal bleeding from minor injuries or spontaneous bruising
• Blood clots, which can lead to organ damage, such as kidney failure or
stroke
• Low blood pressure and organ dysfunction, particularly in severe cases
of DIC
• Symptoms related to the underlying cancer, such as weight loss, fatigue,
and pain.

34. Treatment modalities: Depending on the severity of the condition, treatment may
include:
• Aggressive treatment of the underlying cancer, such as chemotherapy, radiation
therapy, or surgery
• Blood transfusions, to replace the blood cells and platelets that have been
destroyed by DIC
• Medications to control bleeding or promote clotting, such as heparin or tranexamic
acid (antifibrinolytic agent)
• Supportive care, including intravenous fluids, oxygen therapy, and mechanical
ventilation, if necessary.

35. Cardiac tamponade
Cardiac tamponade is a medical emergency that occurs when fluid
accumulates in the pericardium, the sac surrounding the heart, causing
compression and compromising the heart's ability to pump blood.
This condition can be a complication of oncological emergencies, such
as metastatic tumors or chemotherapy-induced pericarditis.

36. Causes and risk factors:
• Metastatic tumors: cancer cells can spread from the primary site to the
pericardium, leading to the accumulation of fluid and subsequent cardiac
tamponade.
• Chemotherapy-induced pericarditis: certain chemotherapy drugs can
cause inflammation of the pericardium, leading to fluid accumulation and
cardiac tamponade.
• Other causes: infections, autoimmune diseases, trauma, and radiation therapy
can also lead to cardiac tamponade.

37. Signs and symptoms:
• Dyspnea, Chest pain, Rapid heartbeat
• Low blood pressure (hypotension), Fainting or dizziness
• Swelling in the legs or abdomen, JVD (jugular vein distention)

38. Treatment modalities:
• Pericardiocentesis: a procedure in which a needle is inserted through the chest
wall to remove the fluid from the pericardium.
• Surgery: in some cases, surgery may be necessary to remove the fluid and repair
any damage to the pericardium or heart.
• Chemotherapy: if the cause of the cardiac tamponade is chemotherapy-induced
pericarditis, switching to a different chemotherapy regimen may help.
• Supportive care: oxygen therapy, intravenous fluids, and medications to manage
blood pressure may be needed to support the patient while treating the underlying
cause of the cardiac tamponade.

39. Diagnosis of oncological emergencies

40. The diagnosis of oncological emergencies requires a high degree of suspicion
and a systematic approach, as these emergencies can present with nonspecific
symptoms and signs.
1. History and physical examination.
2. Laboratory tests: Blood tests can help identify abnormalities in the blood count,
electrolytes, liver and kidney function, coagulation profile, and tumor markers.
3. Imaging studies: X-rays, CT scans, MRI, and ultrasound, can help identify the
location and extent of cancer, as well as detect complications such as obstruction,
bleeding, or perforation.
4. Biopsy: Biopsy is essential to confirm the diagnosis of cancer, identify the type of
cancer, and guide further treatment.

41. 5. Endoscopy: Endoscopy can help identify tumors, bleeding, obstruction, or
perforation.
6. Echocardiography: Echocardiography is useful in diagnosing oncological
emergencies such as cardiac tamponade or heart failure.
7. Bone marrow biopsy: Bone marrow biopsy is essential to diagnose and
stage certain types of cancer, such as leukemia or lymphoma.
The diagnosis of oncological emergencies requires a multidisciplinary
approach involving oncologists, radiologists, pathologists, and other
specialists.

42. Treatment Modalities

43. III. Treatment Modalities
• Chemotherapy
• Radiation therapy
• Surgery
C. Complications and management
• Infection prevention and management
• Pain management
• Nutritional support
• Psychosocial support

44. A. Chemotherapy
Drugs used to destroy cancer cells & quickly reduce tumor burden and
alleviate symptoms. Example: Alkylating agents

45. Types of Chemotherapy:
1. Systemic chemotherapy: Use of drugs that are administered orally or
intravenously and circulate throughout the body to kill cancer cells. Systemic
chemotherapy is typically used for metastatic cancers or hematologic
malignancies.
2. Regional chemotherapy: This type of chemotherapy is delivered directly to the
tumor or affected area. Examples of regional chemotherapy include intra-arterial
chemotherapy, intravesical chemotherapy, and intrathecal chemotherapy.
3. Palliative chemotherapy: Used to improve symptoms and quality of life in
patients with advanced cancer who are not eligible for curative treatment.

46. Administration methods:
1.Intravenous (IV) chemotherapy: IV chemotherapy is the most common
method of administration and involves injecting chemotherapy drugs into a
vein.
2.Oral chemotherapy: Oral chemotherapy drugs are taken by mouth in the
form of pills, capsules, or liquids.
3.Topical chemotherapy: Topical chemotherapy involves the application of
chemotherapy drugs to the skin or mucous membranes.
4.Intrathecal chemotherapy: Intrathecal chemotherapy is delivered directly
into the cerebrospinal fluid via a lumbar puncture.

47. Common side effects of chemotherapy:
1.Nausea and vomiting, Fatigue, Hair loss
2.Anemia, Neutropenia, Thrombocytopenia
3.Mucositis, Diarrhea
4.Peripheral neuropathy, Cardiotoxicity

48. Nursing interventions and patient education:
1.Administer antiemetic medications to prevent or alleviate nausea and vomiting.
2.Monitor for signs of infection, anemia, neutropenia, and thrombocytopenia, and
administer appropriate treatments.
3.Provide emotional support and counseling to help patients cope with hair loss,
fatigue, and other side effects.
4.Encourage patients to maintain a healthy diet and hydration to prevent
dehydration and malnutrition.
5.Educate patients on the importance of hand hygiene and infection prevention
measures.

49. B. Radiation Therapy
Radiation therapy (RT) is a common treatment modality for cancer
patients. It involves the use of high-energy radiation to destroy cancer cells
and shrink tumors. In oncological emergencies, radiation therapy may be used
to alleviate symptoms or to manage complications associated with cancer or
its treatment.
Types: It can be delivered externally (external beam radiation therapy) or
internally (brachytherapy).

50. • Common Side Effects:
Skin irritation, fatigue, nausea, vomiting, and diarrhea. These side effects
may be more severe in patients receiving radiation therapy as an emergency
treatment. In some cases, radiation therapy may also cause damage to nearby
healthy tissue.
• Nursing interventions:
They can help patients manage their symptoms by providing medication
to control nausea and pain, assisting with activities of daily living, and
providing emotional support. Nurses should also monitor patients for signs of
radiation toxicity, such as skin irritation or changes in bowel habits.

51. • Patient education:
Patients receiving radiation therapy should be educated on the side
effects they may experience and how to manage them. They should also be
advised to avoid sun exposure and to use sunscreen on treated areas.
Patients should also be encouraged to maintain a healthy diet and to stay
hydrated during treatment.

52. C. Immunotherapy
Immunotherapy is a type of cancer treatment that uses the body's immune
system to fight cancer.

53. It works by stimulating the immune system to recognize and attack
cancer cells. In oncological emergencies, immunotherapy may be used to
manage complications associated with cancer or its treatment.
Types:
There are several types of immunotherapy used in oncological
emergencies, including monoclonal antibodies, immune checkpoint
inhibitors, adoptive cell transfer, and cytokines.

54. • Immune-related adverse events: These side effects can affect any organ in the
body and can be mild or severe. Common irAEs include skin rash, diarrhea,
liver inflammation, and thyroid problems.
In some cases, irAEs can be life-threatening.
• Nursing interventions: They should monitor patients closely for signs of
irAEs and report them to the healthcare provider promptly.
Depending on the severity of the side effects, nursing interventions may
include administering medication to control symptoms, monitoring vital signs,
and providing emotional support.

55. Patient education:
Patients receiving immunotherapy should be educated on the
potential side effects they may experience and how to manage them.
They should also be advised to report any new symptoms to their
healthcare provider promptly.
Patients should also be encouraged to maintain a healthy lifestyle,
including a healthy diet and exercise.

56. Palliative Care and End-of-Life Issues

57. Palliative care is an approach to care that aims to improve the quality
of life of patients facing life-limiting illnesses, such as cancer, by addressing
their physical, emotional, spiritual, and practical needs.
Palliative care is not limited to end-of-life care but can be provided at
any stage of illness, alongside curative or life-prolonging treatments.
The goal of palliative care is to relieve symptoms, improve the patient's
functional status, and enhance their overall well-being.

58. Symptom Management and Supportive Care:
1. Pain Management: Pain is a common symptom experienced by cancer
patients. Palliative care teams work closely with patients to assess and manage
their pain, using a variety of methods, such as medications, nerve blocks, and
non-pharmacological approaches, like massage and relaxation techniques.
2. Dyspnea Management: Dyspnea, or difficulty breathing, is another common
symptom experienced by patients with advanced cancer. Palliative care teams
can help manage dyspnea through medications, oxygen therapy, and
breathing exercises.

59. 3. Fatigue Management:
Fatigue is a common symptom & Palliative care teams can help patients
manage fatigue through medication, energy conservation techniques, and exercise
programs.
4. Psychosocial Support:
Patients with cancer often experience psychological distress, including anxiety
and depression. Palliative care teams provide psychosocial support through counseling,
support groups, and other interventions aimed at improving patients' emotional well-
being.
5. Spiritual Support:
Palliative care teams also provide spiritual support to patients who desire it,
including support for religious practices, spiritual reflection, and end-of-life discussions.

60. End-of-life care in oncological emergencies:
1.Advance Care Planning: Advance care planning involves discussing patients'
values, goals, and preferences for medical treatment at the end of life. This process
should be initiated early in the patient's care, ideally before they experience a
medical crisis.
2.Hospice Care: Hospice care is a specialized form of palliative care that is designed
to support patients and their families during the end-of-life phase. Hospice care is
usually provided at home, but it can also be delivered in a hospice facility or
hospital.
The goal of hospice care is to provide comfort and support to the patient and
their loved ones, manage symptoms, and facilitate a peaceful death.

61. Nursing Considerations and Patient Education:
Nurses play a critical role in end-of-life care, providing physical and
emotional support to patients and their families.
Nursing considerations for end-of-life care include ensuring patient
comfort, managing symptoms, providing emotional support, and facilitating
communication between the patient, their family, and the care team.
Patient education is also an essential component of end-of-life care,
including discussions about the patient's condition, treatment options, and
advance care planning.

62. Nursing Considerations

63. IV. Nursing Considerations
A. Assessment:
The nurse's first priority,
1.Patient history and physical exam: This helps the nurse to identify any pre-
existing conditions or risk factors that may influence the patient's response to
treatment.
2.Vital signs monitoring: Monitoring the patient's vital signs (blood pressure, heart
rate, respiratory rate, oxygen saturation, and temperature) is essential in detecting
early signs of an oncological emergency.
3.Pain assessment: Oncological emergencies are often associated with pain. The
nurse must evaluate the patient's pain level, location, and characteristics.

64. B. Nursing interventions:
1.Administration of medications and treatments: This may include the
administration of chemotherapy, pain medication, antibiotics, or other medications
to manage the patient's symptoms.
2.Patient education and communication: It is essential to provide clear and
concise information about the patient's condition, the treatment plan, and
potential side effects.
3.Supportive care and symptom management: Providing emotional support,
managing symptoms, and improving the patient's quality of life are crucial.

65. C. Collaborative care:
Collaborative care involves working with the interdisciplinary team to
provide comprehensive care for the patient.
1.Employ an interdisciplinary team approach: The nurse should collaborate
with the physician, pharmacist, and other healthcare providers to develop
an appropriate care plan.
2.Communication with healthcare providers: The nurse should provide timely
updates to healthcare providers about the patient's condition, treatment plan,
and any changes in the patient's status.

66. Importance of prompt recognition and treatment of oncological
emergencies
• Oncological emergencies refer to life-threatening complications that occur as a
result of cancer or its treatment. These emergencies require immediate
intervention to prevent further harm and death.
• Delayed or inadequate intervention can lead to irreversible damage and even
death. Early recognition of oncological emergencies can improve the chances of
successful treatment and a better outcome for the patient.
• Prompt recognition and treatment of these oncological emergencies is crucial to
prevent further complications and improve patient outcomes.

67. Importance of nursing assessment and intervention
• Nursing assessment and intervention are ensure that patients receive appropriate
and timely care. Oncological emergencies are acute medical conditions that
require immediate attention, and they can occur as a result of the underlying
cancer or its treatment.
• Nursing assessment is essential in identifying and monitoring the signs and
symptoms of oncological emergencies. The assessment should include a thorough
physical examination, vital signs, and laboratory tests to identify any changes
in the patient's condition & assess the patient's pain level.

68. • Nurses play a vital role in providing supportive care to patients with
oncological emergencies, including pain management, fluid and
electrolyte replacement, and blood transfusions.
They also provide emotional support and education to patients
and their families, helping them understand the nature of the
emergency and the treatment options available.

69. Some examples:
1.Hypercalcemia: This is a common complication in patients with advanced
cancer. Nurses should assess the patient's serum calcium levels, provide
hydration and diuretics, and administer medications to lower calcium
levels.
2.Neutropenic fever: Nurses should assess the patient's temperature and white
blood cell count, administer broad-spectrum antibiotics, and monitor the
patient closely for any signs of sepsis.
3.Superior vena cava syndrome: Nurses should assess the patient's respiratory
status, provide oxygen, elevate the head of the bed, and administer
medications to reduce swelling.

70. Importance of symptom management and supportive care
The goal of symptom management and supportive care is to
provide relief from the symptoms of the oncological emergency and to
prevent further complications.
These interventions may include pain management, hydration,
nutritional support, and other interventions to address specific symptoms
such as bleeding or infection.

71. • Effective symptom management and supportive care can improve the patient's
quality of life, reduce suffering, and promote healing.
• It can also help patients and their families cope with the emotional and
psychological stress that often accompanies oncological emergencies.
• In addition, symptom management and supportive care can reduce the need for
hospitalization and intensive care, which can be costly and may increase the
risk of complications.
• By managing symptoms and providing supportive care, patients with cancer can
receive appropriate treatment in a timely and efficient manner, and the risk
of adverse outcomes can be minimized.

72. Summary

73. Any Doubts

74. Conclusion

75. Healthcare professionals to be aware of the signs and symptoms of
oncological emergencies and to have a high index of suspicion in cancer
patients. Early recognition and prompt treatment can improve the
outcomes and quality of life of cancer patients.
Therefore, educating patients and their families on the importance
of seeking medical attention in case of any unusual symptoms can play a
vital role in the timely management of oncological emergencies.

76. Thank You