Perioperative Care of the Cancer Patient

1st Edition - March 26, 2022
Editors: Carin A. Hagberg, Joseph L Nates, Berhard P Riedel, Vijaya N.R. Gottumukkala, Donal Buggy
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 5 8 4 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 5 8 5 - 5

More than 80% of patients with cancer will need the services of anesthesiology and perioperative medicine, intensive care medicine, and pain management specialists during thei… Read more

Perioperative Care of the Cancer Patient

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More than 80% of patients with cancer will need the services of anesthesiology and perioperative medicine, intensive care medicine, and pain management specialists during their cancer journey for diagnostic, therapeutic, and symptom management needs, as well as for the management of recurrent disease, secondary cancers, and ongoing non-oncologic surgical needs during survivorship. Perioperative Care of the Cancer Patient is today’s most up-to-date, authoritative, comprehensive reference on the acute care of surgical patients with cancer, from a team of international experts in this emerging and dynamic specialty.

Cover Image
Title Page
Copyright
Dedication
Contributors
Preface
Contents
Section 1 Basic Principles (Epidemiology; Cancer Biology; Overview of Cancer Therapies)
Chapter 1 Cancer Epidemiology, Prevention, and Survivorship
Introduction
Cancer Epidemiology
Cancer Prevention and Early Detection
Cancer Survivorship
References
Chapter 2 Global Cancer Surgery—The Lancet Commission
Introduction
The Global Surgical and Anesthesia Crisis
Perioperative Management
Cancer Anesthesia and Surgery
Pain Management
Future Advances for the Surgical and Anesthesia Management of Cancer Patients in Low-Income Countries
Recommendations
Conclusions
References
Chapter 3 Cancer Biology and Implications for the Perioperative Period
Introduction
Development of a Tumor
Nature of a Tumor
The Tumor Microenvironment
Invasion and Metastasis
Approaching Cancer Biology in Perioperative Medicine
References
Chapter 4 Traditional Cancer Therapies and Perioperative Implications
Introduction
Cardiovascular
Pulmonary
Renal
Nervous System
Gastrointestinal
Hematologic
Endocrine
Premature Aging
Conclusion
References
Chapter 5 Newer Cancer Therapies and Perioperative Implications
Introduction
Surgical Considerations
Chemotherapy and Targeted Therapy
Newer Systemic Treatments: Immunotherapy
Radiation Therapy and Newer Techniques
Conclusion
References
Chapter 6 Cancer and Heart Disease
Introduction
Quantification of Systolic Function in Cardio-oncology
Cardiac Mechanics in Cardio-oncology
Cardiac Dysfunction and the Heart Failure Spectrum
Considerations in Radiation-Induced Heart Disease
Cardiac Tumors
Acute Coronary Syndromes
Acute Pericarditis
Pericardial Effusion and Cardiac Tamponade
Conclusion
References
Chapter 7 Personalized Cancer Care
Introduction
Multidisciplinary Care
The Multidisciplinary Team
Imaging
Computed Tomography
Positron Emission Tomography
Molecular Aspects and Personalized Therapy
Treatment Modalities
Conclusion
References
Section 2 Inflammatory-Immune Responses, Perioperative Period, and Cancer Outcomes
Chapter 8 Anemia, Thrombosis, Transfusion Therapy, and Cancer Outcomes
Introduction
Anemia
Transfusion- and Cancer-Related Outcomes
Thrombosis
Conclusion
References
Chapter 9 Improving Cancer Survival Through Perioperative Attenuation of Adrenergic-Inflammatory Signaling
The Perioperative Period—An Underutilized “Window-of-Opportunity” to Prevent Metastatic Disease
Perioperative Stress-Inflammatory Responses: the Prometastatic Edge of the Sword
Addressing Perioperative Inflammation and Adrenergic Stress Responses
Conclusion
References
Chapter 10 Local Anesthetics and Cancer
The Perioperative Period Is Critical for Postsurgical Cancer Outcomes
Potential Detrimental Effects of Anesthetics and Opioid Analgesics
Indirect Benefits of Perioperative Local Anesthetics
Direct Effects of Local Anesthetics on Cancer Cells
NaV1.5 Structure and Function
Conclusion
References
Chapter 11 Volatile and Intravenous Anesthetics and Cancer
General Introduction: Anesthesia and Cancer Progression
Mechanisms of Cancer Development and Progression
Molecular Actions of Anesthetics and Cancers
Preclinical In Vitro and In Vivo Studies of Cancer and Anesthetics
Clinical Studies
Ongoing Clinical Trials
Implication and Conclusions
References
Chapter 12 Opioids and Cancer
Introduction
Mechanisms
Effect of Opioids in Clinically Diverse Patient Groups
Complexities of Linking Opioid Use and Cancer Risk
Future Outlook and Conclusion
References
Chapter 13 Can Regional Anesthesia and Analgesia Influence the Risk of Cancer Recurrence?
What Is Regional Anesthesia?
General Benefits of Regional Anesthesia
How Regional Anesthesia Might Influence Cancer
Evidence for a Benefit of Regional Anesthesia in Cancer Surgery
Translational Studies
Retrospective Analysis
Prospective Evidence
Peripheral Nerve Blocks and Cancer Recurrence
Systematic Reviews and Meta-analysis
Conclusion
References
Section 3 Perioperative/Periprocedural Care in the Cancer Patient
Chapter 14 Preoperative Evaluation and Medical Optimization of the Cancer Patient
Introduction
History and Physical Examination
Preoperative Testing
Cardiovascular Risk Assessment
Pulmonary Risk Assessment
The Older Patient
Cancer-Specific Concerns
Conclusion
References
Chapter 15 Functional Assessment and Prehabilitation
The Physiologic Impact of Cancer and Surgery on Patient Function
The Surgical Insult and the Importance of Preparing Patients for Stress
Functional Assessment and Risk Stratification
Prehabilitation
Exercise and Physical Activity for the Surgical Cancer Patient
Nutrition and the Importance of Protein for the Colorectal Cancer Patient
Psychologic Support
Medical Optimization: Glycemic Control, Anemia
Literature on Prehabilitation and Impact on Outcome
Prehabilitation as a Compelling Strategy: Successes and Challenges Ahead
References
Chapter 16 Redesign of Perioperative Care Pathways
Introduction
Drivers for Pathway-Based Care
Pathway Reengineering
Implications of Pathway-Focused Care
Conclusion
References
Chapter 17 Airway Management in Special Situations
Management of Unanticipated Difficult Airway
Extubation of the Difficult Airway
Management of Upper Airway Bleeding
Conclusion
References
Chapter 18 Procedural Care of the Adult Cancer Patient Outside of the Operating Room
Introduction
Practice Guidelines
Screening
Scheduling
Anesthesia Provider Evaluation
Non-operating Room Anesthesia
Basic Anesthesia Monitoring
Intraprocedural Anesthetic Plan
Positioning
Respiratory Compromise
Post procedure Recovery
Conclusion
References
Chapter 19 Perioperative Care of the Surgical Patient: Brain
Introduction
Preoperative Assessment
Intraoperative Planning
General Anesthesia for Asleep Craniotomy
Awake Craniotomy
Intraoperative Considerations and Management
Postoperative Management and Pain Control
Conclusion
References
Chapter 20 Anesthesia for Spine Cancer Surgery
Introduction
Surgery for Spinal Metastases
Staging and Scoring Systems
Hematologic Malignancies
Cement Augmentation, Kyphoplasty, Vertebroplasty
Stereotactic Radiosurgery and Intensity-Modulated Radiotherapy
Separation Surgery
Decompressive and Stabilization Surgery
En Bloc Resection
Prognosis
Anesthetic Considerations
Preoperative Evaluation
Anesthetic Technique
Airway Management
Positioning
Bleeding
Postoperative Considerations
Venous Thromboembolism
Conclusion
References
Chapter 21 Anesthesia for Head and Neck Cancer Surgeries
Introduction
Cancer Surgery
Applied Anatomy
Preoperative Assessment and Optimization
Patient Education and Counseling
Intraoperative Management
Postoperative Management
Postoperative Complications
Care of the Patient With a Tracheostomy
Postoperative Rehabilitation
Special Considerations for Specific Surgeries
References
Chapter 22 Perioperative Care of the Surgical Patient: Heart, Lung, and Mediastinum Procedures
Anesthetic Management for Thoracic Procedures in the Cancer Patient
Postoperative Management
Mediastinal Masses
Conclusion
References
Chapter 23 Perioperative Care of the Cancer Patient: Breast Procedures
Background
Management of the Breast Cancer Patient
Plastic and Reconstructive Surgery
Types of Breast Reconstruction Modalities
Anesthesia for Breast Surgery
Conclusions
References
Chapter 24 Intraoperative Care of the Surgical Patient: Upper Gastrointestinal Cancers
Introduction
Chemotherapeutic Toxicity
Esophageal Cancer
Prevention of Pulmonary Complications
Cancers of the Duodenum
Cancers of the Oropharynx
Other Upper Gastrointestinal Tumors
Conclusion
References
Chapter 25 Perioperative Care of the Colorectal Cancer Patient
Introduction
Presentation, Diagnosis, and Treatment
Perioperative Considerations of Neoadjuvant Chemotherapy
Anemia and Perioperative Blood Transfusion
Preoperative Exercise and Prehabilitation
Enhanced Recovery After Surgery (ERAS) Protocols
Operative Risk Assessment
Surgery—Open, Laparoscopic-Assisted, or Robotic-Assisted Laparoscopic Approaches
Choice of Anesthesia and Analgesia and Effect on Clinical Outcomes
References
Chapter 26 Perioperative Care of the Surgical Patient: Genitourinary Cancers
Introduction
Perioperative Assessment and Optimization
Enhanced Recovery and Postoperative Care
Common Complications and Causes for Readmission
Thromboprophylaxis
Opioid-Sparing Surgery
Conclusion
References
Chapter 27 Perioperative Care of the Surgical Cancer Patient: Gynecologic Cancers
Introduction
Ovarian Cancer
Cervical Cancer
Endometrial Carcinoma
Vulval Cancer
Perioperative Considerations
Postoperative Considerations
Conclusion
References
Chapter 28 Anesthesiology and Perioperative Management of Patients Presenting for Surgical Excision of Endocrine Tumors
General Introduction
Perioperative Management of Thyroid Tumor Resection
Pheochromocytoma
Cushing’s Syndrome
Twenty-four Hours Urinary Free Cortisol
Late-night Salivary Cortisol
Dexamethasone Suppression Test
Pituitary Adenomas
References
Chapter 29 Anesthesia and Surgery for Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Introduction
Epidemiology and Cancer Subtypes
Strategy in Cytoreductive Surgery and HIPEC
HIPEC Rationale
The Dedrick Diffusion Model
Techniques of HIPEC
Chemotherapeutic Agents Employed During HIPEC
Conduct of Anesthesia for HIPEC
Intraoperative Management
Postoperative Management
Conclusion
References
Chapter 30 Perioperative Care: Sarcoma and Melanoma
Perioperative Care: Sarcoma
Perioperative Care: Melanoma
Conclusion
References
Chapter 31 Perioperative Care of the Surgical Patient: Bone and Soft Tissue Tumors
Introduction
Oncoanesthesia and Some of the Crucial Steps for Better Perioperative Outcomes
Orthopedic Cancers
Regional Anesthesia and Cancer
Anesthetic Agents and Impact on the Immune System
Conclusions
References
Chapter 32 Perioperative Care of the Surgical Patient: Reconstructive Surgery
Applied Surgical, Pathologic, and Physiologic Concepts
Perioperative Considerations
Conclusion
References
Chapter 33 Perioperative Care of the Surgical Patient: Surgical Emergencies in Cancer
Background
Triage
Risk Stratification
Care Processes to Improve Patient Outcomes
Optimizing Patient Condition
Preoperative Airway Assessment
Airway Management in the Emergency Onco-surgical Patient
Airway Emergencies in Cancer Patients—Anesthetic Management
Carotid Blowout Syndrome
Intra-abdominal and Intra-thoracic Surgeries
Management of Patients With Emergency Colorectal Surgeries
Raised Intracranial Pressure
Spinal Cord Compression
Summary
Acknowledgment
References
Chapter 34 Palliative Surgery in Cancer Patients
Introduction
Preoperative Assessment
Interventional Radiology
Esophagus
Stomach
Pancreas
Biliary Tract/Liver
Small and Large Bowel and Rectum
Brain and Vertebral Column
Head and Neck
Pleura, Chest Wall, Lung, and Mediastinum
Breast
Thyroid Gland
Adrenal Gland
Urology
Gynecology
Orthopedics
Conclusions
Key Points
References
Chapter 35 Frailty in the Perioperative Setting for Cancer Patients
Introduction
Frailty in Cancer Patients
Principles of Frailty and Geriatric Syndromes
Frailty Screening and Measurement Tools
Nutrition and How It Impacts on Surgery
Perioperative Care for Older Cancer Patients: Clinical Implications
Conclusion
References
Chapter 36 Delivering Perioperative Care for Older Patients Undergoing Cancer Surgery
Introduction
Core Components of Perioperative Care for Older Patients Undergoing Cancer Surgery
Current Models of Perioperative Care for Older People Undergoing Cancer Surgery
Geriatrician-Led Model
References
Section 4 Acute Postoperative and Intensive Care of the Cancer Patient
Chapter 37 Special Considerations in the Postoperative Care of the Cancer Patient
Nutrition
Functional Status
Prehabilitation
Wound Healing
Adjuvant Therapy
Postoperative Quality of Life in Cancer Patients
References
Chapter 38 Early Warning and Rapid Response Systems
Introduction
The Rapid Response System
Composition
Evidence
Oncology-Related Issues
Future Directions
Summary
References
Chapter 39 Intensive Care Considerations of the Cancer Patient
The Surgical Oncologic Patient
Patients Requiring Monitoring
Postoperative Considerations
High-Flow Nasal Cannula
Non-invasive Positive Pressure Ventilation
References
Chapter 40 The Challenges of Novel Therapies in the Care of the Critically Ill Cancer Patient
Basic Sciences
Novel Cancer Therapies
Novel Agent Toxicity
Conclusion
References
Section 5 Pain and Palliative/Integrative Medicine
Chapter 41 Acute Postsurgical Pain Management in Patients with Cancer
Introduction
Postoperative Pain Management in Cancer Patients
Various Analgesic Modalities
Neuraxial Modalities
Regional Anesthesia
Side Effects and Complications
Postoperative and Postdischarge Follow-up
Conclusion
References
Chapter 42 Chronic and Interventional Pain Management in Patients With Cancer
Introduction
Evaluating the Patient With Cancer-Related Pain
Pharmacologic Management of Cancer-Related Pain
Interventional Management of Cancer Pain
Conclusion
References
Chapter 43 Rehabilitation, Palliative Care, and Integrative Medicine Interventions in Cancer
Rehabilitation Interventions in Patients With Cancer
Palliative Care Interventions in Patients With Cancer
Integrative Medicine Interventions in Patients With Cancer
References
Chapter 44 Integrating Rehabilitative and Palliative Care Principles Within Acute Care Practice
Introduction
Palliative Care
Rehabilitation
Conclusion
References
Section 6 Perioperative/Periprocedural Care of the Pediatric Patients With Cancer
Chapter 45 Overview of Pediatric Cancers
Introduction
Acute Lymphoblastic Leukemia
Acute Myeloid Leukemia
Pediatric Lymphomas
Bone Sarcomas
Rhabdomyosarcoma
Solid-Organ Tumors: Wilms Tumor and Hepatoblastoma
Central Nervous System Tumors
Preoperative Care for the Pediatric Patient With Cancer
References
Chapter 46 Preoperative Assessment of the Pediatric Patient With Cancer
Introduction
Neurologic Evaluation
Cardiac Evaluation
Pulmonary Evaluation
Gastrointestinal Evaluation
Hepatic/Renal Evaluation
Endocrine Evaluation
Hematologic Evaluation
Pain Evaluation
Preoperative Laboratory Testing
Fasting Guidelines
Parental Concerns
Special Considerations
Syndromes Related to Cancer
Vascular Access
Conclusion
References
Chapter 47 Intraoperative Management: Considerations for Specific Procedures in Children with Cancer
Anesthetic Management of the Child with an Anterior Mediastinal Mass
Anesthesia for Pediatric Radiotherapy
Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy
Conclusion
References
Chapter 48 General Principles for Intensive Care Management of Pediatric Patients With Cancer
Introduction/Overview
References
Chapter 49 Anesthesia for Procedures Outside of the Operating Room
Introduction
Locations Requiring NORA
Challenges Associated With NORA
Who Should be Administering Sedation and Anesthesia?
Patient Evaluation, Preparation, and Preprocedure Checklist
Minimum Monitoring Standards
Anesthesia Techniques
Complications
Postprocedural Care
Conclusion and Key Messages
References
Chapter 50 Do Not Resuscitate and the Terminally Ill Child
Introduction
Decision-Making in Pediatrics
Advanced Care Planning
Palliative Procedures
Care at End of Life
References
Chapter 51 Chronic Pain and Palliative Care in the Pediatric Patient
Introduction
Pain Presentations
Palliative Care
References
Chapter 52 Special Considerations for Intensive Care Management of Pediatric Patients With Cancer
Neurologic Diagnoses in the Pediatric Oncologic Critical Care Patient
Anterior Mediastinal Masses
Intraabdominal Tumors
Transfusion Medicine
Enhanced Recovery After Surgery
References
Section 7 Value Proposition and Research in Perioperative Cancer Care
Chapter 53 Value Proposition in Cancer Care: Quantifying Patient-Centered Value in a Comprehensive Cancer Care Center
Radar Plots
A Comprehensive Value Equation for a Comprehensive Cancer Center
Defining the Value Equation
The Value Equation: Summary
Collecting Data
Visualizing and Comparing Value
The Value Equation Payoff
References
Chapter 54 Enhanced Surgical Recovery and Cancer
Introduction
Preoperative Preparation
Intraoperative Management
Postoperative Care
Conclusion
References
Chapter 55 Symptom Assessment, Patient-Reported Outcomes, and Quality of Life Considerations in Perioperative Care for Patients With Cancer
Introduction
Defining PRO concepts
Clinical Research on Pro Application in Perioperative Care
Methodologies for Applying Pro Measures in Perioperative Care
Future Considerations Regarding the Use of PROs in Perioperative Care
Conclusion
References
Chapter 56 Shared Decision-Making and Advance Care Planning in the Cancer Care Journey
Introduction
What Is Shared Decision-Making?
Why Is Shared Decision-Making Needed?
What Elements Are Required to Make Shared Decision-Making Successful?
Individual and Societal Advantages of Shared Decision-Making
How Does Advance Care Planning Fit Into Shared Decision-Making?
Conclusion and Key Points
References
Chapter 57 Ethics in Cancer Care Delivery—Do Not Resuscitate
Introduction
Cardiopulmonary Resuscitation
Law, Regulations, and Guidelines
Intraoperative CPR Outcomes
Outcomes of CPR in Cancer Patients
Outcomes of Palliative and Rescue Surgery in Cancer Patients
Outcomes of Patients with DNR Orders
Ethical Considerations on Sustaining or Withholding DNR Status During Palliative Surgical Procedures
Advance Care Planning—Communicating and Defining Goals of Care
Conclusion
References
Chapter 58 Economics of Cancer Care Delivery: Opportunities and Challenges
Introduction
Cost of Treatments
Current Strategies to Reduce Cost
Conclusion
References
Chapter 59 The Costs of Postoperative Complications After Major Abdominal Surgery: Opportunities and Challenges
Key Points
Introduction
Rectal Resection Surgery
Colonic Resection Surgery
Liver Resection
Pancreatic Resection
Discussion
Conclusion
References
Chapter 60 Research in Perioperative Care of the Cancer Patient: Opportunities and Challenges
Basic Science and Translational Studies
Clinical Endpoints
Retrospective and Population Database Studies
Randomized Controlled Trials
Conclusion
Key Points
References
Chapter 61 Big Data, Advances in Computational Sciences, and Oncology Care
Little Data to Big Data
NoSQL Technology
Computational Advances
Cloud Computing
Analytics and Visualization
Augmented Decision Support
Machine Learning and Artificial Intelligence
Neural Networks and Deep Learning
Genomic Data
Population Health
Impact on Anesthesia
Conclusions
References
Chapter 62 The MD Anderson Cancer Center Moon Shots Program®: A Global Priority
Introduction
Lung Cancer Moon Shot: Smoking Cessation Initiatives
HPV Cancer Moon Shot: The Global Burden of HPV-Associated Cancers
Pancreatic Cancer Moon Shot: The Quest for Early Detection
Conclusion
References
Index

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Carin A. Hagberg

Joseph L Nates

Berhard P Riedel

Vijaya N.R. Gottumukkala

Donal Buggy