title: A review in the treatment of oncologic emergencies.
abstract: OBJECTIVE
  Oncologic emergencies are often categorized as a group of metabolic abnormalities associated with the diagnosis of cancer or the initiation of chemotherapy for treatment. These syndromes often arise in the acute setting, demanding an accurate knowledge of the associated condition and current treatment. In this review, we evaluate five oncologic emergencies: tumor lysis syndrome, hypercalcemia, hyponatremia, spinal cord compression, and disseminated intravascular coagulation.
  
  
  CONCLUSIONS
  Oncologic emergencies are often diverse in etiology and are often associated with the initiation of chemotherapy. Tumor lysis syndrome presents as severe electrolyte abnormalities that need to be addressed urgently, sometimes prior to initiation of chemotherapy. Hypercalcemia of malignancy is treated with aggressive rehydration, furosemide, and intravenous bisphosphonates. If a patient with cancer presents with normovolemic hyponatremia, syndrome of inappropriate antidiuretic hormone should be suspected. Malignant spinal cord compression happens when cancer cells grow in, or near to, the spine and press on the spinal cord and nerves. This causes swelling and a reduction in the blood supply to the spinal cord and nerve roots. Disseminated intravascular coagulation is characterized by systemic activation of blood coagulation, which results in generation and deposition of fibrin, leading to microvascular thrombi in various organs and contributing to multiple organ dysfunction syndrome.
  
  
  CONCLUSIONS
  Knowledge of oncology emergencies is critical to the understanding of these emergent syndromes in oncology patients. Each of these disease states requires careful evaluation of the patient's symptoms, monitoring parameters for conditions and supportive care measures and interventions.
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Pi
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: Young
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Earl
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: Zaven
authors.initials: Z
authors.lastname: Norigian
authors.affiliation: Rush University Medical Center, Chicago, IL, USA alimcbride@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: McBride
mesh_terms: D004630:Emergencies; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000628:therapy*
keywords: Tumor lysis syndrome; disseminated intravascular coagulation; hypercalcemia; hyponatremia; oncologic emergencies; spinal cord compression