Nigerian Postgraduate Medical Journal (Jan 2012)
Pattern of Oncologic Emergencies seen in Adult Cancer Patients attending the Radiotherapy & Oncology Centre, Ahmadu Bello University Teaching Hospital, Zaria - Nigeria
Abstract
Aims and Objectives: To evaluate the Pattern of Oncologic Emergencies seen in Adult cancer patients and the treatment modalities used. Materials and methods : Between January 2004 and December 2008, a total of 1824 (M:F = 1:1.8) new patients were seen. 196 (M:F = 1:1.4) consecutive patients with histologically confirmed malignancies presenting with or having oncologic emergencies were treated and have been reviewed. Patients′ folders were reviewed retrospectively with a structured pro forma. Results were analysed using Epi Info soft ware Version 3.4.1; 2007 Edition. Results : The median age was 49 years and mean age of 42 years (range, 15 - 82 years). M: F = 1:1.4. 162 patients had oncologic emergencies at presentation while 21 during treatments and 13 during follow up. At the time of diagnosis of oncologic emergency, 126 were not on any treatment, 42 patients on hormonal therapy and 28 patients were on diverse chemotherapy. All the patients presented late with 108 patients presenting with metastatic disease and 88 patients with locally advanced disease. Only 35 patients were treated within 1 week of onset of emergency. 59 patients had cervical cancer, 31 patients with breast cancer and 28 patients with prostate cancer. Tumour haemorrhage wass the commonest oncologic emergency seen in 107 patients followed by bone pain with imminent cord compression from bone metastases in 59 patients. Of 107 patients with tumour haemorrhage, 54 patients had cardiovascular collapse with 7 having acute renal failure. Similarly, of the 107 with tumour haemorrhage, 56 patients bled from cervical cancer, 12 patients from breast cancer and 8 patients from urinary bladder. 129 patients were treated with teletherapy, 31 patients had chemotherapy, 27 patients had emergency surgery and 5 patients had chemoradiation. Oncologic emergencies were corrected in 126 patients. Conclusion : Tumour haemorrhage is the commonest oncologic emergency in this environment and teletherapy is the commonest therapy used. More radiotherapy centres are needed for prompt treatment and their usefulness in managing emergencies should be made known. Oncologic emergencies are commonly seen in metastatic and locally advanced disease.
