“The crucial role of internal medicine in managing cancer treatment complications: Expert insights from a SAV internist”

2023-04-26 20:00:06

Oncological therapies such as radiotherapy, chemotherapy and immunotherapy can cause secondary complications in cancer patients, such as affections in the cardiovascular system, in the digestive system, severe infections or generate disorders that affect mental health.

Although in the first instance these conditions are treated by the oncologist, the specialist in internal medicine is able to prescribe specific treatments to alleviate them, and even work together with other specialties if necessary. For example, in cases where antineoplastic drugs cause cardiotoxicity, patients should be seen by a cardiologist.

The internist of the Anticancer Society of Venezuela (SAV), Dr. Oriana Cermeño, explained that “there are various complications secondary to cancer treatment and among them infections, mucositis (inflammation and ulceration of the mucosa of the oral cavity and rest of the gastrointestinal tract), pain, diarrhea, constipation, nausea, vomiting, anxiety, insomnia, decreased cell lines, as well as cardiovascular adverse effects.

He indicated that oncologists, in general, treat these conditions, however, internists can provide comprehensive care and their intervention is very useful, for the treatment of comorbidities and some cases of complications secondary to treatment, such as, for example, in the selection of antibiotics in severe infections.

He also stressed that there are cases in which comprehensive care of the patient is necessary to achieve control of both the oncological disease, as well as endocrine-metabolic, cardiovascular or other pathologies, such as hypertension, diabetes, lipidemia, depression, among other.

most common ailments

Dr. Cermeño explained that antineoplastic treatments that are aimed at eradicating malignant cells can produce side effects such as cytopenia, a condition in which the main cell lines decrease, including white blood cells and red blood cells.

He added that “a patient with decreased white blood cells has an immune system that is incapable of defending itself and is predisposed to the appearance of infections, which can be severe, in some cases even requiring intervention from another specialty such as infectious diseases.”

The SAV internist said that another common ailment in people who receive cancer treatment is diarrhea, “in people with cancer this condition has various mechanisms, either radiation enteritis (inflammation of the digestive tract) or by involvement of the the mucosa that lines the digestive system, which decreases the absorption of water and other nutrients, and diarrhea occurs.

Cermeño pointed out that the treating doctor will prescribe specific treatments to address the side effects suffered by the patient, “if the side effect presented by the patient is nausea or vomiting, antiemetics are indicated; if it is anemia, erythropoietin or blood products are indicated”. In this way, the treatment is directed according to the complication or side effect that each patient presents.

He clarified that the drugs used to treat these complications generally do not interfere with cancer therapies, “the range of drugs that can be used without interacting with cancer therapy is wider than those that interfere with it. Likewise, the internist must keep in mind the existence of these drug interactions when he cares for a person with cancer ”.

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