Journal
BIOMEDICINE & PHARMACOTHERAPY
Volume 146, Issue -, Pages -Publisher
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.biopha.2021.112503
Keywords
Anesthesia; Cancer; Chemotherapy; Toxicity; Perioperative
Funding
- Heart, Lung, and Blood Institute (NHBLI) [5K01HL144882-0]
- Center for Redox Biology and Cardiovas-cular Disease
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Chemotherapy, a common treatment option for cancer, often causes toxicities in multiple organ systems due to its inability to differentiate between malignant and healthy cells. These toxic effects can be acute, chronic, or even appear long after chemotherapy is finished. Additionally, chemotherapy can significantly impact the anesthetic management of patients undergoing surgery.
Cancer is the second most common cause of death in the United States and is a challenging disease to treat. The treatment options for various cancers include but are not limited to surgery, radiation, and chemotherapy. The mechanism behind chemotherapy is intended to promote cellular damage to cells that are proliferating uncontrollably. Unfortunately for the recipients, most chemotherapeutic agents cannot differentiate between malignant cells and healthy cells and tissues. Thus, chemotherapy-induced toxicities are often observed in once-healthy organs. These effects can be acute and self-limiting or chronic, appearing long after chemotherapy is completed. Cancer survivors can then present for non-cancer related surgeries later in life, due to this toxicity. Furthermore, the administration of chemotherapeutic agents can profoundly impact the anesthetic management of patients who are undergoing surgery. This review discusses how chemotherapy-induced organ toxicity can occur in multiple organ systems and what drugs should be avoided if prior toxicity exists in these organ systems.
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