Doctor: With Cancer, Patients Are First Line of Defense
Often, it’s not cancer that kills; it’s the complications of cancer, says physician Stephen Garrett Marcus, a senior biotechnology research executive.
Complications are common and become more frequent and severe if cancer progresses or spreads, he says. Spotting them early and treating them quickly can lessen their impact and save lives.
“Patients and their families are the first line of defense; they need to know what to watch for and seek treatment immediately,” says Marcus, author of a comprehensive new reference, Complications of Cancer (www.DrStephenMarcus.com). “Many can be successfully treated if they’re addressed at the first signs of trouble.”
What to watch for? Marcus describes the symptoms of six common complications:
• Malignant spinal cord compression: Compression of the spinal cord is caused by a malignant tumor or by bones in the spine damaged by cancer. Symptoms may include pain in the neck or back and weakness in the arms or legs. This is a medical emergency and should be promptly treated, or patients risk paralysis. Cancers of the lung, breast, and prostate, commonly spread to the spine and are the most likely cancers to produce spinal cord compression.• Neutropenic sepsis: This condition often occurs during chemotherapy. The most common signs of infection are fever, chills, difficulty breathing, a new persistent cough, a sore throat, or a change in mental clarity. An easy way to lower risk is to keep hands clean. If there is an intravenous access line in place, it is important to keep the area clean.• Pulmonary embolism: Symptoms usually include sudden, severe shortness of breath associated with pain in the chest area. Treatment may include supplemental oxygen and blood pressure support, if necessary, and administration of blood thinning “anticoagulant” medications.• Bacterial pneumonia: Cancer or treatments such as chemotherapy, radiation and steroid medications can diminish a person’s ability to prevent the growth of dangerous bacteria in the lungs and increase the risk of pneumonia. Symptoms can include cough, fever and chills. Antibiotics will generally cure pneumonia caused by the most common types of bacteria. If the person also is having severe difficulty breathing or low blood pressure, hospitalization and intravenous antibiotics may be required.• Intestinal obstruction: The most common first symptom is bouts of severe pain in the middle of the abdomen. Treatment includes intravenous fluids and along with a tube passed into the stomach to decompress the intestine by withdrawing excess fluid and air. Emergency surgery may be necessary to relieve the obstruction.• Delirium, stupor, and coma: The most common causes of these symptoms in people with cancer are problems with blood chemistry, spread of cancer to the brain, side effects of medications and infections. These complications have various treatments after the cause is identified.
“Attitude is the great wild card for surviving cancer,” Marcus say, “both in vigilance for possible complications, and the courage to keep fighting.”
About Stephen Garrett Marcus, M.D.
Stephen Garrett Marcus, M.D. received his medical degree from New York Medical College and completed a medical oncology fellowship at the University of California in San Francisco. As a senior research executive in the biotechnology and pharmaceutical industry since 1985, he played a lead role in developing Betaseron as the first effective treatment of multiple sclerosis, and has led multinational research teams for other treatments. Marcus is the president and CEO of a biotechnology company developing new treatments for cancer and other life-threatening illnesses.