Intensivists often refuse admission to cancer patients needing critical
care, which may result in denial of effective care for some deserving
patients. A cancer patient may need admission to intensive care units
for a variety of reasons. The outcomes of patients with hematological
malignancies, previously dismal, have improved over last 10 years. The
previously known indicators of poor outcome are no longer valid in view
of recent advances in intensive care. A select group of patients with
hematological malignancies may be offered aggressive therapy for a
limited duration and then prognosis can be reassessed. Cancer
chemotherapy can produce toxicities affecting all major organ systems.
Such patients may be admitted with acute organ dysfunction or years
afterwards for incidental illnesses. Knowledge of these toxicities is
essential for early diagnosis, management and prognostication in such
patients. The post-surgical cancer patient has unique problems, the
problems of these groups are discussed. The post-surgical cancer
patient may need care ranging from only monitoring; in view of
supra-major surgery in some patients; to fully aggressive intensive
care for post-surgical anastomotic dehiscence, mediastinitis, septic
shock and multiorgan dysfunction in others. The metabolic and
mechanical complications commonly seen in non-surgical cancer patients
are also discussed. Intensive care should be offered to all cancer
patients who have a reasonable chance of cure or palliation of their
disease
