Hematology/Oncology Emergencies
Foreword Hematology/Oncology Emergencies
Amal Mattu, MD Consulting Editor
Medical advances have produced a reduction in many chronic and deadly diseases afflicting our society. Paradoxically, however, these advances have actually produced an increase in the number of patients living with cancer in our society. Mind you, this is not the result of carcinogenic medications or other cancer-inducing therapies! Instead, the rise in cancer prevalence is largely the result of three other factors that we would normally consider medical successes. First, diagnostic testing for cancer has improved so much that we are now able to make these diagnoses in many cases long before terminal stages develop, and in many cases, diagnoses are made even before symptoms begin. Second, advances in cancer therapies have increased the number of “cancer survivors” or turned traditionally rapidly fatal forms of cancer into more chronic diseases. Finally, advances in diagnosis and treatment of many other conditions have helped people live longer lives than at any other point in human history. With longevity comes an increase in the risk of developing cancer. Three-quarters of all cancers in the United States, according to the American Cancer Society, are diagnosed in patients over the age of 55 (http://www.cancer.org/acs/groups/content/@ research/documents/webcontent/acspc-042151.pdf). According to recent statistics from the American Cancer Society, cancer is now the second-leading cause of death in the United States, following only heart disease. Almost 14 million Americans have or have had cancer, and 1.6 million new cases are expected to be diagnosed in 2014 alone. It is estimated that 1,600 Americans die each day from cancer. It is no surprise to anyone working in emergency medicine that the Emergency Department (ED) is the point of entry into the medical system for a great many of these patients when they are first diagnosed or when they suffer a complication related to their cancer. It is therefore imperative that all emergency physicians gain greater familiarity with oncologic conditions and their treatments.
Emerg Med Clin N Am 32 (2014) xv–xvi http://dx.doi.org/10.1016/j.emc.2014.06.001 0733-8627/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
emed.theclinics.com
xvi
Foreword
Fortunately for the readers of Emergency Medicine Clinics of North America, guest editors Drs Jack Perkins and Jonathan Davis have assembled an outstanding group of authors that address the pertinent issues we need to be aware of in managing these patients in the ED. Both solid tumors and hematologic types of cancer are addressed, including specifics about many individual diseases themselves as well as complications of diseases and chemotherapeutic agents. The editors and authors then turn their attention to several basic nononcologic hematologic disorders, including anemia, sickle cell disease, thrombotic microangiopathies, and bleeding disorders. They finish up the issue with an article on blood product transfusions and reactions, and an article that addresses the hot topic of reversal of current antithrombotics. Overall, this issue of Emergency Medicine Clinics of North America represents a mini-fellowship curriculum in hematology 1 oncology for the emergency physician. This issue represents an important contribution to education and is certain to improve the care of this ever-growing patient population in the ED. Our thanks go to the guest editors and their dedicated authors for this excellent work. Amal Mattu, MD Department of Emergency Medicine University of Maryland School of Medicine 110 South Paca Street 6th Floor, Suite 200 Baltimore, MD 21201, USA E-mail address: [email protected]
Foreword Hematology/Oncology Emergencies
Amal Mattu, MD Consulting Editor
Medical advances have produced a reduction in many chronic and deadly diseases afflicting our society. Paradoxically, however, these advances have actually produced an increase in the number of patients living with cancer in our society. Mind you, this is not the result of carcinogenic medications or other cancer-inducing therapies! Instead, the rise in cancer prevalence is largely the result of three other factors that we would normally consider medical successes. First, diagnostic testing for cancer has improved so much that we are now able to make these diagnoses in many cases long before terminal stages develop, and in many cases, diagnoses are made even before symptoms begin. Second, advances in cancer therapies have increased the number of “cancer survivors” or turned traditionally rapidly fatal forms of cancer into more chronic diseases. Finally, advances in diagnosis and treatment of many other conditions have helped people live longer lives than at any other point in human history. With longevity comes an increase in the risk of developing cancer. Three-quarters of all cancers in the United States, according to the American Cancer Society, are diagnosed in patients over the age of 55 (http://www.cancer.org/acs/groups/content/@ research/documents/webcontent/acspc-042151.pdf). According to recent statistics from the American Cancer Society, cancer is now the second-leading cause of death in the United States, following only heart disease. Almost 14 million Americans have or have had cancer, and 1.6 million new cases are expected to be diagnosed in 2014 alone. It is estimated that 1,600 Americans die each day from cancer. It is no surprise to anyone working in emergency medicine that the Emergency Department (ED) is the point of entry into the medical system for a great many of these patients when they are first diagnosed or when they suffer a complication related to their cancer. It is therefore imperative that all emergency physicians gain greater familiarity with oncologic conditions and their treatments.
Emerg Med Clin N Am 32 (2014) xv–xvi http://dx.doi.org/10.1016/j.emc.2014.06.001 0733-8627/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
emed.theclinics.com
xvi
Foreword
Fortunately for the readers of Emergency Medicine Clinics of North America, guest editors Drs Jack Perkins and Jonathan Davis have assembled an outstanding group of authors that address the pertinent issues we need to be aware of in managing these patients in the ED. Both solid tumors and hematologic types of cancer are addressed, including specifics about many individual diseases themselves as well as complications of diseases and chemotherapeutic agents. The editors and authors then turn their attention to several basic nononcologic hematologic disorders, including anemia, sickle cell disease, thrombotic microangiopathies, and bleeding disorders. They finish up the issue with an article on blood product transfusions and reactions, and an article that addresses the hot topic of reversal of current antithrombotics. Overall, this issue of Emergency Medicine Clinics of North America represents a mini-fellowship curriculum in hematology 1 oncology for the emergency physician. This issue represents an important contribution to education and is certain to improve the care of this ever-growing patient population in the ED. Our thanks go to the guest editors and their dedicated authors for this excellent work. Amal Mattu, MD Department of Emergency Medicine University of Maryland School of Medicine 110 South Paca Street 6th Floor, Suite 200 Baltimore, MD 21201, USA E-mail address: [email protected]
