Manual of Cardio-oncology: Cardiovascular Care in the Cancer Patient

Description:

This concise and handy manual provides straightforward, up-to-date guidance for cardiologists and other practitioners on the management of cancer patients with cardiac problems, whether they be due to the cancer itself or to antineoplastic treatment. Detailed attention is devoted to the various forms of cardiotoxicity associated with chemotherapy and radiotherapy. The drugs commonly responsible for each toxicity are identified and clear advice is offered on monitoring techniques and treatment approaches. In addition, the issue of cardiotoxicity due to cancer treatment in particular patient groups – children, the elderly, and those with pre-existing cardiac disease – is addressed separately, with guidance on when and how antineoplastic (and/or cardiological) treatments should be modified. Further sections describe the correct responses to cardiac problems secondary to the cancer itself, including thromboembolic disorders and electrolyte imbalances, and the diagnosis, treatment, and follow-up of cardiac tumors.  A closing section considers how to improve cooperation between oncologists, cardiologists, and general practitioners to ensure that cancer patients’ cardiovascular needs are met in a multidisciplinary approach.

 

Table of Contents:

List of Contributors

I: Introductory Aspects

1: Epidemiology of Cancer: Prevalence, Incidence of Neoplastic Diseases and Trends in Survival i

1.1 Background

1.2 Cancer Distribution

1.2.1 Incidence of All Cancers Excluding Nonmelanoma Skin Cancers

1.2.2 Mortality of All Cancers Excluding Nonmelanoma Skin Cancers

1.3 Lung Cancer

1.3.1 Incidence

1.3.2 Mortality

1.3.3 Risk Factors

1.3.4 Survival

1.4 Breast Cancer

1.4.1 Incidence

1.4.2 Mortality

1.4.3 Risk Factors

1.4.4 Survival

1.5 Colorectal Cancer

1.5.1 Incidence

1.5.2 Mortality

1.5.3 Risk Factors

1.5.4 Survival

1.6 Prostate Cancer

1.6.1 Incidence

1.6.2 Mortality

1.6.3 Risk Factors

1.6.4 Survival

1.7 Discussion

1.8 European Code Against Cancer

References

2: Cancer, Heart Diseases, and Common Risk Factors: Smoke

2.1 Key Points

2.2 Epidemiology

2.3 Cigarette Smoke: Chemical–Physical Characteristics

2.4 Pathophysiology

2.5 Smoke as Risk Factor for Cancer and Other Diseases

2.6 Conclusions

References

3: Cancer, Heart Diseases and Common Risk Factors: Diet and Physical Activity

3.1 Background

3.2 Diet

3.2.1 Dietary Supplements

3.2.2 Prevention of Cardiotoxicity

3.2.3 Traditional and Alternative Dietary Patterns (. Table 3.1)

3.3 Physical Activity

3.3.1 Physical Activity and Cardiovascular Diseases

3.3.2 Physical Activity in Cancer Prevention (. Fig. 3.5)

3.3.3 Physical Activity After Cancer Diagnosis

3.3.4 Cardiovascular Disease, Cancer, and Physical Activity

References

II: Cardiac Problems as a Consequence of Cancer

4: Thromboembolic Disorders as a Consequence of Cancer

4.1 Introduction

4.2 Clinical Aspects

4.3 Screening for Occult Cancer in Patients with Idiopathic VTE

4.4 Primary Thromboprophylaxis and Identification of High-Risk Outpatients

4.4.1 Surgical Prophylaxis

4.4.2 High-Risk Cancer Outpatients Identification for Primary Thromboprophylaxis

4.4.3 Multiple Myeloma

4.5 Appropriate Immediate and Long-Term Treatment for Patients with Acute Thromboembolism and t

4.5.1 Acute Treatment (First 10 Days)

4.5.2 Long-Term (First 3 Months) and Extended Therapy (No Planned Stop Date)

4.5.3 Treatment of Catheter-Related DVT

4.5.4 Vena Cava Filters

4.6 Management of Recurrent VTE on Anticoagulation Therapy [55, 63–67]

4.7 Treatment Strategy in Patients with Thrombocytopenia

References

Suggested Reading: Society Guidelines

5: Arrhythmias and Electrolyte Imbalances as Consequences of Cancer

5.1 Arrhythmias

5.2 Electrolyte Imbalances

5.2.1 Hypokalemia

Clinical Manifestations

Treatment

5.2.2 Hyperkalemia

Clinical Manifestations

Treatment [19, 20]

5.2.3 Hypercalcemia

Clinical Manifestations

Treatment [19, 20]

5.2.4 Hypocalcemia

Clinical Manifestations

Treatment

5.2.5 Hypomagnesemia

Clinical Manifestations

Treatment [19, 20]

5.2.6 Hypermagnesemia

Clinical Manifestations

Treatment

5.2.7 Hyponatremia

Clinical Manifestations

Treatment [25, 26]

5.2.8 Hypernatremia

Clinical Manifestations

Treatment [28]

5.2.9 Hyperphosphatemia

Clinical Manifestations

Treatment

5.3 Tumor Lysis Syndrome

5.3.1 Clinical Manifestations

5.3.2 Treatment [38–40]

References

III: Oncologic Treatments and Cardiotoxicity

6: Molecules, Drugs, and First-­Line Therapies: A Guide for the Cardiologist

6.1 Introduction: Cardiovascular Toxicity with First-Line Therapy in Solid Tumors, Risk, and Ben

6.2 First-Line Therapy in Different Cancers: Challenges and Pitfalls with Cardiotoxic Drugs

6.2.1 Breast Cancer

Chemotherapy

Anthracyclines and Taxanes Alone or in Combinations

Anti-HER2 Agents

Endocrine Therapy (Tamoxifen, Aromatase Inhibitors, Fulvestrant)

6.2.2 Colorectal Cancer and Other Upper Gastrointestinal Malignancies

Fluoropyrimidines

Anti-VEGF Agents

Bevacizumab

Anti-EGFR Agents

Cetuximab and Panitumumab

6.2.3 Lung Cancer

Platinum-Based Chemotherapy

Cisplatin

Anti-EGFR and Anti-ALK TKIs

6.2.4 Genitourinary Cancers (Renal Cell Carcinoma and Prostate and Bladder Cancer)

Multitarget TKIs Used in Renal Cell Carcinoma

Systemic Therapy Used for Prostate Cancer

LHRH Agents and Antiandrogen (Chemical Castration)

New Antiandrogen (Abiraterone and Enzalutamide)

6.2.5 Rare Tumors

Imatinib Used as First-Line Therapy in GIST

Anti-BRAF Agents (Vemurafenib, Trametinib) Used in BRAF- Mutated Advanced Melanoma

Chemotherapy Agents Used Upfront for Metastatic Sarcomas

6.3 Recommendations

References

7: The Pharmacologist’s Point of View: Mechanisms of Cardiotoxicity

7.1 Introduction

7.2 Anticancer Agents Associated with Cardiotoxicity

7.2.1 Anthracyclines

7.2.2 Fluoropyrimidines

7.2.3 Microtubule-Targeting Agents

7.2.4 Alkylating Agents

7.2.5 Proteasome Inhibitors

7.2.6 Tyrosine Kinase Inhibitors

Trastuzumab

Lapatinib

Imatinib

VEGFR Inhibitors

Bevacizumab

Tyrosine Kinase Inhibitors Targeting the VEGF Pathway

Sunitinib

Sorafenib

Other VEGF-Targeting TKIs

7.3 Cardio-oncological Early Detection and Prevention: The Future

References

8: Cardiotoxicity: Left Ventricular Dysfunction

8.1 Which Drugs Are Involved

8.1.1 Definition and Graduation of LVD

8.1.2 Anthracycline-Related LVD

8.1.3 Non-anthracycline-Related LVD

8.1.4 Targeted Therapy and LVD

Trastuzumab

Bevacizumab and TKI Small Cell

8.2 How to Monitor

8.2.1 LV Systolic Function

8.2.2 LV Diastolic Function

8.2.3 Myocardial Deformation

8.2.4 Use of Biomarkers

8.3 How to Treat

8.3.1 Left Ventricular Dysfunction Induced by Anthracyclines

8.3.2 Left Ventricular Dysfunction Induced by Trastuzumab

References

9: Cardiotoxicity: Cardiac Ischemia

9.1 Introduction

9.2 Fluoropyrimidines

9.2.1 Pathophysiology

9.2.2 Incidence

9.2.3 Clinical Presentation

9.2.4 Laboratory Analysis Data

9.2.5 Challenges in Diagnosis

9.2.6 Therapy

9.2.7 FP Therapy Must Be Stopped Immediately When Cardiotoxicity is Detected

9.2.8 Time to Recovery

9.2.9 Rechallenge

9.3 Anti-VEGFR

9.3.1 Pathophysiology

9.3.2 Therapy

9.4 Other Drugs Which Have Been Involved in Acute Cardiac Ischemia or in Increased Risk of Myoca

9.4.1 BCR-ABL-Targeted Tyrosine Kinase Inhibitors

9.4.2 All-Trans Retinoic Acid

9.4.3 Platinum Compounds

9.4.4 Interleukin-2 (Il-2) and Alpha-Interferon

9.4.5 Taxanes

9.4.6 Aromatase Inhibitors

9.4.7 Androgen Deprivation Therapy

References

10: Cardiotoxicity: Hypertension

10.1 Introduction

10.2 Proteinuria

10.3 Hypertension

10.4 Cardiotoxicity

10.4.1 Anti-vascular Endothelial Growth Factor Agents

10.4.2 Antihuman Epidermal Growth Factor Receptor 2

10.4.3 Anti-active Breakpoint Cluster Region Abelson Receptor

10.4.4 Prevention and Management of Cardiotoxicity

10.5 Renal Dysfunction

References

11: Cardiac Arrhythmias in Cancer Patients

11.1 Introduction

11.1.1 Incidence of Cardiac Arrhythmias

11.2 Atrial Fibrillation

11.2.1 Epidemiology

11.2.2 Pathophysiology

11.2.3 Clinical Considerations

11.2.4 Therapy

11.3 Bradyarrhythmias

11.3.1 Thalidomide

11.3.2 Paclitaxel

11.3.3 Other Drugs

11.4 Ventricular Arrhythmias Without QT Prolongation

11.5 Diagnosis of Cardiac Arrhythmias

11.6 Arrhythmias and Targeted Therapy

11.6.1 Vandetanib

11.6.2 Sunitinib and Sorafenib

11.6.3 Lenvatinib

11.6.4 Ponatinib

11.7 Monitoring and Management of Cardiac Arrhythmias Due to Targeted Therapy

References

12: Radiotherapy: Clinical Aspects and Cardiotoxicity

12.1 Pathophysiology

12.2 Acute Toxicity

12.2.1 Acute Pericarditis

12.2.2 Ventricular Dysfunction

12.2.3 Cardiac Ischemia

12.3 Late Toxicity

12.3.1 Coronary Artery Disease (CAD)

12.3.2 Left Ventricular (LV) Dysfunction

12.3.3 Valvular Heart Disease (VHD)

12.3.4 Chronic Pericarditis

12.3.5 Arrhythmias

12.4 Clinical Presentation

12.5 Diagnosis of RIHD

12.5.1 Coronary Artery Disease

12.5.2 LV Systolic and Diastolic Dysfunction

12.5.3 Restrictive Cardiomyopathy

12.5.4 Valve Disease

12.5.5 Pericardial Disease

12.6 Prevention Strategies in Subjects Treated By RT

12.7 Therapy

12.8 Vascular RT Complications

References

13: Cardiotoxicity in Children

13.1 General Considerations

13.2 Etiology and Pathophysiology

13.2.1 Therapeutic Agents Responsible for Cardiotoxicity

13.2.2 Preexisting Cardiovascular Disease or Cardiac Risk Factors and Comorbidities

13.3 Cardiovascular Manifestations

13.4 Cardiologic Clinical Setup of a Childhood Cancer Patient or Survivor

13.5 Preventive Strategies

13.6 Practical Surveillance Program

References

14: Cardiotoxicity in the Elderly

14.1 Introduction

14.2 Characteristics of Elderly People

14.3 Evaluating Older Patients for Screening Purpose: The Comprehensive Geriatric Assessment (CGA

14.4 The Frail Cancer Patient: Definition and Identification

14.5 Selected Physiologic Age-Related Changes

14.5.1 Multi-morbidity and Co-morbidity

14.5.2 Unusual Presentations of Illness in the Elderly

14.6 Drug Therapy in the Elderly

14.7 Drug-Related Problems in the Elderly

14.7.1 Before Starting a New Drug

14.7.2 After Starting a Drug

14.7.3 Ongoing

14.7.4 Cardiac Effect of Anticancer Therapy in the Elderly

14.7.5 Anthracycline

Duration and Frequency of Administration

Type of Anthracycline

References

15: Treatments in Patients with Cancer and Cardiac Diseases

15.1 Introduction

15.1.1 Risk of Worsening of Cardiac Status Due to the Tumor

15.1.2 Antineoplastic Treatments Interfering with the Cardiovascular Function

15.1.3 Pharmacological Interactions Between Cardiac and Antineoplastic Drugs

Metabolic Interactions

Cumulative Effects

15.2 Practical Approach to the Patient with Cardiovascular Disease

15.2.1 Dilated and/or Hypokinetic Cardiomyopathies (CMP)

15.2.2 Hypertension

15.2.3 Coronary Artery Disease (CAD)

Treatment Options for Chronic CAD

Treatment Options for CAD with Acute Coronary Syndrome (ACS)

15.2.4 Arrhythmias

15.2.5 Valvular Heart Disease

Native Valve Disease

Prosthetic Valves

15.2.6 Varicose Veins

15.2.7 Patients with Cardiac Implantable Electronic Devices (CIED) Who Need Radiotherapy

15.3 Practical Approach to the Patient with Cardiac Implantable Electronic Devices [22, 23]

15.3.1 Before Starting Radiotherapy

15.3.2 During Radiotherapy

15.3.3 After Radiotherapy

References

16: Hematopoietic Stem Cell Transplantation and Cardiotoxicity

16.1 Introduction

16.2 Pretransplant Evaluation

16.2.1 Medical History

16.2.2 Twelve-Lead Electrocardiogram (ECG)

16.2.3 Chest X-Ray

16.2.4 Assessment of Left Ventricular Ejection Fraction (LVEF)

16.2.5 Noninvasive Stress Testing

16.2.6 Cardiac Biomarkers

16.3 Clinical Manifestation of Cardiac Complication

16.3.1 Early Manifestations

As a Consequence of High-Dose Chemotherapy

As a Consequence of Radiotherapy

16.3.2 Infectious Complications

Endocarditis

Myocarditis and Pericarditis

16.3.3 As a Consequence of Hematopoietic Stem Cell Reinfusion

Dimethyl Sulfoxide (DMSO)

16.4 Cardiac Complications of GvHD

16.4.1 Immunosuppressive Therapy

Cyclosporine and Tacrolimus (Calcineurin Inhibitors)

Mycophenolate Mofetil

Sirolimus

16.5 Long-Term Complications

16.5.1 Risk Factors

16.5.2 Follow-Up

16.5.3 Interventions

References

17: Cardiotoxicity in Long-Term Survivors

17.1 General Consideration of Cancer Survivorship

17.2 Cardiotoxicity and Cancer Treatment

17.2.1 Definition

17.2.2 Classification

17.2.3 Pathogenesis

17.2.4 Diagnosis

17.3 Antineoplastic Drugs Associated With Chronic Cardiotoxicity

17.3.1 Anthracyclines and Other Agents Associated with Type 1 Cardiotoxicity

17.3.2 Cardiotoxicity of Type II Agents

17.4 Cardiac Toxicity in Cancer Survivors

17.4.1 Definitions of “Cardiotoxicity” in Cancer Survivors

17.4.2 Risk Factors of Cardiotoxicity

17.4.3 Early Diagnosis of Cardiac Toxicity

17.4.4 Treatment of Cardiotoxicity in Cancer Patient Survivors

17.4.5 Prevention of Chemotherapy-Related Cardiac Dysfunction (CRCD)

17.4.6 Follow-Up of Chemotherapy-Related Cardiac Dysfunction (CRCD) in Cancer Survivors

17.5 Conclusions

References

IV: Cardiac Tumors

18: Cardiac Malignancies: Clinical Aspects

18.1 Symptoms

18.2 Physical Examination

18.3 ECG Abnormalities

References

19: Secondary Cardiac Tumors

19.1 Introduction

19.2 Pathophysiology

19.3 Neoplastic Pericardial Disease

19.3.1 General Considerations

19.3.2 Clinical Manifestations

Typical Cardiac Tamponade

Atypical Cardiac Tamponade

Constrictive or Effusive Constrictive Pericarditis

Asymptomatic Pericardial Effusions

19.3.3 Diagnosis of Neoplastic Pericardial Diseases

Echocardiography

Computed Tomography

Magnetic Resonance Imaging (MRI)

Positron Emission Tomography (PET) with 18-Fluorodeoxiglucose (18FDG)

Cytology of the Pericardial Fluid [9]

Neoplastic Markers in the Pericardial Fluid

19.4 Practical Diagnostic Imaging Approach in Neoplastic Pericardial Disease

19.4.1 Treatment of Neoplastic Pericardial Disease

Treatment of Cardiac Tamponade

Prevention of Recurring Tamponade

Treatment of Pericardial Metastases

19.5 Myocardial Metastases

19.5.1 General Considerations

19.5.2 Clinical Manifestations

19.5.3 Diagnostic Imaging (See Also 7 Chap. 24 for Further Details)

Electrocardiography (ECG)

Echocardiography (. Fig. 19.5)

Computed Tomography and Magnetic Resonance Imaging (. Fig. 19.6)

PET

Biopsy

19.5.4 Treatment of Myocardial Metastases

19.6 Endocavitary Metastases

19.6.1 General Considerations

19.6.2 Clinical Manifestations

19.6.3 Cardiac Imaging (See Also 7 Chap. 24 for Further Details)

19.6.4 Treatment of Endocavitary Metastases

References

20: Primary Cardiac Malignancies: Epidemiology and Pathology

20.1 Epidemiology

20.2 Clinical Features

20.3 Surgical Pathology

20.4 Tumor Grading and Staging

20.5 Treatment and Prognosis

20.6 Key Points

20.7 Cardiac Sarcomas

20.7.1 Angiosarcoma

Definition

Epidemiology

Localization

Clinical Features

Pathology

Differential Diagnosis

Genetics

20.7.2 Undifferentiated Pleomorphic Sarcomas

Definition

Epidemiology

Localization

Clinical Features

Pathology

20.7.3 Osteosarcoma

Definition

Epidemiology

Localization

Clinical Features

Pathology

Differential Diagnosis

20.7.4 Myxofibrosarcoma

Definition

Epidemiology

Clinical Features

Pathology

Differential Diagnosis

20.7.5 Leiomyosarcoma

Definition

Epidemiology

Localization

Clinical Features

Pathology

20.7.6 Rhabdomyosarcoma

Definition

Epidemiology

Localization

Clinical Features

Pa thology

Differential Diagnosis

Somatic Genetics

20.7.7 Synovial Sarcoma

Definition

Epidemiology

Localization

Clinical Features

Pathology

Differential Diagnosis

Genetics

Prognosis

20.7.8 Miscellaneous Sarcomas

Definition

20.8 Primary Cardiac Lymphoma

20.8.1 Definition

20.8.2 Epidemiology

20.8.4 Clinical Features

20.8.5 Pathology

20.8.7 Differential Diagnoses

20.8.8 Prognosis

20.8.9 Key Points: Primary Cardiac Lymphoma

20.9 Tumors of the Pericardium

20.9.1 Solitary Fibrous Tumor

Definition

Localization

Clinical Features

Pathology

Immunohistochemistry

Differential Diagnosis

Prognosis

20.9.2 Malignant Mesothelioma

Definition

Epidemiology

Clinical Features

Pathology

Immunohistochemistry

Differential Diagnosis

Prognosis

20.9.3 Germ Cell Tumors

Definition

Epidemiology

Localization

Clinical Features

Pathology

Differential Diagnosis

Prognosis

References

21: Diagnosis of Primary Cardiac Malignancies: Echocardiography

21.1 Echocardiography

21.1.1 Transthoracic Echocardiography

21.2 Echocardiographic Contrast Agents

21.3 Transesophageal Echocardiography (TEE)

21.4 Three-Dimensional Echocardiography (3D-ECHO)

21.5 Pitfall

References

22: Diagnosis of Primary Cardiac Malignancies: Magnetic Resonance

22.1 Introduction

22.2 MRI Technique and Protocol

22.2.1 Morphological and Functional Evaluation

22.2.2 Tissue Characterization

22.2.3 MRI Pulse Sequences

T1-Weighted Pulse Sequence

T2-Weighted Pulse Sequence

T2*-Weighted Pulse Sequence

SSFP Images

First Pass Perfusion

Early Enhancement

Late Gadolinium Enhancement (LGE)

22.3 Benign Tumors and Pseudomass

22.3.1 Pseudomass

22.3.2 Lipoma

22.3.3 Myxoma

22.3.4 Cardiac Hemangioma

22.3.5 Fibroma

22.3.6 Rhabdomyoma

22.3.7 Fibroelastoma

22.3.8 Cystic Tumor of the Atrioventricular Node

22.3.9 Paraganglioma

22.4 Malignant Tumors

22.4.1 Sarcoma

22.4.2 Lymphoma

22.4.3 Cardiac Metastasis

22.5 Future Perspectives

References

23: Other Imaging Techniques: Computed Tomography and Positron Emission Tomography

23.1 Introduction

23.2 Computed Tomography

23.2.1 Limits

23.3 Positron Emission Tomography (PET)

23.3.1 Pitfalls [10]

References

24: Surgical Treatment of Primary Cardiac Malignancies

24.1 Background

24.2 Clinical Scenarios

24.2.1 Background

24.2.2 Clinical Features

24.2.3 Malignant Tumor Types and Cardiac Chamber Involvement: Surgeon’s Tips

Cardiac Sarcomas

Angiosarcoma

Sarcomas of Various Lines of Differentiation

Rhabdomyosarcoma

Lymphoma

Primary Malignancy of the Pericardium

24.3 Surgery

24.3.1 Resectability

24.3.2 What Does the Surgeon Need to Know from the Available Diagnostic Tools to Judge About T

Chest X-Ray

2-D and 3-D Echocardiography (TTE)

Computed Tomography (CT)

Gated Cardiac Magnetic Resonance Imaging (MRI)

Positron Emission Tomography (PET)/CT

Cardiac Catheterization

24.3.3 Surgical Considerations

Surgical Approaches

Complex Tumor Resection

24.3.4 Survival Outcome

References

25: Cardiac Tumors: Multimodality Approach, Follow-Up, and Prognosis

25.1 Primary Cardiac Lymphomas

25.2 Primary Cardiac Sarcomas

25.2.1 Radiotherapy

25.3 Follow-Up and Prognosis

References

V: Improving the Cooperation Between Oncologists, Cardiologists, and General Practitioners

26: Understanding the Most Common Oncologic and Cardiologic Terms

26.1 Intents of Chemotherapy

26.2 Antineoplastic Drugs

26.3 Common Chemotherapeutic Regimen Adopted in the Clinical Practice According to Tumor Type

27: What the Oncologist Needs to Know: How to Ask for a Cardiology Consultation

27.1 When and Why to Ask for a Cardiologic Consultation

27.1.1 Timing of the Consultation

27.1.2 Different Situations for a Consultation

27.1.3 Asking a Consultation Before Initiating Anticancer Treatment

27.1.4 What Is the Key Question?

27.2 How to Ask the First Cardio-oncologic Consult: What the Cardiologist Needs to Know in Eva

27.3 Consultation for a Suspected Cardiovascular Problem

27.3.1 When Reporting a Suspected Cardiovascular Problem the Oncologist Has to Focus on

27.3.2 The Oncologist Should Also Report to the Cardiologist in Order to Help the Differential

27.4 Asking a Cardiovascular Follow-Up

27.5 How to Help the Cardiologist to Implement Cardiovascular Treatment

27.6 Helping the Management of Cardiovascular Treatment: What the Cardiologist Has to Know?

27.7 Some Practical Considerations

References

28: What the Cardiologist Needs to Know: How to Write the Consultation

28.1 Background: Clinical Facts Acquired in the Visit

28.2 Conclusions: Cardiological Interpretation

28.3 Cardiological Suggestions in the Cancer Patient

28.3.1 Drug Prescription

28.3.2 Cardiovascular Exams and Invasive Procedures

28.3.3 Anticancer Treatment Discontinuation for Cardio-toxicity

28.4 The Equilibrium Between Cardiological and Oncologic Needs

28.5 Messages to the Patient

References

29: What the General Practitioner Needs to Know: When to Consult the Cardiologist and/or the On

29.1 Introduction

29.1.1 What the General Practitioner Can Do to Solve These Problems

29.2 Deep-Vein Thrombosis (DVT)

29.2.1 Diagnosis

29.2.2 Treatment

29.2.3 Recurrent DVTs in Cancer Patients

29.2.4 DVT Prevention

29.2.5 Central Venous Catheters (CVCs)

29.3 Long-Term Side Effects

29.4 Drug Interactions

29.5 Most Frequent Cardiac Problems in Cancer Patients

29.6 Dyspnoea

29.6.1 Causes of Dyspnoea [22]

29.6.2 Assessment of Dyspnoea

29.6.3 Investigations (Personalised for Each Individual Patient)

29.6.4 Management of Dyspnoea

General Measures

Treatment of Reversible Causes and Disease-Specific Measures [22]

Symptomatic Measures: Drugs

Symptomatic, Non-pharmacological Measures [22]

29.7 Peripheral Oedema

29.7.1 Treatment

29.8 Superficial Thrombophlebitis

29.8.1 Superficial Thrombophlebitis in a Healthy Vein

Management

Treatment

Follow-up

29.8.2 Superficial Thrombophlebitis in a Varicose Vein

Management

Treatment

29.8.3 Superficial Thrombophlebitis of the Great Saphenous Vein Progressing into the Deep Femora

29.8.4 Superficial Thrombophlebitis of the Small and Great Saphenous Veins not Extending to the

29.8.5 Superficial Thrombophlebitis Affecting Other Parts of the Body

References

 

An aparitie	2017
Autor	Lestuzzi, Chiara, Oliva, Stefano, Ferraù, Francesco
Dimensiuni	16.8 x 2.8 x 24 cm
Editura	Springer
Format	Paperback
ISBN	9783319402345
Limba	Engleza
Nr pag	488