Cancer intoxication is a pathological condition caused by a widespread oncological process and the disintegration of a malignant tumor. Occurs in the late stages of cancer. It can be provoked by active anticancer therapy. It is manifested by weakness, fatigue, pallor of the skin, dry mucous membranes, nausea, vomiting, weight loss and appetite, sweating, hyperthermia, bone and joint pain, sleep disorders, mental disorders, anemia and decreased immunity. The diagnosis is made on the basis of anamnesis, clinical symptoms, test results and instrumental studies. Treatment is symptomatic.
Meaning
Cancer intoxication is a complex of disorders that occur in cancer patients when the body is poisoned by the decay products of a malignant tumor. It is detected mainly at the terminal stages of the disease, is considered as one of the main causes of death of patients. In addition, cancer intoxication is often observed during chemotherapy, is a natural consequence of active anticancer treatment, causing the destruction of the tumor.
Cancer intoxication can provoke disorders of various organs and systems, including renal and hepatic insufficiency, sepsis and other severe infectious complications, which determines the importance of a thoughtful selection of dosages and types of medications, taking into account the general condition of the patient, as well as the presence of certain chronic diseases. The treatment is carried out by specialists in the field of oncology.
Causes
One of the distinctive features of a malignant tumor is its ability to rapidly uncontrolled growth. As a rule, the growth rate of the vessels providing blood supply to the neoplasm lags behind the growth rate of the tumor tissue. Malignant cells are quite resistant to hypoxia and may exist for some time in conditions of insufficient blood supply, but sooner or later they die. Usually this process is observed in tumors of a sufficiently large size. Mass cell death causes the collapse of the neoplasm and causes cancer intoxication.
A large number of decay products enter the body, which provoke disorders of all types of metabolism and disorders of the activity of various organs and systems. Cancer intoxication causes an increase in urea levels. Urea crystals settle in the renal tubules, causing the development of renal failure, which further aggravates metabolic disorders. Due to the increase in the amount of phosphates, there is a deficiency of calcium ions, which results in disorders of the nervous system. An increase in calcium levels negatively affects the functioning of the heart. In patients with cancer intoxication, arrhythmias occur, in severe cases, cardiac activity may cease. An increase in the number of free radicals stimulates the breakdown of red blood cells and the development of anemia.
The manifestations of cancer intoxication are very variable. The formation of the clinical picture is determined by the severity of the patient’s condition, the rate of destruction of the neoplasm, the amount of toxic substances entering the main bloodstream, the localization and course of the oncological process, the scale of surgical intervention, the presence and volume of blood loss (both arising during the operation and postoperative period, and associated with the collapse of the tumor), the addition of inflammatory complications, the dose of chemotherapy and other factors.
Symptoms
The most constant signs of cancer intoxication are progressive weakness and causeless fatigue. There are characteristic changes in appearance: body weight deficiency (in severe cases – up to cachexia), pale, earthy or yellowish skin tone, dry skin and mucous membranes. Cyanosis of the distal extremities is possible. In patients with impaired liver function, ictericity of the sclera is detected. Patients with cancer intoxication complain of increased sweating. As a rule, sweating is more pronounced at night.
During the survey, the doctor determines that a sharp weight loss occurred within a short period of time and was accompanied by appetite disorders: aversion to food (especially meat products), taste perversion, etc. In addition, with cancer intoxication, dyspeptic disorders are observed: nausea, vomiting and stool disorders. Constipation, diarrhea or alternation of constipation and diarrhea are possible. There is a prolonged increase in temperature to subfebrile (in some diseases – to febrile) figures. There are pains in the bones and joints.
Patients with cancer intoxication may report periodic migraines and dizziness attacks. Questioning patients and their relatives allows us to identify changes in mental and emotional status. Apathy, irritability and emotional lability may be observed. Cancer intoxication is often accompanied by depressive disorders. Possible sleep disorders: insomnia, shallow sleep, difficulty falling asleep, night and early awakenings. Cardiac arrhythmias are often detected. With cancer intoxication, there is a high probability of developing thrombosis and a tendency to infectious complications. The blood test shows signs of anemia (usually moderate normochromic).
Diagnostics
The diagnosis is made taking into account anamnesis, complaints, objective examination data and the results of additional studies. The identification of the underlying pathology plays a crucial role in determining the cause of cancer intoxication. With a characteristic clinical picture and no established diagnosis of cancer, patients with suspected cancer intoxication are prescribed a comprehensive examination, which includes general blood and urine tests, biochemical blood analysis, blood analysis for cancer markers, chest X-ray, skeletal scintigraphy, abdominal ultrasound, pelvic ultrasound, gynecological examination and other studies. The examination plan is determined individually.
With an already diagnosed oncological disease, an assessment of the severity of cancer intoxication is required to determine treatment tactics (drawing up a chemotherapy plan, deciding on surgery, selecting symptomatic drugs, etc.). To assess the severity of cancer intoxication, standard blood parameters are used: the level of urea, creatinine and C-reactive protein, neutrophil reactive response, leukocyte intoxication index etc. Along with the listed indicators, data on the state of various organs and systems of a patient with cancer intoxication obtained during ECG, urine tests, blood tests for hormones and other studies may be required.
Treatment
Treatment is symptomatic, includes measures for detoxification, elimination or mitigation of clinical manifestations and correction of disorders of various organs and systems. Enterosorption, hemosorption and application sorption are carried out. Patients are prescribed sorbents for oral administration. In severe cancer intoxication, hemodialysis or plasmapheresis is used. In the presence of open wounds in the area of tumor decay, dressings with local sorbents are carried out.
When vomiting, patients with cancer intoxication are prescribed antiemetics (domperidone, metoclopramide), with constipation – laxatives for oral administration and rectal candles (macrogol, hay preparations, bisacodil, castor oil, etc.). With anemia, iron preparations are used orally and parenterally, erythropoietin is used. The choice of medications for cancer intoxication accompanied by mental disorders depends on the type and severity of the disorders. With emotional lability, mild sedatives are prescribed, with sleep disorders – sleeping pills, with depression – tranquilizers and antidepressants.
The prognosis is determined by the causes of cancer intoxication, the severity of the underlying process, the age and general condition of the patient, the presence and severity of concomitant somatic pathology. The conditions that occur during the disintegration of large widespread tumors in the advanced stages of the disease are prognostically unfavorable. Patients with cancer intoxication die from bleeding, disorders of the organs affected by primary tumor or hematogenous metastases, as well as from exhaustion, infectious complications, renal failure, thrombosis, cardiac disorders or multiple organ failure caused by metabolic disorders and weakening of the body. In case of cancer intoxication that occurred during chemotherapy, the prognosis may be favorable. When taking chemotherapy drugs, this is a temporary condition that is part of the treatment process.