Neurologic Complications of Cancer

Hardcover | October 24, 2008

EditorLisa M. DeAngelis, Jerome B. Posner

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Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or oneof several nonmetastatic complications of cancer. The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. This monograph, an update of the firstedition published in 1995, is divided into 3 sections. The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach tosupportive care of common neurologic symptoms such as seizures, pain, and side effects of commonly used supportive care agents. The second section is devoted to nervous system metastases, addressing in turn, brain, spinal cord, meningeal and cranial and peripheral nerve metastases, describingclinical symptoms, approach to diagnosis and current treatment. The third section addresses several nonmetastatic complications of cancer and includes sections on vascular disease, infections, metabolic and nutritional disorders, side chemotherapy, radiation and other diagnostic and therapeuticprocedures. The final chapter addresses paraneoplastic syndromes. The book is intended for practicing oncologists, neurologists, neurosurgeons and radiation oncologists as well as internists who treated patients with cancer. Our attempt was to write a book that would assist oncologists in understanding neurologic problems and neurologists in understandingoncologic problems. The book is also intended for physicians training to specialize in any of the above areas. It includes a practical approach to the diagnosis and management of patients with neurologic disease who are with known to have cancer or in whom cancer is suspected.

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Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or oneof several nonmetastatic complications of ca...

Jerome B. Posner is George C. Cotzias Chair in Neuro-Oncology, Chairman of the Department of Neurology, Memorial Sloan-Kettering Cancer Center, and Professor of Neurology and Neurosciences at the Cornell University Medical College.

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Kobo ebook|Sep 24 2011

$191.49 online$248.67list price(save 22%)
Format:HardcoverDimensions:656 pages, 6.42 × 10.12 × 1.1 inPublished:October 24, 2008Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195366743

ISBN - 13:9780195366747

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Table of Contents

Part I: General Principles1. OverviewIntroductionRationale for Neuro-Oncology:Neurologic System Complications are CommonNeurologic Complications of Cancer Are IncreasingNeurologic Complications of Systemic Cancer Are SeriousDiagnosis Is Often DifficultTreatment HelpsProblems in Neuro-Oncology Are UniqueResearch Is EssentialRelationships between the Brain and Systemic Cancer Are Biologically ImportantClassification of Neuro-Oncologic Disorders:Spread of Cancer to the Nervous System (Metastic or Direct Effects of Cancer)Indirect Neurologic (Nonmetastatic or Paraneoplastic) Complications of CancerApproach to the Patient:Known CancerNo Known CancerEvaluating the PatientReferences2. Pathophysiology Of Nervous System MetastasesIntroductionPathyphysiology of the Metastatic Process:Transformation and GrowthVascularization (Angiogenesis)InvasionIntravasationCirculationArrest: First Capillary BedPassage to Arterial CirculationArrest: Final Capillary BedTumor EmboliExtravasationDormancyGrowth in the CNSClinical Considerations Relevant to Nervous System Metastasis:Tumor Size and Lymph Node InvolvementProperties of MetastasesDifferences between a Primary Tumor and Its MetastasesSite of MetastasesPathophysiologic Factors Relevant to Spread and Growth of Cancer to Specific Neural Structures:BrainSpinal CordLeptomeningesCranial and Peripheral Nerves3. Blood-Nervous System Barrier Dysfunction: Pathophysiology And TreatmentIntroductionAnatomy and Physiology:Blood-Brain BarrierBlood-Peripheral Nerve BarrierBlood-Cerebrospinal Fluid BarrierDisruption of Blood-Central Nervous System Barriers:Brain EdemaOther Sources of DisruptionOther Substances Causing Blood-Brain Barrier DisruptionConsequences of Blood-Brain Barrier Disruption: Increased Intracranial Pressure, Plateau Waves, and Cerebral Herniation:Treatment of Cerebral HerniationTransport of Chemotherapeutic Drugs Across the Blood-Brain Barrier:Resoration of Blood-Central Nervous System Barriers:Lowering Intracranial PressureCorticosteroidsReferences4. Supportive Care and Its ComplicationsIntroductionEdema/Corticosteroids:Salutary Effects of CorticosteroidsUnwanted Effects of CorticosteroidsSeizures/Anticonvulsants:Incidence/EpidemiologyTherapyUntoward Effects of AnticonvulsantsVenous Thrombosis/Anticoagulants:Pain/Analgesia:Psychological Distress/Psychotropic Agents:Fatigue:Nausea, Vomiting/Antiemetic Agents:Infection/Antibiotics:Intensive Care/Common Agents:ReferencesPart II: Metastases5. Intracranial MetastasesGeneral Principles:IntroductionClassificationIncidenceBrain Metastases (Parenchymal):SourcePathophysiology of Neurologic Symptoms and SignsPathologyClinical FindingsLaboratory FindingsDifferential DiagnosisApproach to the Ptient without Known CancerTreatmentPrognosisSpecific Tumors:Small Cell Lung CancerNon-Small Cell Lung CancerBreastMelanomaRenalColonTestisGynecologic TumorsSarcomasHematologic CancersUnknown PrimaryLess Common Sites of Intracranial Metastases:Calvarial MetastasesDural MetastasesPinealChoroidPituitaryReferences6. Spinal MetastasesIntroductionEpidural Metastases:FrequencyBiology of Epidural MetastasesPathophysiology of Symptoms and SignsPathologyClinical FindingsLaboratory ExaminationDifferential DiagnosisTreatmentDecision-Making in Epidural Spinal Cord CompressionSpecific TumorsIntradural and Intramedullary Metastases:DiagnosisTreatmentReferences7. Leptomeningeal MetastasesIntroductionFrequency:Pathophysiology of Signs and Symptoms:HydrocephalusParenchymal InvasionIschemiaMetabolic CompetitionImmune ResponsesInflammationBlood-Cerebrospinal Fluid Barrier disruptionClinical Findings:Cerebral (Brain) Symptoms and SignsCranial Nerve Symptoms and SignsSpinal Symptoms and SignsLaboratory Tests:Magnetic Resonance ImagingLumbar PunctureOther Diagnostic TestsDifferential Diagnosis:Diagnostic ApproachTreatment:Radiation TherapyChemotherapySurgeryPrognosis:References8. Cancer Involving Cranial and Peripheral Nerves and MusclesIntroductionFrequency:Cranial Nerves:Clinical FindingsDiagnosis and TreatmentSpinal Roots:Nerve Plexuses:Cervical PlexusBrachial PlexusLumbosacral PlexusPeripheral Nerves:MononeuropathiesPolyneuropathyMuscles:ReferencesPart III: Nonmetastatic Complications of Cancer9. Vascular DisordersIntroductionFrequency:Pathophysiology of Cerebrovascular Disease:HypocoagulationHypercoagulationCentral Nervous System Hemorrhage:Hemorrhage into Brain MetastasesSubdural HemorrhageCoagulopathic HemorrhageLeukostasisHyperviscosityHypertensionCentral Nervous System Infarction:AtherosclerosisDisseminated Intravascular CoagulationArterial Occlusion by Extrinsic TumorCerebral EmboliThrombotic MicroangiopathyCerebral VasculitisIntravascular LymphomaThrombocytosisVenous Occlusions:Compressive Venous Sinus OcclusionVenous Sinus ThrombosisTumor EmboliOther Disorders:Systemic ThrombophlebitisEpisodic Neurologic Dysfunction in Patients with Hodgkins DiseaseSystemic HypotensionAir EmbolismApproach to the Patient:References10. Central Nervous System InfectionsIntroductionPathophysiology of Central Nervous System InfectionHost DefensesInfection Sites within the Central Nervous SystemClinical Findings:Signs and SymptomsMeningitisMeningoencephalitisBrain AbscessVascular LesionsApproach to the Patient:Specific Organisms Causing Central Nervous System Infectioni Patients with Cancer:T-Lymphocyte and Mononuclear Phagocyte DefectsNeutrophil DefectsSplenectomy or B-Cell AbnormalitiesCerebrospinal Fluid-Surface CommunicationOther InfectionsReferences11. Delirium and metabolic and Nutritional Complications of CancerIntroductionDelirium Associated with Cancer:DefinitionIncidencePathophysiologyClinical FindingsDiagnosisCauses of DeliriumMetabolic Brain Disease in Patients with Cancer:IncidenceClinical SignsLaboratory TestsDifferential DiagnosisTreatmentSpecific Metabolic Causes of Delirium:Postoperative DeliriumDrugsSubstrate Deprivation (Hypoxia-Ischemia-hupoglycemia)HyperglycemiaSepsisElectrolyte ImbalanceEndocrine and Other Organ DysfunctionsOrgan FailureTumor Lysis SyndromeLactic AcidosisNutritional Disorders Associated with Cancer:Malnutrition and CachexiaDisorders of Nutrient Deprivation Associated with CancerReferences12. Side Effects of ChemotherapyIntroductionClinical Findings and Diagnosis:Peripheral Nervous SystemCentral Nervous SystemNon-Neurologic ToxicitySpecific Agents:Cytotoxic AgentsAntineoplastic HormonesBiologic AgentsDifferentiation AgentsHematopoietic Stem Cell Transplantation (HSCT)Adjuvant AgentsReferences13. Side Effects of Radiation TherapyIntroductionBiology of Radiation Damage:IonizationFractionationMechanisms of Nervous System DamageThe Linear-Quadratic ConceptDiagnosis of Radiation-Induced Neurotoxicity:Direct Radiation Damage to the Nervous SystemIndirect Nervous System DamageTreatment:References14. Neurotoxicity of Surgical and Diagnostic ProceduresIntroductionDisorders Resulting from Anesthesia:General AnesthesiaRegional AnesthesiaIntubationSurgery:CraniotomyBase of Skull SurgerySpinal SurgeryHead and Neck SurgeryBreast SurgeryThoracotomyAbdominal/Pelvic SurgeryExtremity SurgeryDiagnostic Procedures Causing Neurotoxicity:Computed TomographyLumbar PunctureArterial/Venous CathetersEpidural/Intrathecal CathetersReferences15. Paraneoplastic SyndromesIntroductionGeneral Considerations:ClassificationFrequencyImportancePathogenesisDiagnosisPrognosisTreatmentSpecific Syndromes:Paraneoplastic Cerebellar DegenerationSubacute Sensory Neuronopathy/EncephalomyelitisOpsoclonus/Myoclonus (OM)Spinal Cord SyndromesCranial NervesPeripheral Nerve SyndromesNeuromuscular JunctionMuscleReferencesIndex

Editorial Reviews

"...This seminal book by two of the world's most experienced and respected neuro-oncologists is an impressive example of excellent cooperation focusing on particular diseases or conditions related to cancer and the nervous system. It will be a reference guide which should not be missed on thebookshelfs of (neuro)-oncologists and related health professionals." European Journal of Neurology