Open Access Debate

CCC meets ICU: Redefining the role of critical care of cancer patients

Michael von Bergwelt-Baildon12*, Michael J Hallek1, Alexander A Shimabukuro-Vornhagen1 and Matthias Kochanek12

Author Affiliations

1 Department I of Internal Medicine, University of Köln, Kerpenerstrasse 62, 50937 Cologne, Germany

2 Center for Integrated Oncology Köln-Bonn, University of Köln, Kerpenerstrasse 62, 50937 Cologne, Germany

For all author emails, please log on.

BMC Cancer 2010, 10:612  doi:10.1186/1471-2407-10-612

Published: 8 November 2010

Abstract

Background

Currently the majority of cancer patients are considered ineligible for intensive care treatment and oncologists are struggling to get their patients admitted to intensive care units. Critical care and oncology are frequently two separate worlds that communicate rarely and thus do not share novel developments in their fields. However, cancer medicine is rapidly improving and cancer is eventually becoming a chronic disease. Oncology is therefore characterized by a growing number of older and medically unfit patients that receive numerous novel drug classes with unexpected side effects.

Discussion

All of these changes will generate more medically challenging patients in acute distress that need to be considered for intensive care. An intense exchange between intensivists, oncologists, psychologists and palliative care specialists is warranted to communicate the developments in each field in order to improve triage and patient treatment. Here, we argue that "critical care of cancer patients" needs to be recognized as a medical subspecialty and that there is an urgent need to develop it systematically.

Conclusion

As prognosis of cancer improves, novel therapeutic concepts are being introduced and more and more older cancer patients receive full treatment the number of acutely ill patients is growing significantly. This development a major challenge to current concepts of intensive care and it needs to be redefined who of these patients should be treated, for how long and how intensively.