Traditional Cancer Therapies and Perioperative Implications

Preoperative cancer therapies such as chemotherapy and radiation can have direct implications on perioperative management during cancer surgery. Chemotherapy is intended to prevent proliferation of malignant cells (cytostatic) and cause death of tumor cells (cytotoxic). It can be given at various stages during cancer treatment, including before surgery (neoadjuvant), after surgical resection (adjuvant), or as palliative therapy to improve quality of life. Chemotherapy is usually administered in cycles every 2–3 weeks, which allows patients to recover from its toxic effects. In this chapter, we focus on reviewing traditional chemotherapeutic agents, their toxicities on organ systems, and how to mitigate these effects perioperatively. Most commonly, patients experience toxicities related to cardiac, pulmonary, gastrointestinal, and hematologic systems.