Department I of Internal Medicine, University of Köln, Kerpenerstrasse 62, 50937 Cologne, Germany.
BMC Cancer. 2010 Nov 8;10:612. doi: 10.1186/1471-2407-10-612.
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.
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.
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.
目前，大多数癌症患者被认为不适合接受重症治疗，肿瘤医生也在努力让他们的患者入住重症监护病房。重症监护和肿瘤学通常是两个相互独立的领域，很少进行沟通，因此无法分享各自领域的新进展。然而，癌症医学正在迅速发展，癌症最终正在成为一种慢性病。因此，肿瘤学的特点是越来越多的老年和身体不适的患者接受了许多具有意外副作用的新型药物。
所有这些变化都将产生更多患有急性疾病且需要接受重症治疗的具有挑战性的患者。重症监护医生、肿瘤医生、心理学家和姑息治疗专家之间需要进行深入的交流，以沟通每个领域的发展，从而改善分诊和患者治疗。在这里，我们认为“癌症患者的重症监护”需要被视为一个医学亚专科，并且迫切需要系统地发展它。
随着癌症预后的改善，新的治疗概念正在被引入，越来越多的老年癌症患者接受了完整的治疗，急性病患者的数量显著增加。这一发展对重症监护的现有概念构成了重大挑战，需要重新定义哪些患者应该接受治疗、治疗多长时间以及治疗强度。
