Cancer patients require specialised care at every step of their journey, and anesthesiologists play an indispensable role in ensuring their comfort and safety throughout treatment. From the initial diagnosis to surgery, chemotherapy, and recovery, onco-anesthesiologists are pivotal in managing pain, sedation, and anxiety. Their involvement starts early—during procedures such as biopsies—where they ensure patients, especially children, are sedated or anesthetised appropriately to provide maximum comfort. Often working behind the scenes, their expertise is vital to the success of cancer care, enabling a smoother and less stressful experience for patients.
Recognising the key areas where anesthesiologists contribute is crucial to understanding their profound impact on patient outcomes and quality of life throughout the cancer journey.
1. Anaesthesia for cancer surgeries
Anesthesiologists play a central role in cancer surgeries. The role starts right from the pre-anesthesia check-up (PAC). The PAC primarily has two roles: in pre anesthesia clinic the anesthesiologist is the ‘first point of contact’ with the patient scheduled for surgery. A good quality PAC serves as the reflection of the perioperative care that will be provided. This is very important component for the patient to develop confidence in the institution where is undertaking the treatment. Secondly, a detailed and thorough PAC provides the overall risk assessment of the patient. It helps in preoperative optimisation which is essential in view of prolonged course of treatment ahead. An anesthesiologist helps to manage pain and ensures that patients are well-sedated during procedures. Onco-anaesthesiologists determine the necessary level of sedation based on the type of surgery, patient age, and overall health. This is particularly challenging in pediatric, geriatric, and bariatric patients, where specialised techniques are essential to minimise risks and provide safe anaesthesia. Whether routine surgery or a more complex oncological procedure, the anesthesiologist customises the anaesthesia plan to suit each patient’s unique needs.
2. Supporting chemotherapy and radiotherapy
Cancer treatments like chemotherapy and radiotherapy often require sedation to ensure patient comfort. For instance, chemotherapy can involve painful procedures such as the insertion of PICC lines or chemoport which are difficult for patients to tolerate without sedation. Similarly, pediatric patients undergoing radiotherapy need anaesthesia to remain still during long sessions, preventing anxiety and physical discomfort. Onco-anesthesiologists make these treatments more manageable, ensuring that patients are as comfortable as possible, which is essential for the effectiveness of the therapy.
3. Supporting cancer diagnostics
Sedation to tolerate painful CT/ USG guided core biopsies and microwave ablations, and to overcome claustrophobia in MRI suites is provided by the onco-anesthesiologists.
4. Postoperative care and ICU management
After cancer surgeries, many patients require time in the Intensive Care Unit (ICU) for close monitoring and care. Anesthesiologists continue to play a vital role in these cases, managing postoperative pain and ensuring the patient’s vital signs—such as heart rate, blood pressure, and oxygen levels—are stabilised. Especially for those with advanced cancer, anesthesiologists tailor pain management strategies and adjust sedation as needed, supporting recovery and minimising discomfort.
5. Pain management: A vital aspect of cancer care
One of the primary responsibilities of onco-anesthesiologists is to manage pain effectively throughout the cancer journey. Good pain relief ensures early ambulation which in turn improves mental health, enables quick recovery and early discharge. Whether it’s pain from surgery, chemotherapy, or the progression of the disease, anesthesiologists employ various methods to provide relief. Techniques such as epidural injections, nerve blocks, or systemic pain medications are used to cater to the individual needs of the patient, ensuring comfort throughout treatment. Often, patients first meet their anesthesiologist at the pre-anesthetic checkup clinic, where trust is built, and their concerns are addressed. This initial consultation plays a crucial role in reducing anxiety, especially for those undergoing major surgeries or challenging treatments.
6. Palliative and end-of-life care
For patients in the advanced stages of cancer, anesthesiologists extend their role to palliative care, focusing on alleviating pain and improving quality of life. In the final stages, onco-anesthesiologists manage symptoms like pain and shortness of breath, providing comfort and minimising suffering. Their role in end-of-life care is essential, as they help patients pass more peacefully by addressing physical discomfort and emotional distress, offering a dignified end to their cancer journey.
Technological advancements in cancer and anaesthesia care
The integration of new technologies in both cancer treatments and anaesthesia has significantly enhanced patient care. Modern anaesthesia machines offer greater control over anaesthetic delivery, reducing risks and complications. Innovations in monitoring systems also provide real-time data on a patient’s condition, enabling anesthesiologists to adjust anaesthesia levels as needed during surgery and recovery. These technological advancements contribute to faster recovery times and improved comfort for cancer patients, helping them focus on healing rather than managing side effects.
Future of onco-anesthesia and cancer care
Onco-anesthesia is a relatively new sub-speciality in anesthesiology that has grown in importance as cancer treatments have evolved. Anesthesiologists now have access to fellowships and advanced training programs to gain the skills necessary to care for cancer patients. The development of this sub-speciality ensures that patients receive the most appropriate anaesthesia tailored to their unique cancer care needs, improving overall treatment outcomes and patient satisfaction.
The future of onco-anaesthesia lies in the continued growth of the field through technological advancements and specialised education. As cancer care becomes more individualised and treatment options become more complex, onco-anesthesiologists need to stay at the forefront of these developments to provide the best possible care for their patients. With more institutions offering fellowships in onco-anaesthesia, the next generation of anesthesiologists will be better equipped to meet the growing demand for specialised cancer care.
Onco-anesthesiologists may work behind the scenes, but their expertise and dedication make them silent yet irreplaceable pillars of support throughout the cancer journey.