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Oncology patients commonly present for surgical procedures that may or may not be related to their cancer. In addition to the usual medical history, it is important to discern the type of cancer, staging and presence of metastases, and/or paraneoplastic syndromes. The patient should be asked about treatments received, including chemotherapy and radiation. Certain chemotherapy drugs (anthracyclines, herceptin) can affect cardiac contractility; hence, a review of the patient’s functional capacity and available cardiac investigations would be appropriate. If radiation is administered to the patient’s neck or chest, be sure to conduct a thorough airway examination as radiation fibrosis of the airway tissues is associated with an unanticipated difficult tracheal intubation (see Chapter 7).

OTHER KEY INFORMATION TO ELICIT

In addition to the review of systems, there are several other basic elements of the patient’s medical history that should be addressed.