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Gastrointestinal Cancers • Medical Oncology
How would you manage a patient with anal squamous cell carcinoma and 5 FU induced coronary vasospasm 36 hours after starting definitive chemoradiation?
No known cardiac risk factors
Answer from: Medical Oncologist at Community Practice
I'm not sure if this is helpful to you in this situation, but in a different GI cancer, I was pleased to learn recently that it is the infusional 5 FU that causes vasospasm that is also seen with capecitabine; bolus 5 FU may be safe to use. See the reference below: Safety and tolerability of th...
Answer from: Radiation Oncologist at Community Practice
If the cancer is early staged or non bulky, consider forgoing further 5FU and finish with mitomycin as planned and slightly higher radiation boost dose. If the cancer is bulky/advanced stage, I would change the regimen to perhaps carbo/tax. Both options would allow a safe alternative.
ST elevation was noted, but no troponin leak.
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