Shock: managing the septic syndrome in patients with cancer.

The septic syndrome remains a major clinical challenge in the management of patients with cancer. Significant advances have resulted in some improvement in outcome, but mortality remains high. Cancer patients with sepsis must be treated aggressively, and empiric antibiotic therapy, as well as early transfer to an intensive care unit (where invasive monitoring can be undertaken), may prove lifesaving. Though we have stressed early diagnosis and treatment, these issues only address part of the problem: the septic syndrome should also be considered a potentially preventable condition. Meticulous attention to measures designed to prevent infection in immunocompromised patients is perhaps even more important; such measures are sometimes overlooked. Cancer patients are fragile, and they should always be thought of as potential hosts for serious infection. Only with a combination of vigilance at preventing infection as well as early intervention once infection is established can the bleak statistics of the septic syndrome be improved.