Point-of-care ultrasound (POCUS) continues to transform and revolutionize medicine. This non-invasive device holds numerous benefits for the user and patient alike. Characterized as a fast, repeatable, accurate, and a radiation-free diagnostic bedside tool, POCUS has been deemed useful when critical decision-making is required.
The undeniable value of POCUS has taken the entire world of medicine by storm. POCUS use by non-radiologists has amplified and developed the hand-held device into a life-saving modality. Today, POCUS is utilized throughout the numerous stages of a patient’s care plan; diagnosis, resuscitation, operation, and postoperative critical care. Included in this usage growth are oncologists and other cancer specialists exploring how POCUS can diagnose and manage the disease.
Though the jury is still out on how well POCUS can detect early signs of cancer or small tumors, it has been found useful in evaluating masses, hepatic lesions, the presence of ascites, and lymph nodes. Studies have also shown POCUS to be essential in assessing benign and malignant conditions of the chest.
The Case Series, Point-of-Care Ultrasound on Oncology Inpatients with Respiratory Abnormalities, involved 13 cancer patients with various types of malignancies. Each patient received a POCUS assessment for dyspnea, which revealed in 11 of the 13 patients findings that led to alterations in their medical management. Six patients had new procedures performed that entailed four pleural taps, one pleural drain removed, and one dialysis. A new imaging study, echocardiography, was ordered for three of the 11 patients. In two patients, a new consult, one for nephrology and another for surgery, was requested. A care management change was required in three of the 11 patients after conducting a POCUS examination, which revealed pneumonia in one patient, requiring antibiotics. Two others were treated for heart failure.
The study outcome points to the relevant and vital need for POCUS in sub-acute settings. In this case, using POCUS unveiled clinical findings that led to alteration management among 84% of patients involved. In this same study, two additional cases were noted that support these findings.
Admitted to the hospital was a 66-year-old male with symptoms of fever and dyspnea. His medical history included lung cancer, hypertension, COPD, and congestive heart failure. A POCUS examination revealed severe decompensated heart failure and pulmonary hypertension. The rapid diagnosis provided allowed the care team to immediately spring into action. They initiated medical treatment and ordered formal imaging.
A second case involved a 69-year-old male with a history of lung cancer, ischemic heart disease, and chronic kidney failure. His hospital admission was due to shortness of breath and a high fever. Discovered was a large left sided pleural effusion during a POCUS assessment. His care team’s rapid response was to drain the fluid found.
As described in the examples, the inclusion of POCUS in caring for cancer patients, particularly conditions of the chest, can indeed be life-saving. In each of these cases employing POCUS to monitor and assess the patient proved to be a vital measure taken to prevent or reverse further complications. The incorporation of POCUS led to informing critical decisions that had to be made to provide the best care for the majority of the patients involved.
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