This chapter explores the relationship between chemotherapy and anesthesia, highlighting the challenges faced in perioperative management of cancer patients. As chemotherapy remains a cornerstone of modern oncologic therapy, its systemic toxicities—including cardiotoxicity, neurotoxicity, hepatotoxicity, nephrotoxicity, and myelosuppression—present unique anesthetic considerations. The chapter systematically reviews major chemotherapeutic drug classes, including alkylating agents, antimetabolites, plant alkaloids, anti-tumor antibiotics, hormonal therapies, and biological response modifiers, alongside their mechanisms, indications, and adverse effects. Common malignancies, such as breast, colorectal, brain, and lung cancers—are discussed in detail to demonstrate how chemotherapy impacts anesthesia choices and perioperative planning. Strategies such as regional anesthesia, preoperative organ function assessment, and individualized anesthetic approaches are emphasized to mitigate risk. The chapter underscores the importance of multidisciplinary collaboration between oncologists, anesthesiologists, and surgeons to optimize outcomes and safety in the evolving field of oncologic surgery.
Keywords: Chemotherapy, Glioblastoma, Lung cancer, Alkylating agents, Anthracyclines, Regional anesthesia, Chemotherapy-induced complications, Anesthetic risk stratification, Oncologic anesthesia.
