ABSTRACT

This chapter will outline various aspects of the diagnosis and treatment of Tuberculosis in the cancer patients. Rather than reviewing basic tenets of Tuberculosis diagnosis and therapy, which have been extensively reviewed and codified in national guidelines, the focus is on aspects of Tuberculosis specific to cancer patients. In many cases, specific clinical data about TB in cancer patients is lacking. Therefore, clinical decisions about TB risk, prevention, and therapy in the cancer patient must be made based on extrapolation from data in HIV infected patients, assessment of cancer related immunosuppression, and drug interactions specific to cancer patients. Modern therapy of cancer is in rapid evolution and therapies that suppress immune function are myriad and constantly evolving.   We hope to provide a clinical framework to manage Tuberculosis in cancer patients that draws on presently available clinical data and can also adapt to the evolution of cancer therapy over time. To understand the epidemiology of TB in cancer patients, it is necessary to examine both the underlying immune response to TB infection and the impact of various cancers and their therapies on the immune system.