Lessons From Two Cases of Life‐Threatening Hemorrhage Which Occurred Immediately Before Tooth Extraction in Elderly Cancer Patients With Diabetes

Tooth extraction is often required before chemoradiotherapy in patients with cancer. We herein report two cases of elderly cancer patients who experienced life-threatening hemorrhage immediately before scheduled extractions. Case 1 involved a 79-year-old man who underwent chemotherapy for malignant lymphoma. The patient had a history of diabetes mellitus and cerebral infarction. The night before his scheduled tooth extraction, he suffered intracerebral hemorrhaging and was emergently transported to a neighboring general hospital. Case 2 involved a 72-year-old man with oropharyngeal cancer who had completed induction chemotherapy. This patient was diabetic, living alone, and failed to appear on the day of scheduled tooth extraction. His sister, living in a neighboring town, found him in an abnormal condition. He was emergently transported to our hospital and diagnosed with gastrointestinal bleeding. These cases highlight the fragility of elderly patients with diabetes undergoing cancer treatment and the importance of perioperative interdisciplinary coordination, including family involvement.