Chemotherapy

chemotherapy

chemical agents that destroy cancer cells by interfering with cellular division; dose not distinguish between healthy and cancerous cells

chemo Acute effects

Anaphylaxis, hypersensitivity reaction

Extravasation

N/V

chemo delayed effects

N/V

Mucositis

Alopecia

Bone marrow suppression

chemo chronic effects

Organ toxicities (e.g., heart failure, renal failure)

Extravasation

escape of chemo into surrounding tissue

Extravasation signs and symptoms

absence of blood return

resistance

IV site swelling/pain

CINV

most common symptom of chemotherapy

CINV Nutrition

non-irritating, low fiber, high calorie/protein diet

CINV nonpharmacologcial treatment

Acupuncture

Ginger & Peppermint

5-HT3 anatagonists

ondansetron, alosetron

Immunotherapy

use of immune cells to boost immune system to fight cancer

Non-specific immunotherapy

stimulates immune system in general (e.g. injection of cytokines)

Specific Immunotherapy

stimulates immune system to attack cancer directly (monoclonal antibodies and vaccines)

Immunotherapy side effects

Flulike symptoms

BP fluctuations

Skin rash

Organ inflammation

Stem cell therapy

leukemia cancer treatment used when there is a failure t respond to standard treatment or for treating refractory cancers

allogenic stem cells

stem cells from a matched donor

GVHD

serious condition occurring when the host rejects stem cell therapy

Neutropenia

increased infection risk caused by chemotherapy treatment; patient should be on isolation precautions and on a strict diet

Filgrastim or Pegfilgrastim

neutropenia treatment

Thrombocytopenia

deficiency of clotting cells

brusing

<50,000 thrombocyte level causes

spontaneous bleeding

<20,000 thrombocyte level causes

thrombocytopenia treatment

treat with oprelvekin and monitor neuro status

"Chemo brain"

difficulty focusing or thinking caused by chemo treatment

Lymphedema

swelling due to an abnormal accumulation of lymph fluid within the tissues

hypercalcemia

caused when cancer cells invade the bone or when tumors secrete PTH

hypercalcemia management

maintian hydration

loop diuretics

Biphosphontaes and gluccocortcoids

Tumor lysis syndrome

Chemotherapy can cause massive destruction of cells causing toxic organ damage

Tumor lysis syndrome treatment

Give potassium, phosphorus and purines

Spinal Cord Compression

occur either when a tumor directly enters the spinal cord causing nerve root compression

Spinal Cord Compression signs

intense localized back pain

numbness/tingling

motor loss

bladder/bowel dysfunction

Spinal Cord Compression treatment

Dexamethasone

Radiation (XRT) therapy

Surgical decompression

Superior Vena cava syndrome

tumor causes Compression in vena cava→ impaired venous drainage of head, neck, arms

early symptoms of SVC syndrome

edema of the face, tightness of shirt collar (Stoke's sign)

late symptoms of SVC syndrome

hemorrhage, cyanosis, mental status changes, decreased CO, hypotension death

SVC syndrome treatment

respiratory support

patient positioning

corticosteriods

radiation/surgery to remove tumor