Cancer Treatment/Meds

Overview of Cancer Treatment and Medications

  • Cancer is classified as a chronic illness.

  • Thousands of people live five years or longer with cancer, with around 68% being cured.

  • Cancer often causes exacerbations and remissions, impacting physical and psychological functions and quality of life.

Consequences of Cancer

Impaired Immunity and Clotting

  • Cancer can develop in any organ/tissue, destroying normal tissue and decreasing its function.

  • Bone marrow invasion by cancer leads to reduced healthy white blood cell production.

  • Conditions such as leukemia increase infection risk.

  • Chemotherapy can reduce neutrophil numbers, further increasing infection risk.

  • Results in anemia (decreased red blood cells) and thrombocytopenia (reduced platelets), impairing clotting.

Symptoms of Anemia

  • Fatigue

  • Tachycardia

  • Shortness of breath

Altered Gastrointestinal Function

  • Tumors in the GI tract can lead to increased metabolic rate and nutrient needs.

  • Loss of appetite and taste can contribute to weight loss and cachexia (extreme body wasting).

  • Increased catabolism leads to reduced sense of fullness (early satiety).

  • Management includes small, frequent meals, nutritional supplements, and possibly internal feedings.

  • Tumors can obstruct the GI tract, affecting nutrient absorption and waste elimination.

Tumor Effects on Organs

  • Liver tumors can lead to malnutrition and death.

Altered Peripheral Nerve Function

  • Tumors or chemotherapy can damage peripheral nerves, causing peripheral neuropathy (CIPN).

  • Symptoms include decreased sensation, numbness, tingling, neuropathic pain, and gait/balance changes.

  • Pre-existing conditions like diabetes can exacerbate symptoms.

Motor and Sensory Deficits

  • Can occur with metastasis, especially from lung, breast, or prostate cancers.

  • Linked to bone weakness, increasing fracture risk, and spinal cord compression.

Cancer Pain Management

  • Cancer pain can be acute or chronic; requires an interprofessional approach.

  • Involves oncology teams, pain management specialists, and patient education on medications and side effects.

Altered Respiratory and Cardiac Function

Respiratory Changes

  • Tumors can obstruct airways and alter gas exchange leading to hypoxemia and dyspnea.

  • Superior vena cava syndrome poses an oncology emergency due to vessel compression.

Cardiac Changes

  • Cancer treatments can lead to issues such as pericarditis, coronary artery disease, and myocardial dysfunction.

  • Risk increases with pre-existing conditions.

Cancer Management Approaches

Surgery

  • Aims to cure or control cancer while minimizing treatment side effects.

  • Types of surgery:

    • Prophylactic: Removes potentially cancerous tissue (e.g., colon polyps).

    • Diagnostic: Biopsy to examine lesions.

    • Curative: Remove all cancer tissue.

    • Cytoreductive: Debulking surgery to alleviate symptoms.

    • Palliative: For symptom relief, not intended to cure.

    • Reconstructive: Enhances function and appearance post-surgery.

Side Effects of Surgery

  • Potential loss of body parts/function, leading to scarring and psychological impact.

  • Post-operative care includes psychosocial support and education on recovery and rehabilitation.

Radiation Therapy

  • Involves high-energy radiation to kill cancer cells and manage symptoms.

  • Delivered via external beam radiation or brachytherapy.

  • Side effects include skin changes, hair loss, and fatigue.

  • Requires good skin care practices and regular dental visits.

Chemotherapy

  • Cytotoxic system therapy for widespread cancer.

  • Different drug categories:

    • Alkylating Agents: Interfere with DNA synthesis.

    • Anti-metabolites: Impair cell division.

    • Anti-mitotic Agents: Disrupt mitosis.

    • Anti-tumor Antibiotics: Damage DNA/RNA synthesis.

  • Side effects include nausea, myelosuppression, hair loss, and cognitive changes.

Important Aspects of Chemotherapy

  • Administered through IV or orally with PPE precautions for nurses due to toxicity.

  • Patient education on handling, side effects, and monitoring for serious complications (e.g., extravasation).

Oncologic Emergencies

Sepsis and Disseminated Intravascular Coagulation (DIC)

  • Sepsis poses infection risks; DIC affects blood clotting and organ perfusion.

  • Treatment includes antibiotics, anticoagulants, and strict aseptic techniques.

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

  • Causes excess water retention and diluted blood sodium levels.

  • Symptoms include muscle cramps, weakness, and fatigue.

Spinal Cord Compression

  • Damage from tumor or vertebral collapse affects neurological function.

  • Treated with corticosteroids, radiation, or surgery depending on severity.

Hypercalcemia

  • High serum calcium levels can cause severe complications and even death.

  • Symptoms include skeletal pain, altered cognition, and dehydration.

  • Treatment with hydration and diuretics; may require dialysis.

Superior Vena Cava Syndrome

  • Results from tumor growth or clots causing obstruction of blood return to the heart.

  • Initial signs include facial edema and upper-body congestion.

  • Treatment involves radiation, chemotherapy, surgery, or stents.

Tumor Lysis Syndrome

  • Rapid cell destruction can lead to electrolyte imbalances.

  • Requires extensive hydration, possible diuretics, and dialysis for severe cases.

Conclusion

  • Encourage questions and active participation in care and management.