Professional Documents
Culture Documents
OR IN
COMBINATION.
Frequent infections
Diarrhea CHEMOTHERAPY- chemo + therapy.
Nausea and loss of appetite The use of drug (chemical entity/
Hair loss substance derived form
Bruising and anemia microorganisms) with selective
toxicity against infections/ viruses,
bacteria, protozoa, fungi and
OBJECTIVES OF IT: helminthes is called as this.
To eliminate or reduce the tumor or INTRO:
cancer cells at the original site (and side
with mestasis) modern chemotherapy begun in 1948
Can be primary or secondary treatment with the introduction of nitrogen
alongside with radiation therapy, and mustard
surgical incision. The use of chemicals to treat cancer
These drugs can be given via IV, IM and began in the early 1940's
Orally in pills, capsules and liquid, It is only in the last 10 to 15 yrs,
systemically. For locally, can be catheters, however, that chemotherapy has
also injected of csf, or dissolving vapors become a major treatment modality.
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OBJECTIVES
DEFINITIONS
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S-PHASE (synthetic phase) - Shorter time results in higher kill when
exposed to - specific agents.
o DNA synthesis
o Cellular DNA is duplicated in
preparation in - preparation for
Growth fraction
cellular division.
o Length of time S phase is - The percentage of cells actively dividing at a
approximately 18-30hrs. given - point in time. High growth fraction
o A weak link, and large number of results in higher cell kill with exposure to
anticancer agent - act. specific agent.
- In this phase, which last only 30-60min, the • To repair DNA damage, Regulation is lost in
cell actually split into 2 new cells. cancer cells.
Significance: - INHIBITORS:
-Drugs works mainly on cells that are • Cyclin dependent kinase inhibitors lead
active(not in the Go) generation of PS3, Rb which inhibits at
Some drugs specifically attack cells in G₁/S(restriction point), G₂/M and M phase.
a particular phase
Determine drug combination
How often drug is given base on PROMOTERS:
timing. Cyclin dependent kinase + proteins → E2F,
cyclin D1, and B drives the cycle at S and G2
phase
CELL CYCLE TIME/GENERATION
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According to chemical groups
o Alkylating agents
o Antimetabolites
-Basalfan
Administration of chemotherapy:
-Cisplatin
Planning drug doses and schedules
-Cyclophosphamide Doses: drugs are measured in milligrams
(mg) and doses are determined based on:
Body weight in kilograms
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Body surface area
Step A
Step B
✓Intravenous route
Step C
-Angiocatheter, PICC line, non tunneled
catheters, tunneled catheters and port a-cath Personnel preparing the drugs should wear
PPE (Gloves,gown, facial protection
✓Subcutaneous routes respiratory protection apparatus, caps and
✓Intraventricular/ Intrathecal route: ommaya shoe covers)
reservoir *Gloves should be changed regularly and
✓Intra-arterial routes immediately if torn or punctured
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Step E Step L
The external surface contaminated with a Cytotoxic drugs are categorized regulated
drug should be wiped clean with an alcohol wastes and therefore, should be disposed of
swab prior to transfer or transport according to National, state and local
requirements
Step G
Step H
Step I
Step J
Cont*
Step K
• Exposure can be occur through
Hand should be washed between glove
changes and after glove removal - Inhalation of aerosols
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-Absorption through the skin Treatment:
- Carboplatin
Extravasation: -Bleomycin
The inappropriate or accidental leakage of -Cisplatin
intravenous drugs from the vein into the
surrounding healthy tissue. -Teniposide
- Dizziness
- Pruritis
- Anxiety
- Inability to speak
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- Nausea • Neurotoxicity
- Hypotension •Cardiotoxicity
•Skin changes:
• Myelosuppression
• Fatigue
• Pulmonary toxicity
• Renal toxicity
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Tetracyclines: Broad spectrum Erythromycin
gram (+)
Principles of antimicrobial therapy
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*Aminoglycosides: Streptomycin, Gentamycin, C. Type of organisms (against which primarily
Amikacin, Neomycin active)
B. Mechanism of action
D. Spectrum of activity
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E. Type of action (bacteriostatic and Toxicity
bactericidal)
Local irritancy:
Systemic toxicity:
F. Source of antibiotics
Systemic toxicity:
Toxicity
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*Natural resistance: Some microbes have
resistant to certain AMAS. E.g.: Gram negative
bacilli not affected by penicillin G; M.
tuberculosis insensitive to tetracyclines.
Resistance
Hypersensitivity reaction
Development of resistance
. All AMAs are capable to causing
hypersensitive reaction, and this this reactions • Resistance mainly developed by mutation or
are unpredictable and unrelated to dose. E.g.: gene transfer
Penicillin induced anaphylactic shock (prick Single gene mutation may confer high degree
skin testing) of resistance. E.g.: enterococci to
streptomycin
Resistance
• Unresponsiveness of a microorganism to an
AMA, and is similar to the phenomenon of
drug tolerance.
- Natural resistance
- Acquired resistance
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- Multistep mutation may modify the more
number of gene that will decreases the
*The nonpathogenic organisms may transfer
sensitivity of AMAs to pathogens.
'R' factor to pathogenic organisms, which may
become wide spread by contamination of
food and water.
Drug Tolerant
Development of resistance
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Superinfection (Suprainfection) Choice of an antimicrobial
Development of superinfection
associated with the use of broad/ Patient age
extended-spectrum of antibiotics, such
tetracyclines, chloramphenicol, ampicillin Patient age (chloramphenicol produce gray
and cephalosporins. as newer baby syndrome in newborn; Tetracyclines
More common when host defence is deposition in teeth and bone-below the age of
compromised. 6 years)
Generally most difficult to treat. Renal and hepatic function
Bacterial superinfection in viral (aminoglycoside, vancomycin renal failure;
respiratory disease infection of a chronic erythromycin, tetracycline- liver failure)
hepatitis B carrier with hepatitis D virus Drug allergy (History of known AMAs
Piperacillin-tazobactam may cause allergy should be obtained).
superinfection with candida Syphilis patient allergic to penicillin-drug
of choice is tetracycline Fluoroquinolones
cause erythema multiforme
Treatment for superinfection: Impaired host defense
Candida albicans: Monilial diarrhoea,
Candidal vulvovaginitis or vaginal thrush Drug factor:
(an infection of the vagina's mucous Pregnancy
membranes) treat with nystain or
clotrimazole - All AMAs should be avoided in the pregnant
Resistant Staphylococci: treat with
- many cephalosporins and erythromycin are
coxacillin or its congeners -
safe, while safety data on most others is not
Pseudomonas: Urinary tract infection,
available.
treat with carbenicillin, piperacillin or
gentamicin.
Superinfections minimized by
Genetic factors
using specific (narrow-spectrum) AMA
(whenever possible) - Primaquine, sulfonamide fluoroquinolones
avoid using (do not use) antimicrobials to likely to produce haemolysis in G-6-PD
treat self-limiting or untreatable (viral) deficient patient)
infection
avoid prolong antimicrobial therapy.
Drug factor:
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-Type of activity travelers to endemic area may take
chloroquine/ mefloquine)
- Sensitivity of the organism (MIC)
• Prevention of infection in high risk situations
- Relative toxicity
• Prophylaxis of surgical site infection
- Pharmacokinetic profile
• Prophylaxis against specific organisms
- Route of administration
• Prevention of infection in high risk situations
- Cost
Prophylaxis of surgical site infection
*Organism-related considerations:
Failure of antimicrobial therapy
-A clinical diagnosis should first be made, and
• Improper selection of AMAS, dose, route or
the choice of the AMAS selected
duration of treatment.
-Clinical diagnosis itself directs choice of the
• Treatment begun too late
AMA
• Failure to take necessary adjuvant measures
-Choice to be based on bacteriological
examination (Bacteriological sensitivity • Poor host defense
testing)
• Trying to treat untreatable (viral) infections
• Immunotherapeutic agents
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• Steroids and Non-steroidal Hormones +METHODS
- Clinical evaluation
- Laboratory test
PRE-CHEMOTHERAPY ASSESSMENT
• CLINICAL EVALUATION
- History
• Detail history
• Systemic involvement
. Co-morbidities
• Performance status
+AIM
- Establish diagnosis
- Fitness of patient
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Chemotherapy II
Laboratory test
- Diagnostic: Histology
- Extent
o Imaging; CXray, CT, MRI, PET,SPET
o Uss
o LFT
PRE-CEMOTHERAPY ASSESSMENT
Baseline
o FBC
- PCV-30%
-WBC<2.5,2.5-3.9>4.0x10^9/L
-PLT<75,75-150x10^9/L
o U&Ecr
o Stool microscopy-Strogiliodes
Stercoralis
Others, depend on the type of cancer e.g
tumuor markers.
COUNSELING
Adequate counseling
- Disease explained in simple terms that
Physical assessment
The extent of primary and metastatic can be understood
disease via the general and thorough - Extent
systemic examination
- Plan of treatment
Body surface area
- Side effect expected
- Fair idea of prognosis
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Opportunity given to ask adequate ADMINISTRATION
questions and get accurate answers. Choice of Agents
A professional counselor/psychologist -type of cancer
should be involved. -the stage
The aim of the therapy must clearly be -age
stated to the patient and relative -clinical state of patient
-curative -co-morbidities
-paliative -treatment in the past
Modalities of treatment -drug interactions
DOSE
MODALITIES
- Calculate the body surface area
Modalities is selected based on the type
- Dose prescription
and stage of the cancer.
o Standard dose; anticipate mild side
Neoadjuvant effect, minimal supportive care
adjuvant o High dose; above standard,
Multimodality anticipated side effect requires
-surgery supportive care; G-CSF, blood
-chemo-radiation transfusion
o Ablative dose; ablation of tumuor
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o Extracorporeal limb perfusion
o Intracavitory
o Intrathecal
o Subcutaneous
o Intramuscular
o Topical
Pre-chemotherapy medications
-IV Fluids (allopurinol, alkylanization of
urine) – Prevent risk of tumour lysis
syndrome
-Antiemetric: Ondansetron 0.15mg/kg
given 30 min before commencement.
-Antidotes; leucovorin andtidote for
antifolate-metothraxate. (Co-
administered, after administration.
MODES/METHODS
COMBINATION CHEMOTHERAPY
o single agent continuous therapy
Superior to single drug chemotherapy
-little value in modern cancer
considerations:
management
o Drug should be active as a single agent
-low response rates
o Avoid drugs with similar toxicity
-complete remissions were infrequent
o To reduce toxicity
-kill small fraction of tumour cell
o Use drugs with different mech. of
-potentiates the development of drug
actions
resistance
o Use maximum therapeutic doses
CYCLICAL CEMOTHERAPY
Monitoring
Drug is given in cyclical fashion
-Premedication vital signs take, then
To prevent drug resistance
regular monitoring
This gives normal cells time to recover
-Mainly cardiovascular-Cardiotoxicity
from the drug’s side effects.
o Tachycardia
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o Arrhythmias o Treatment; (easily prevented-good vein,
o S3 gallop ensure no leakage before chemo,
o Chest pain, tightness – acute, set fresh not pre-existing line,
coronary syndrome monitor line, start with vesicant.)
o Esp anthracyclins, trastuzumab, -Stop immediately
cyclophosphamide, paclitaxel -Antihistamine
-Nausea, vomiting -Hydrocortisone
-Breathing pattern -Analgesics
-Antidotes and emergency drugs -Care of ulcer when developed
SAFETY Systemic
-Chemotherapeutic agents are hazardous o Haemopoietic; Myelosuppression –
o Mutagenic treatment emergencies (Anemia,
o Teratogenic thrombocytopenia, treat infection,
o Carcinogenic treatment with CSF
o Skin irritation o Gastrointestinal; nausea, vomiting,
-Gloved, goggle and gowns when anorexia, constipation, diarrhea, 5-HT
administering. In good ventilation to prevent antagonist-ondaserton
inhalation of droplets when preparing. o Hyperglycemia – Biophosphonate,
-Care in handling patient urine and feces. corticosoid
o Urinary – hemorrhagic cystitis-mesna
MANAGEMENT OF SIDE EFFECTS o Neurologic – peripheral neuropathy
Local o Cardiovascular – pulmonary fibrosis
o Flare reaction/thrombophlebitis – o Reproductive – infertility, menorrhagia
irritation along the tracts.
Triggering inflammation along the FOLLOW UP
tract and surrounding skin. Complication
o Vesiculation – from extravasation into -History
surrounding subcutaneous tissue -Physical examination
leading to vesicles with -Laboratory investigation- repeat
subsequently ulcerates. Chemical baseline and histology, tumour
burns. marker
-Treat complication as they arise
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Response -CMF
Resistance -CAF/VAC-P
-TAXANE BASED eg
RESPONSE >paclitaxel and xeloda
WHO >paclitaxel, cyclophosphamide and
Objective response – change in longest doxorubicine
diameter of the target lesion Gastric
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2. Systemic treatment Success depend on the difference in the
o chemotherapy sensitivity between the tumor and
o hormonal therapy normal tissue.
o monoclonal antibodies It involves the administration of ionizing
o radioactive material radiation in the form of x-ray or
3. Supportive care gamma rays to the tumor site.
4. Non-conventional therapy Method of delivery: External beam
(Teletherapy). Internal beam therapy
(Brachytherapy)
SURGERY Radiation therapy is planned and
surgery was the first modality used performed by a team of nurses,
successfully in the treatment of cancer. dosimetrists, physician and radiation
It is the only curative therapy for some oncologist.
common solid tumors. A course of radiation therapy is
The most important determinant of a preceded by a simulation session in
successful surgical therapy are the which low- energy beam are used to
absence of distant metastases and no produce radiographic images that
local infiltration. indicate the exact beam location.
Microscopic invasion of surrounding Usually delivered in fractionated doses
Normal tissue with necessitate multiple such as 180 to 300 cGY per day, five
frozen section. times a week for a total course of 5-8
Resection or sampling of regional lymph weeks.
node is usually indicated. Radiation therapy with curative intent is
Surgery may be used for palliation in the main treatment in limited stage
patients for whom cure is not possible. Hodgkin’s disease, some NHL, limited
Has significant role in cancer prevention. stage CA prostate, gynecologic tumors
E.g familial polyposis coli. & CNS tumor.
Also can be used in palliative &
RADIATION THERAPY emergency setting.
Radiation therapy: is a local modality
used in the treatment of cancer. COMPLICATION OF RADIATION
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There are two types of toxicities – acute o Nobel prize 1908
and long term toxicity. o Magic bullet concept
Systemic symptoms such as fatigue,
Historical perspective
local skin reaction, GI toxicity,
>Nitrogen mustards were a product of the
oropharyngeal mucositis, xerostomia secret war gas programs in both world
& myelosuppression wars
>In WWII, an explosion at Bar Harbor
Long-term sequelae: may occur many exposed seamen to mustard gas – they
months or years after radiation developed severe marrow and lymphoid
hypoplasia
therapy. Led to the use of these agents to treat
Radiation therapy is known to be Hodgkins and non-Hodgkins lypmhomas at Yale
in 1943
mutagenic, carcinogenic, and having In the 1950’s, folic acid was shown to
increased risk of developing both accelerate the progression of childhood
leukemias; led to development of folic acid
secondary leukemia and solid tumor. antagonists
In the 1960’s, combination chemotherapy for
childhood leukemias and Hodgkins lymphoma
NUCLEAR MEDICINE began to be used.
> Radionuclides
For decades have been used
CHEMOTHERAPY
systematically to treat malignant
o Systemic chemotherapy is the main
disorders.
treatment available for disseminated
They are administered by specialists in malignant diseases.
nuclear medicine or radiation oncologist. o Progress in chemotherapy resulted in cure
for several tumors.
Radioactive iodine in the form of 131 is
o Chemotherapy usually require multiple
effective therapy for well differentiated cycles.
thyroid ca.
MODES OF CHEMOTHERAPY
Strontium-89. Is used for the treatment of
Primary Chemotherapy – chemotherapy is use as
bony metastasis. It is alkaline earth element the sole anti-cancer treatment in a highly sensitive
in the same family as calcium. tumor types. Example; CHOP for non-Hogdkins
lymphoma
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Neoadjuvant chemotherapy – treatment is given
before surgery to shrink tumor and increase
chance of successful resection. Example;
Adriamycin, ifosfamide for osteosarcoma.
Concurrent chemotherapy – treatment is given
simultaneous to radiation to increase sensitivity
of cancer cells radiation. Example; Cisplatin, 5-
fluorouracil, XRT for head and neck tumors
CANCER CHEMOTHERAPY
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doxorubicin (Adriamycin), and etoposide HEMATOLOGICAL CONSIDERATIONS FOR DOSE
(VePesid) SCHEDULING
Inhibit the synthesis of new DNA – strands
Lifespan
to stop the cell from replicating, because
>Platelet 7-10 days
the replication of the cell is what allows the
>RBC 120 days
tumor to grow. e.g methothrexate
>Neutrophils 6-12 hours
(Albitrexate) mercaptopurine (purinethol),
Time from stem cell to mature neutrophil 7-
fluorouracil (adrucil) and hydroxyurea
10 days.
(hydrea)
Stop the mitotic process of a cell – stopping DECIDING ON TREATMENT INTERVALS
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Antiestrogen
Progestins Aromatase inhibitor
Gonadotropin-releasing hormone agonist:
Somastostatin
Analogues
ADRENOCORTICOSOIDS
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cancer cell by interfering with the natural this is taken into account when determining a
functions of tumor growth. chemotherapy schedule. The next dose of
chemotherapy should be given only after a
How they work. They ‘target’ specific parts of a
person’s blood counts have increased to safe
cancer cell or its actions; hand in a glove
levels after the nadir period. This happens
analogy.
gradually and typically takes 3-4 weeks.
What it means in cancer treatment; Potentially
fewer side effects
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important function by helping the blood to Vitamin B-12 (cobalamin): Found in organ
clot, which prevents bleeding. meat, beef, tuna, trout, salmon, sardines,
When the number of platelets in the body clams and eggs.
fall too low, the condition is called Vitamin C: Found in citrus fruit, cantaloupe,
thrombocytopenia. It is marked by bruising, kiwi, papaya, strawberries,, sweet
nosebleeds, excessive bleeding from cuts potatoes, tomatoes, bell peppers, broccoli,
and fatigue. A reddish-purple skin rash that cauliflower and kale
looks like small dots is also a symptom of a Copper: Found in shitake mushrooms,
low platelet count. spirulina, almonds, cashews, sesame seeds,
lobster, oyster, organ meats, swiss chard,
MANAGING LOWERED BLOOD CELL COUNTS
spinach, and kale.
When blood counts become too low, Vitamin E: Found in salmon, trout, shrimp,
WBCs, RBCs, and platelets can be increased goose, spinach, broccoli, turnip greens,
through drugs that boost cell production, squash, avocados, wheat, olive oil,
as well as through transfusions. Upping sunflower seeds, almonds, hazelnuts,
your consumption of certain healthy peanuts, brzail nuts, mango, and kiwi.
meats, fruits, and vegetables can also help
MANAGING LOWERED BLOOD CELL COUNTS
boost the body’s natural production of
blood cells. • Vitamin C: Found in citrus fruit,
Protein sources like poultry and fish may cantaloupe, kiwi, papaya, strawberries,
promote the production of WBCs. Platelets sweet potatoes, tomatoes, bell peppers,
can be increased by eating foods rich in broccoli, cauliflower, and kale
vitamins B-9 and B-12. • Copper: Found in shitake mushrooms,
The following vitamins and mineral help spirulina, almonds, cashews, sesame
increase they body’s production of RBCs. seeds, lobster, oyster, organ meats,
Consider adding supplements and/or Swiss chard, spinach, and kale.
eating foods that are rich in the following. • Vitamin E: Found in salmon, trout,
Iron: Found in leafy green vegetables like shrimp, goose, spinach broccoli, turnip
kale and spinach, organ meats, lean red greens, squash, avocados, wheat(diko
meat, egg yolks, beans and legumes. nagets yakan ni maam), olive oil,
Vitamin A (retinol): Found in cod liver oil, sunflower seeds, almonds, hazelnuts,
sweet potatoes, spinach, broccoli, black pine nuts, peanuts, brazil nuts, mango
eyed peas, carrots, squash, pumpkin, and kiwi
cantaloupe, mango, and apricots. • Precautions to Take During Nadir
Vitamin B-6 (pyridoxine): Found in salmon, • It’s important to avoid infection or any
poultry, eggs, potatoes, sweet potatoes, activities that could induce bleeding, as
bananas, avocado, pistachios, peanuts, WBCs that fight infection and platelets
whole grains, and brown rice. that help with clotting are diminished.
Vitamin b-9 (folate): Found in citrus fruit, Follow some simple tips including:
banana, papaya, beets, asparagus, Brussels Washing hands often
sprouts, avocado, walnuts, and flax seeds.
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• Thoroughly washing and cooking food -Ensure adequate fluid intake being consumed
before consuming
& retained
• Avoiding contact with those who may
carry an infection, as well as pet waste • Low fiber and residue diet (Eg. Fresh
fruits. Vegetables, seeds and nuts)
• Avoiding getting scratches or cuts
should be recommended to patient as
• Help boost your immune system by:7
these foods can cause diarrhoea
• Getting enough sleep
-Fried food should be avoided as they
• Eating a healthy, balanced diet rich in produced gas
fruits and vegetables
• Patient should be taught to maintain a
• Avoiding caffeine and alcohol
record of episodes of diarrhoea & foods
• Drinking plenty of water that cause diaarhoea
-Rectal area of patient should be kept clean &
dry to maintain skin integrity.
When to Consult a Doctor
• For oral mucositis: patient should be
• Seek immediate medical attention if taught to do oral assessment and
you have bleeding that won’t stop or a characteristics of saliva
fever of 100 degrees or higher, as that & ability to swallow
could indicate the presence of a serious -Patient should be taught to do tooth brushing
infection. & flossing before and after each meal and bed
time.
Nursing management of patient undergoing -Patient should feed with soft non irritating
chemotherapy high protein and high calorie foods -Tobacco
and alcohol should be avoided
• Patient should be protected from
infections Body weight should be measured at least
twice a week. If patient is malnourished, give
-Wash hands regularly with antibacterial agent
parental nutrition
-Avoid crowd with, flu or infections
• For alopecia: patient should be
-Avoid raw fruits and vegetables addressed to use turban, cap or wig as
hair loss is very stressful to patient
• Help the patient to identify period of
more fatigue and activeness -Advice the patient that hair will grow after
-Patient should take rest prior to an activity - chemotherapy treatment
Maintain good nutritional status an hydration
status by taking balanced diet • Patient should be carefully assessed for
pulmonary side effects (pulmonary
• Antiemetics should be administered one edema) & cardiovascular effects
hr prior to chemotherapy (ventricular dysfunction & hear failure)
-Patient should take light meal of non- • Patient should be taught
irritating food before treatment about management of adverse
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effects and interventions are planned and begins to proliferate abnormally,
so patient can self-manage the illness ignoring growth-regulating signals in the
and facilitate coping strategies with environment surrounding the cell
help with of support groups. • Hyperplasia
• Metaplasia
CONCLUSIONS • Dysplasia
• People with cancer are living longer • Anaplasia
• The focus is on quality of life in addition • Neoplasia- new growth; tumor; can
or quantity benign or malignant; uncontrolled cell
• People surviving cancer want to live growth that follows no physiologic
normal lives demand
• New treatment of various kinds are • Benign- not malignant; an abnormal
available and there is no need to suffer growth that is stable, treatable and
generally not life- threatening
• Cancer chemotherapy is an important
component in cancer management singly • Malignant- cancerous; cells that are
or in multi-modal therapy. They are toxic invasive and tend to metastasize,
to normal tissues hence require uncontrollable or resistant to therapy;
knowledge of drugs, early recognition, rapidly spreading
and management of side effect • Invasion- refers to the growth of the
• Adequate counseling is required for primary tumor into the surroundings host
compliance to treatment. tissues
CANCER
TERMS
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Benign vs Malignant Tumors - Epithelial malignant tumors that
have not broken through BM or
Benign Malignant
Grow slowly Grow rapidly
Well-defined capsule Not encapsulated
Not invasive Invasive
Well differentiated Poorly differentiated
Low mitotic index High mitotic index
Do not metastasize Can spread distantly Stage of Cancer Spread Viruses and
Cancer
(metastasis)
• Implicated
• Stage 1: Confined to organ of origin
Mitotic index = rate of growth Hepatitis B and C viruses
• Stage 2: Locally invasive
Classification and Nomenclature
Epstein-Barr virus (EBV)
• Benign tumors- Named according Stage 3: Spread to lymph nodes –
to the tissues from which they
arise, and include the suffix “-oma” Kaposi’s sarcoma herpesvirus (KSHV)
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• Peptic ulcer disease Stomach
carcinoma
• Mucosa-associated lymphoid
tissue lymphoma
-Enzymes
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-Invadopodia (pseudopodia) • HeLa cells were used by Jonas Salk to
test the first polio vaccine in the
HeLa cell
1950’s
• a cell type in an immortal cell line
used in research
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Examples:
TERMINOLOGY
carcinoma)
2. Loss of information
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DMCIR - melanoma
SUSCEPTIBILITY
DAPC-colorectal cancer
□ COMT-breast cancer
GSTM1
OLTA- myeloma
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