Cancer Treatment Flashcards
(22 cards)
What is chemotherapy toxicity and how is it quantified?
chemo kills any rapidly dividing cells so it can cause a whole host of problems and can be medication dependent
Quantifying toxicity is by the following
1-mild
2-moderate
3-severe
4-disabling
5-death
What is a common issue with pt and reporting chemotherapy toxicity and what is two major toxicities that PT should be on the lookout for?
Pts often do not metion their side effects because they dont want to stop what is helping heal them
peripheral motor/ sensory neuropathy
What is myelosuppression?
Myelosuppression can affect all the cell types in the myeloid line which originate in the bone marrow
white blood cells- immune deficient
platelets- bleeding risk
red blood cells- risk of anemia
most common does limiting toxicity
What is neutropenia and what are the associated precautions
Decrease in neutrophils which protect agains infection
management: must wash hands and minimize exposure from sick people and large crowds
What is Thrombocytopenia and what should a PT watch for?
thrombocytopenia- low level of platelets
increase risk of bleeding consider fall risk, muscle trauma
watch for:
increased bruising/petechiae
prolonged bleeding times
concomitant medications (anticoagulants)
What is a critical value of thrombocytopenia?
low platelet level of 10-20,000
What is Anemia, SS, and Critical Value?
decreased RBC decreased oxygen carrying capacity
SS: fatigue/cardiac symptoms
Critical value <7-8
What is alopecia
loss of scalp hair from chemotherapy since it attacks rapidly dividing cells
onset 1-2 weeks but is reversible
What should be recognized if a patient has diarrhea?
the pt is at risk for dehydration hypovolemic hypotensive
What are the different types of Nausea/Vomiting associated with chemo
acute, delayed, anticipatory, breakthrough, refractory
Define Cancer Related Fatigue?
CRF- distressing, persistant, subjective sense of physical, emotional, cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activities and interferes with usual functioning
it is not relieved by rest
Explain the prevalence of chemo brain and how it impacts an individual
found in 75% of pt
may be seen early or late mechanism unknown it is not related to anemia, fatigue, or depression
Effect:
difficulty concentrating, performing multiple tasks, short term memory
What are some key facts about toxicity
-every pt has toxicity
no one gets all toxicities
grade1-2 most common
grade 3-4- MD may hold dose reduce addition doses
Describe what phase and what 2 toxicities are correlated with taxanes & vinca alkaloids (vincristine)
interferes with M phase cell reproduction
side effects:
peripheral neuropathy- distal to proximal stocking glove
loss of DTR, paralysis, irreversible
Cardiotoxicity- arrhythmia- bradycardia, hypotension, heart failure
Describe what phase and what 4 toxicities occur with Alkylating Agents
Interferes with S phase- DNA replication preventing cross linking DNA strands
Side Effects:
-myelosuppression- decreased myeloid line WBC Platelets RBC
-hemorrhagic Cystitis- more common in poorly dehydrated appears as hematuria
-cardiotoxicity- declines in LV systolic function
Neurotoxicity- cerebellar ataxia, mental confusion, complete visual hallucinations
Describe what phase and what toxicity occurs with anthracycline the “rubicins”
interferes with s phase- prevents cell division between base pairs DNA replication
side effect
Cardiotoxicity: acute- arrhythmia chronic- heart failure
What is there a high risk of when a pt is taking Doxorubicin?
Heart Failure
Explain HER 2 and what HER 2 antibodies do in relation to a certain cancer?
HER 2 is a growth promoting protein common in breast cancer then spread faster and grow most common in breast cancer
HER 2 antibodies- binds to HER2 receptor preventing the receptor from activating slowing the growth
Is radiation therapy selective?
no radiation therapy works by damaging the DNA of exposed tissue it is non selective` thus will impact nearby fast dividing cells
the goal is to cure slow cancer progression, shrink palliation
Brachytherapy is internal radiotherapy ____ and ____ for multiple types of cancer ____, ___, ___, ___.
localized and precise
prostate, cervical, breast, skin
What are the 6 common side effects for Radiation Therapy?
- immunosuppression
- skin changes
- gastrointestinal changes
- Fatigue- may resolve when radiation is complete or last 6 months to one year post radiation
- avascular necrosis- loss of blood supply to an area resulting in necrosis of tissue
- Radiation myelitis
Define Radiation myelitis and how it may present?
radiation myelitis- radiation may damage small blood vessels in the spinal column resulting in loss of blood flow, necrosis and demyelination
symptoms include sensory dysfunction and motor weakness can present like a spinal cord injury
