Chemotherapy

Question 1

What is the primary aim of systemic chemotherapy?

Answer 1

Maximal therapeutic cytotoxic effect whilst avoiding extreme toxicity to normal healthy tissues

Systemic chemotherapy can be administered via oral, IV, SC, or IM routes.

Question 2

What is the goal of regional chemotherapy?

Answer 2

To deliver cytotoxics directly into the cavity where the tumour is located or the blood vessel supplying the tumour, minimizing side effects

Regional chemotherapy includes intrathecal and intraarterial methods.

Question 3

What is extravasation in the context of IV chemotherapy?

Answer 3

Leakage of cytotoxic drug from vein into subcutaneous or subdermal tissue, which can lead to permanent tissue damage

Refer to local guidelines for prevention and prompt management.

Question 4

What are common side effects of chemotherapy?

Answer 4

Nausea and vomiting, bone marrow suppression, oral mucositis, diarrhoea, fatigue, organ toxicities, hyperuricaemia, urothelial toxicity

Bone marrow suppression does not occur with vincristine and bleomycin.

Question 5

When does bone marrow suppression typically occur after chemotherapy administration?

Answer 5

7-10 days after administration

It’s important to treat infection before or when starting cytotoxic therapy.

Question 6

What are warning signs of neutropenic sepsis?

Answer 6

• Feeling unwell with two temperature readings of 37.5°C or above
• Shivering episodes or flu-like symptoms
• Uncontrolled gum/nose bleeds or unusual bruising
• Diarrhoea and/or uncontrolled vomiting
• Mouth ulcers that stop patient from eating or drinking

Question 7

What actions should be taken if signs of neutropenic sepsis develop?

Answer 7

• Advise patient to attend their nearest A&E department
• Do not take paracetamol without seeking advice
• Report immediately to a doctor if any side effects occur

Question 8

True or False: Anti-emetics should be prescribed only on an as-needed basis for patients experiencing severe emesis.

Answer 8

False

Antiemetics should always be prescribed on a regular basis for severe or moderate emesis.

Question 9

Fill in the blank: Patients should maintain good oral hygiene by rinsing their mouth more frequently and effective brushing of teeth ______ times daily.

Answer 9

2-3

Question 10

What is a medical emergency associated with chemotherapy?

Answer 10

Neutropenic sepsis

Warning signs include feeling unwell, temperature spikes, and bleeding.

Question 11

What should patients be advised regarding gum/nose bleeds?

Answer 11

Report uncontrolled gum/nose bleeds or unusual bruising immediately

These can be warning signs of neutropenic sepsis.