Chemotherapy Flashcards
(31 cards)
What is a cycle?
repeating pattern of treatment & rest
What is a course?
complete pattern of cycles
What is a line?
order of treatments
What type of chemotherapy?
Patient with osteosarcoma, aim is to make tumour smaller before surgery
Neoadjuvant
What type of chemotherapy?
Patient with breast cancer undergoing chemo post-mastectomy
Adjuvant
What type of chemotherapy?
Patient with in-situ breast cancer given tamoxifen before invasive carcinoma is recognised
Prophylactive
Why is chemo usually given as a combo of drugs? (3 reasons)
- Synergism: different drug classes have different actions & may kill more cells together
- Less chance of drug-resistant cells
- Different sites of toxicity
What are two cell types commonly affected by chemo & the resulting SEs?
haematopoietic stem cells: myelosuppression
Lining GI tract: mucositis
What is intravesical chemo?
Pros
Drug directly into bladder
High dose at tumour site with minimal systemic toxicity
What is intraperitoneal chemo?
What cancer can it be used for?
Into peritoneum
Ovarian cancer
what is an indication for intra-arterial chemo
Tumour with a well-defined blood supply
How is chemo dose calculated?
Based on body surface area using the DuBois formula
What drug is commonly used for chemo-induced nausea & vomiting?
What are two common SE?
Ondansetron
5 HT antagonist
SE: constipation & headache
Define:
- Myelosuppression
- Leucopaenia
- Thrombocytopenia
- Decreased bone marrow activity
- Low WBCs
- Low platelets
How long does haematopoietic recovery take?
3-4 weeks
What is the low-point of myelosuppression called? and when does this occur?
Nadir
10-14 days after beginning a treatment cycle
A patient receiving chemo has peripheral neuropathy & high tone hearing loss. What chemo agent are they on?
Cisplatin (an alkylating agent)
Which agent can cause haemorrhagic cystitis?
ifosfamide
What is extravasation?
leakage of intravenously (IV) infused, and potentially damaging, medications into the extravascular tissue around the site of infusion
What is hand-foot syndrome? and its likely cause
How is it managed?
(plantar erythema)
5-FU
Withdrawal & emolients
What are beau’s lines?
Grooved lines in the nails, recurring evenly spaced lines
Give 3 long-term complications of chemo
Secondary malignancy (due to sub-lethal DNA damage). Alkylating agents are most carcinogenic
Fertility problems
Pulmonary (fibrosis - bleomycin & busulphan)
What is it important to discuss with patients re: reduced fertility from chemo
Council prior to treatment & discuss sperm storage/ storage of fertilised ova if applicable
What types of cancer are myelosuppression mos common in? (i.e. due to bone marrow infiltration)
Heamatological malignancies
Solid tumours: breast, lung & prostate
