Chemotherapy and Side Effects

Question 1

What does Chemotherapy target?

Answer 1

Targets rapidly dividing cells

Question 1

What is Chemotherapy?

Answer 1

Drugs for treating cancer
- many different kinds and combinations

Question 2

Is Chemotherapy different for everyone, if so what differs?

Answer 2

Yes, everyone has a different experience.
- Different combos of drugs
- Individual differences in reactions

Question 3

What is Chemotherapy used for?

Answer 3

1. Primary treatment
2. Adjuvant therapy
3. Neoadjuvant therapy

Question 4

What is Primary treatment?

Answer 4

Typically for treatment when surgery is not possible
ex: if tumour is in a dangerous area where surgery would be life threatening

Question 5

What is Adjuvant therapy?

Answer 5

After surgery to get any metastasized cells or parts of the tumour that were not excised
ex: if surgery doesn’t cure or get rid of the whole tumour.

Question 6

What is Neoadjuvant therapy?

Answer 6

Given before surgery
Ex: shrink tumour so easier to surgically remove

Question 7

What is Oral Chemotherapy?

Answer 7

A form of Chemotherapy inserted orally.
(Pill, capsule, liquid)

Question 8

What are some advantages of Oral Chemotherapy?

Answer 8

• Can be taken at home
• Good for those squeamish about injections
  (Easier for patients to take and for those who can’t get to the hospital)

Question 9

What are some disadvantages of Oral Chemotherapy?

Answer 9

• Variable absorption (passes through stomach and may tackle unnecessary issues on the way)
• Variation in bioavailability (takes longer to absorb)
• Patient compliance (may not want to take it)

Question 10

What is Intravenous Chemotherapy?

Answer 10

A single venipuncture where chemotherapy is directly delivered into the vein. Can be injected or attached to a drip bag

Question 11

What is needed after Intravenous Chemotherapy?

Answer 11

RECOVERY!! Veins will harden if poked too often. Can’t be done as often

Question 12

What is a Central Line? When is it used?

Answer 12

A form of intravenous chemotherapy and remains inserted through duration of chemo in the central vessel in chest. Used when chemo is required more frequently

Question 13

What is a PICC? Where is this inserted and for what duration?

Answer 13

Peripherally inserted central catheter line. Stays in until the chemo is done and enters the body from the arm.

Question 14

Disadvantages of a PICC?

Answer 14

• Can’t get wet
• Uncomfortable
• Difficult to exercise
• Cannot lift heavy weight

Question 15

How long is a cycle (schedule of treatment)?

Answer 15

• Can be one day on, many days rest
• Can be everyday followed by a long rest
• Can be every other day

Question 16

What are 3 goals of Chemotherapy?

Answer 16

1. Cure - cancer goes away
2. Control - Stop disease from spreading
   - Managed like a chronic disease
3. Palliation - Improve quality of life rather than extend life (shrink a tumour that may effect the way they live, ex - colon cancer that prevents them from pooping)

Question 17

What causes side effects?

Answer 17

Damage to normal tissues and cells due to:
- Chemo drugs target fast dividing cells (hair, bone marrow, etc)
- Chemo drugs travel around the body

Question 18

What tissues are most commonly damaged?

Answer 18

• Bone marrow
• Mouth
• Digestive tract
• Reproductive system
• Hair follicles

Question 19

What tissues can sometimes become damaged?

Answer 19

• Heart
• Kidneys
• Bladder
• Liver
• Lungs
• Nervous System

Question 20

What are some common side effects?

Answer 20

• Nausea/vomiting
• Hair loss
• Fatigue
• Blood counts
• Appetite and weight changes

Question 21

Who experiences nausea/vomiting?

Answer 21

7 to 8/10 people on chemo

Question 22

What is nausea/vomiting?

Answer 22

A reaction to perceived poisoning

Question 23

What can help nausea/vomiting?

Answer 23

Antiemetics (anti-nausea) drugs

Question 24

What can nausea/vomiting lead to?

Answer 24

- Fatigue - Difficulty concentrating - Dehydration - Slow wound healing - Loss of appetite

Question 25

What is Acute nausea/vomiting?

Answer 25

Occurs soon after chemo administration, goes away within 24 hours

Question 26

What is Delayed nausea/vomiting?

Answer 26

Onset is at least 24 hours after chemo

Question 27

What is Anticipatory nausea/vomiting?

Answer 27

Occurs as a person is preparing for chemo

Question 28

How does chemo induced nausea affect physical activity?

Answer 28

Interferes with PA during chemo. No one wants to be active when they feel sick

Question 29

Does PA help with nausea?

Answer 29

No known evidence

Question 30

What is fatigue like during Chemotherapy?

Answer 30

- Most common side effect (90%) - Worst during chemotherapy but can continue years after survivorship - Different than fatigue in healthy people

Question 31

What is chemo induced fatigue caused by?

Answer 31

- Low blood cell counts - Sleep disruption - Stress - Eating too little

Question 32

What is difficult to do when fatigued?

Answer 32

Everyday tasks

Question 33

What does the American Cancer society website say to do when dealing with fatigue?

Answer 33

"limit your activities: do only the things that are most important to you"

Question 34

How does fatigue relate to physical activity?

Answer 34

It is difficult to exercise but can be helpful to feel less fatigued

Question 35

What is Anemia? What side effects does it cause?

Answer 35

Low red blood cell count Side effects - Fatigue, dizziness, paleness, cold

Question 36

What is Leukopenia? What side effects does it cause?

Answer 36

Low white blood cell count Side effects - Infections can occur in mouth, lungs, skin, urinary tract, rectum, reproductive organs

Question 37

What is Thrombocytopenia? What side effects does it cause?

Answer 37

Low platelet counts Side effects - Bruising, more bleeding than usual, headaches

Question 38

Physical activity in relation to low blood cell counts

Answer 38

Less red blood cells - not want to exercise Less white and platelet counts - not recommended to exercise

Question 39

What can happen to weight changes and appetite during chemo?

Answer 39

- Many lose appetite and weight (anorexia) - Others (many breast cancers) gain weight

Question 40

What can cause weight gain in chemo patients?

Answer 40

- Steroids (in chemo) - Electrolyte imbalances - Fluid retention - Inactivity

Question 41

How is PA related to weight changes and appetite?

Answer 41

- May motivate someone to lose weight - Can promote weight loss and increase appetite

Question 42

What causes heart damage?

Answer 42

Usually from anthracyclines (doxorubicin) that damage muscles of the heart

Question 43

What Research has been done to study physical activity and cardiotoxicity?

Answer 43

Animal models (rats) trained on a treadmill prior to receiving doxirubicin and had less cardiotoxicity Therefore PA can protect against acute cardiotoxicity

Question 44

What is Chemobrain? What changes in the brain?

Answer 44

- Mental cloudiness (during and after chemo) - Changes in brain: shrinking in areas responsible for memory, planning, putting thoughts together

Question 45

How long are chemobrain changes detectable post treatment?

Answer 45

10 years

Question 46

What study was done to observe physical activity and chemobrain?

Answer 46

Wheel running rats after chemotherapy injections help attenuate declines in spatial reference memory (maze) and novel object recognition

Question 47

Other side effects caused by Chemotherapy?

Answer 47

- Diarrhea - Constipation - Leukemia - Menstrual changes - Reproductive system damage - Nervous system

Question 48

What do all side effects compromise?

Answer 48

Quality of Life