Patients with Cancer Flashcards
(23 cards)
What is DMSM? What does it consist of?
- distress management screening measure
- distress rating from 0-10
- problem checklist (physical, practical, emotional etc.)
What are some symptoms of distress?
- fear about the future
- sadness about loss of health
- feeling powerless, angry
- decreased appetite
- poor sleep
- difficulty concentrating
- thoughts of illness or death
What are some interventions for distress?
- regular exercise
- educate patient (symptoms to expect)
- support groups
- relaxation, meditation
- medication
- multidisciplinary approach
Why is identifying distress in cancer patients important?
- distress can affect decision making, decrease quality of life, decrease compliance and treatment outcomes
- often unrecognized (may be due to time limits in dr. office)
What did patients with advanced cancer find helpful in terms of communication with health care professionals?
- not appearing rushed
- being caring (empathy, touch, calls to checkup)
- acknowledge fear, reassure
- balance hope and honesty when giving information (don’t give false hope, don’t destroy hope)
What were helpful communication strategies during the diagnostic period for patients with cancer?
- professional demeanor (non-judgemental, compassionate, attentive)
- receptive (to emotions, to questions)
- sensitive to terminology used
- attention to time and space (not rushed, given time, space to regain composure before leaving dr. office)
- emotional way-finding (offer emotional guidance)
What is anticipatory chemotherapy-induced vomiting? When does it occur? What medication might you use to treat?
- occurs in 24 hours before chemo
- occurs in patients with experience of chemo (not in first time patient)
- can use benzodiazepines to treat
When does acute chemotherapy-induced vomiting occur? What pathways are triggered? How might you treat?
- occurs in the 24 hours after chemo
- vomiting centre stimulated via GI tract and chemotherapy trigger zone
- 5HT3 receptor antagonist (serotonin receptor blockers) work well
- best to use drug combo to treat
When does delayed chemotherapy-induced vomiting occur? What neurotransmitter might be involved? What treatment works well?
- occurs more than 24 hours after chemo, up to 7 days later
- substance P might be the neurotransmitter involved
- neurokinin 1 receptor antagonists work well but are costly
What is primary disease prevention? What would this involve in cancer prevention?
- reducing risk
- avoiding carcinogens, healthy lifestyle (diet, exercise, quit smoking)
What is secondary disease prevention? What would this involve in cancer prevention?
- screening and early detection
- ex. self exams, DRE, PAP tests, mammography
What system is used to stage a tumour? When might another system need to be used?
- TNM system (size 0-4, node involvement 0-3, metastasis 0-1)
- TNM system only works on solid tumours, doesn’t work for blood cancers
How is cancer graded?
- histologic classification of cancer
- graded 1-4
- grade of 1 = well differentiated cells
- grade of 4 = poorly differentiated cells
What are different goals of cancer treatment?
- cure
- control
- palliate (relieve symptoms)
What are goals of surgery in the management of cancer?
- diagnostic (ex. biopsy)
- curative (excise tumour and some surrounding tissue - lots of surrounding tissue, structures and nodes if severe/aggressive)
- prophylactic (ex. Angelina Jolie’s mastectomy because she had BRCA1 or 2 gene)
- palliative (decrease symptoms)
- reconstructive (to aid with body image)
What is radiation and how does it work to treat cancer?
- a localized treatment
- works by damaging/altering DNA in cells, especially effective during DNA synthesis and mitosis, so affects tissue undergoing frequent cell division
- tumours that are well oxygenated are more sensitive
What is brachytherapy? Is there a health risk to others for patients receiving this treatment?
- type of internal radiation where radiation seed can be implanted to treat localized area, can use radioisotopes (ex. prostate)
- patient may be radioactive to certain degree - take appropriate cautions
What is chemotherapy? How does it work to treat cancer and how is it different from radiation?
- medication, can be administered in different ways
- usually used to treat systemic disease vs. localized
- goal is to shrink tumour to size where patient’s own immune system can destroy it
- most work through interference with cell division and thus effect cells that are replicating more quickly (cancer and normal cells)
What is biologic response modifier therapy? Give a few examples.
- therapy to enhance the patient’s immune response against tumour cells, has the benefit of not damaging healthy cells
- examples: mononuclear antibodies, cytokines (colony-stimulating factors, interferons, interleukins), cancer vaccines (guardasil for HPV)
What are side effects of radiation?
- skin reactions at site
- stomatitis (inflammation of oral tissues)
- xerostomia (dry mouth)
- GI irritation (nausea, vomiting, diarrhea, anorexia)
- myelosuppression
- fatigue, malaise
What are side effects of chemotherapy?
- GI irritation (nausea, vomiting, diarrhea)
- myelosuppression
- changes in reproductive function (sterility)
- fatigue
- alopecia (thinning and loss of hair)
- damage to kidneys
- some drugs can cause heart, CNS or lung damage that is permanent
What are complications of cancer treatment? (radiation and chemo)
- risk infection (from low WBCs)
- risk bleeding (from low platelets)
- risk of fluid and lyte imbalances, decreased nutrition from nausea, vomiting etc.
- for chemo: if given IV it is a vesicant, watch for extravasation
What are nursing priorities during cancer treatment?
- maintain skin integrity
- promote nutrition
- relieve pain
- decrease fatigue
- improve body image
- assist in grieving
- monitor for complications
