4.3 Treatment for Cancer Flashcards
What are the treatments for cancer? (4)
- Surgery
- Radiation
- Surgery + Radiation
- Chemotherapy
How many treatments of radiation does a patient typically receive?
4-6 weeks of daily treatments
A radiation oncologist prescribes a certain number of ________ to be directed at the tumor site
“rads”
In regards to radiation, what are the types of yeast infection? (2)
Thrush
Vaginal infections
Why is chemotherapy used?
Used to decrease the size of tumors or to prevent mets after resection
What are the big disadvantage of chemotherapy?
Makes people feel sick
In regards to surgery, what is the microflap?
elevating flap of epithelium
How is a cordectomy done?
Incision through neck
What symptoms might justify a cordectomy?
- Breathy, weak, hoarse voice
What are the two types of partial laryngectomy?
- Hemilaryngectomy
- Vertical partial laryngectomy
What is removed during a partial laryngectomy?
Removal of at least half of thyroid, arytenoids, vocal folds, and the membranous tissues on involved side
What would voice sound like after a partial laryngectomy?
Hoarse/breathy vocal quality
What might you see with a partial laryngectomy?
May see dysphagia (usually resolves)
Why would someone get a supraglottic laryngectomy?
Management of tumors confined to the epiglottis and false vocal folds only
What is removed during a supraglottic laryngectomy?
True vocal folds not affected, so vocal quality is also likely not affected
What happens during a near total laryngectomy? (3)
Removal of the entire larynx
Only a narrow strip of tissues left on the contralateral side to connect the trachea to the pharynx
A speaking shunt is created for voice production
What is created as a result of a patient getting a near total laryngectomy?
- Tracheostoma
Someone must _________ tracheostoma for voice production
occlude
What is a near total laryngectomy associated with?
associated with dysphagia
What happens during a total laryngectomy?
removal of the entire larynx, hyoid bone to upper tracheal rings
What is created for breathing after a total laryngectomy?
Tracheostoma for breathing
How is speech created after a total laryngectomy? (3)
Speech through tracheal esophageal puncture (TEP), artificial larynx, or esophageal speech (ES)
What are the physiological differences of the nose after laryngectomy? (3)
- Alternate breathing channel, no longer filters and warms air
- Can’t smell, sniff, or blow the nose
- Taste is often affected
What are the physiological differences of the mouth after laryngectomy? (2)
- Eating and drinking are reestablished orally after the removal of the N-G tube
- Eating and swallowing problems reported in over 50% (important to know)
In regards to the physiological differences of the tongue after larynectomy, ________ from the base of the tongue are severed during surgery, with the removal of the _______ ________, and subsequently sutured to the ________.
Fibers
Hyoid bone
Pharynx
In regards to the physiological differences of the tongue after laryntectomy, some tongue fibers are ________, resulting in a __________ of the base of the tongue.
Excised
Shortening
Surgical damage to the __________ ________ affects the tongue.
Hypoglossal Nerve (XII)
What are the physiological differences of the esophagus after laryngectomy?
In surgery, some fibers within the PE segment are cut and some may be removed. Nerve damage may occur.
What are the respiratory difficulties after laryngectomy? (7)
- Cough is lost
- Lifting is impaired
- Filtering, humidfying and warming of air is lost
- Mucous plugs
- Crusting
- Stoma sensitivity
- Decreased oxygenation
What are the treatment options for improving hydration? (6)
- Increased fluid intake
- Stoma covers
- Air filters
- Humidification regimen
- Saline washes of stoma
- Suctioning
What does increased fluid intake?
Decreases thickness of secretions
What are the advantages of stoma covers? (2)
Disposable
Washable
Where do you place air filters? (2)
- in rooms
- in HVAC system
What is the humidification regimen? (2)
Steam
Decrease caffeine, alcohol, and diuretics
What does suctioning do to help with improving hydration?
Taking out extra food and liquid in that place
How should we handle the social factors that have been affected by the laryngectomy? (5)
- Help pt. conceal the tracheostoma
- Amplification possible
- Telephone particularly difficult
- Don’t let spouse get into habit of speaking for patient
- Hobbies limited or eliminated -water sports, singing, playing wind or brass instruments - encourage patient in related areas
What are the emotional fears after a laryngectomy? (4)
- Depression, loss of self-esteem, feeling of inferiority and lack of motivation common
- Fear of return of cancer and/or death
- Patients most at risk for emotional problems
- Laryngectomy clubs and support groups
What complications can happen after a laryngectomy?
fistulae develops
