Cancer treatments (oncology)

Question 1

3 treatments of cancer?

Answer 1

surgery
radiation
chemo

Question 2

which is the most frequent treatment method for cancer?

Answer 2

surgery

Question 3

what is surgery used in conjuction with?

Answer 3

chemo or radiation
to prevent diagnose stage and treat

Question 4

what is important to know for surgery and chemo?

Answer 4

we will wait for either chemo or surgery (2 months) because of delayed healing

Question 5

Types of surgery:

Answer 5

diagnostic: biopsy
primary
prophylactic: preventative surgery
palliative: helps w quality and end of life
reconstructive: augmentation

Question 6

Diagnostic surgery includes what?

Answer 6

tissue biopsy:
shave
punch
incisional
excisional
fine needle
core needle

Question 7

surgery as primary treatment:

Answer 7

debulking: removes as much as tumor as possible
radical excisions: disfiguring and alter function
salvage surgery: extensive surgery to site at which previous therapies have failed

Question 8

Prophylactic surgery:

Answer 8

removal of non vital tissue or organs that may develop cancer

Question 9

what are considerations for prophylactic surgery? 6

Answer 9

fam history
genetic predisposition
presence or absence of symptoms
risk vs benefits
ability to detect cancer early
pt acceptance of post op outcomes

Question 10

Palliative surgery: 4

Answer 10

pain relief
not intended to treat or cure
high quality of life
alleviate disease without curing it

Question 11

reconstructive surgery:

Answer 11

plastic surgery
repair injury or loss of function from curative or radical surgeries
may take several procedures

Question 12

Radiation and chemo therapy GOALS:

Answer 12

to eliminate cancerous cells
affects rapidly proliferating cells
can cause wide range of symptoms
death can result from symptoms
benefits outweigh the risks….. in some cases

Question 13

Radiation therapy

Answer 13

choice of treatment for localized cancer which is cancer that is contained in one organ
- energy to kill tumors, shrink tumors, to eliminate cancer cells
-damages cells dna
- healthy cells can also be damages

Question 14

what are the factors effecting radiation therapy dosing?

Answer 14

1. radio sensitivity of the tumor: dependent on presence of oxygen
2. normal tissue tolerance: point at which normal tissues are irreparably damage
3. volume of tissue to be irradiated: total proscribed dose usually divided into several smaller doses
   treatments are given daily 5x per week for an average of 25 to 30 treatments.q

Question 15

Benefits of radiation therapy:

Answer 15

• used before surgery to shrink tumors
• intra-operative radiation: during surgery
• given before during or after chemo
• palliative: shrink, reduce pressure pain and other symptoms

Question 16

Radiation toxicity:

Answer 16

localized to area of treatment
may be higher when used with chemo
generalized effects include ; fatigue anemia nausea vomiting and thrombocytopenia (decreased platelets)

Question 17

Types of radiation therapy

Answer 17

external (teletherapy)
internal (brachytherapy)

Question 18

side effects of internal or brachytherapy:

Answer 18

stay away from children and pregnant women
body will give off radiation, body secretion can be contamintated
isolation
fatigue anorexia immunosupression other side effects are the same as external radiation

Question 19

patient education for brachytherapy:

Answer 19

1. avoid close contact w others
2. no pregnant women or children
3. bedrest to avoid dislodging radioactive source
4. maintain balanced diet
5. small frequent meals
6. maintain fluid intake

Question 20

Side effects of radiation:

Answer 20

1. fatigue
2. skin changes
   3, alopecia
3. immunosuppresion
4. radiation pneumonia
5. ulceration of oral mucus mem
6. GI
7. N/V
8. diarrhea
   * symptoms increase as symptoms progress

Question 21

pt education for radiation therapy:

Answer 21

1. wash with tepid water and soft wash cloth
2. use electric razor
3. do not remove markings
4. no hot or cold packs
5. do not use any products
6. avoid wearing tight clothing

Question 22

Chemotherapy:

Answer 22

use of anticancer drugs to elimate cancer cells
affects entire body both cancerous and non cancerous cells
numerous side effects
death may occur due to side effects

Question 23

administration of chemo:

Answer 23

excreted in body fluids up to 48 hours after treatment
usually requires port a cath
monitor WBC RBC H&H Platelets before administering medications
only chemo-certified nurse

Question 24

patient education for chemo:

Answer 24

1. HAND WASHING
2. 48-72 following chemo CLEAN SURFACES SO WELL SO NO BODY FLUIDS ARE ON SURFACES
3. no sex ya nasty or 2 forms of birthcontrol

Question 25

Handling chemo drugs:

Answer 25

no safe exposure limit risk of exposure: - handling body fluids of a pt 48hrs after chemo - wear ppe - accidental spills routes of exposure: inhale absorption ingestion

Question 26

Targeted therapy and its side effects?

Answer 26

Flu-like symptoms-headache, fever, chills, fatigue, extreme weakness, anorexia, and nausea Tachycardia Orthostatic hypotension Neurologic deficits- confusion, memory loss, insomnia Bone marrow depression * targets specific receptors, new treatments

Question 27

chemo side effects:

Answer 27

N/V/D alopecia stomatasis- sores in mouth pain Anemia enteritis

Question 28

anorexia cachexia syndrome :

Answer 28

loss of skeletal muscle and fat not starvation SKIN AND BONE

Question 29

how can chemo affect immunsupression?

Answer 29

decrease ability to fight infection lowers WBC NUETRPHILS = increased risk of infection LOWER RBC and H&H= risk increases for anemia LOWEER PLATELETS= risks for bleeding

Question 30

NADIR:

Answer 30

blood cell count at its lowest point occurs at different times wbc and platelets if labs are too low they are going to wait for furthering treatments

Question 31

what is nuetropenia?

Answer 31

Abnormally low ANC (Absolute Neutrophil Count) No symptoms until onset of infection Monitor CBC with differential Treatment varies depending upon cause Caused by: Decreased production of WBC Increased destruction of WBC

Question 32

s/s of nuetropenia ?

Answer 32

Neutropenia: resp rate is going to go up before spiking a temp!!!!! usually means they are going septic chills, sweating hypotension fatigue

Question 33

nuetropenic precautions?

Answer 33

Wash hands frequently Low bacteria diet No fresh flowers, plants, pets Avoid crowds No visitors with infections No immunizations

Question 34

thrombocytopenia is what?

Answer 34

low platelets count

Question 35

thrombocytopenia precautions?

Answer 35

Monitor stools/urine for bleeding Use electric razor only, Apply ice to affected area if trauma occurs Avoid dental work or other invasive procedures Avoid aspirin and aspirin-containing products Soft toothbrush and no flossing No aspirin

Question 36

what is chemo brain?

Answer 36

A “mental fog” caused by chemotherapy, radiation, and some types of immunotherapy

Question 37

what is ascites?

Answer 37

fluid in belly (peritoneal cavity) late sign of cancer hypovolemic bc fluid isnt where it needs to be

Question 38

what is the management for ascites?

Answer 38

low salt diet diuretic therapy paracentesis - palliative may place pluerx to enable pt to drain at home poor prognosis and comfort is key