Chapter 11: Nutritional Effects Of Cancer Treatment Flashcards
What is medical oncology?
The diagnosis and treatment of cancer using antineoplastic therapies (chemotherapy, hormone therapy and biotherapy)
What is radiation oncology?
The diagnosis and treatment of cancer utilizing a spectrum of ionizing teletherapy (external beam radiarion machines), brachytherapy (sealed sources of radiation), radiopharmaceutical therapy (unsealed sources of radiation)
What is chemotherapy?
The use of chemical agents or drugs to systematically kill cancer cells. Usually done in cycles.
Which body cells have rapid turnover and are susceptible to chemotherapy?
Bone marrow, hair follicles, gonads (testes and ovaries) GI mucosa.
What are cell cycle non-specific chemotherapeutic agents?
They damage cells in all phases of the cell cycle (alkylating agents), antitumor antibiotics, hormone therapies, nitrosoureas
What are cell cycle specific chemotherapeutic agents?
They exert their effect within a specific phase of the cell cycle. Include: antimetabolites, camptothecins (synthesis phase), plant alkaloydes and taxanes (mitosis phase)
T/F: It can take weeks, months and even years for treatment related side effects to resolve.
True
What is Biotherapy?
The treatment to boost or restore the ability of the immune system to fight cancer, infection and other diseases by inducing, enhancing, or suppressing an individual’s own immune response. (AKA Immunotherapy or Biological Response Modifier)
What are some types of biotherapy?
Monoclonal Antibodies, protein-targeted therapies, angiogenesis inhibitors, cytokines, and cancer vaccine.
What is Hormone Therapy?
Use in the treatment of hormone-sensitive cancers (breast, ovarian, prostate)
What are the types of Radiation Therapy?
External beam radiation, Brachytherapy or internal radiation or radiopharmaceutical therapy
Diarrhea is an acute side effect of radiation to ___, ___, and ___.
pelvis, rectum, and stomach/abdomen
Fatigue is an acute side effect of radiation to which sites>
All sites (brain, breast, chest, head/neck, pelvis, rectum, stomach/abdomen).
Hair loss is an acute side effect of radiation to which sites?
All sites (brain, breast, chest, head/neck, pelvis, rectum, stomach/abdomen).
Nausea/Vomiting are acute side effects of radiation to which sites?
Brain, chest, stomach/abdomen
Throat changes are an acute side effect of radiation to which sites?
chest, head/neck
T/F: Myelosuppression, nausea, vomiting, diarrhea, fatigue are common side effects of chemotherapeutic agents.
True
Acute side effects of radiation to the brain?
Fatigue hair loss N/V skin changes headache blurry vision
Late side effects of radiation to the brain?
Headache cognitive impairment Memory loss Leukoencephalopathy Dementia
Acute side effects of radiation to the breast?
Fatigue
Hair loss
Skin changes
Breast swelling and tenderness
Acute side effects of radiation to the chest?
Fatigue Hair loss N/V Skin changes Cough Dyspnea (difficulty breathing)
Acute side effects of radiation to the head and neck?
Fatigue
Hair loss
Skin changes
Throat changes (dysphasia, odynophagia, esophagitis)
Acute side effects of radiation to the pelvis?
Diarrhea Fatigue Hair loss Fertility / sexual changes Skin changes Urinary/Bladder changes
Acute side effects of radiation to the rectum?
Diarrhea Fatigue Hair loss Fertility / sexual changes Skin changes Urinary / Bladder changes (urinary frequency, cystitis, incontinence)
Late side effects of radiation to the bone?
Damage to osteoblasts
Osteopenia
Late side effects of radiation to the chest (cardiovascular area)?
Angina upon exertion
Pericarditis
Cardiac enlargement
CHF
Late side effects of radiation to the esophagus?
Esophageal stenosis, fibrosis or necrosis
Late side effects of radiation to the GI tract?
Diarrhea
Malabsorption
Chronic enteritis/colitis
Intestinal changes ( obstruction, stricture, ulceration, fistula, etc)
Late side effects of radiation to the head and neck?
Trismus
Permanent xerostomia
Alterations in taste and smell
Osteoradionecrosis (bone death)
Late side effects of radiation to the lymphatics?
Secondary lymphedema in irradiated area
Late side effects of radiation to the lungs?
Dyspnea
Cough
Pneumonitis
Late side effects of radiation to the sexual organs?
Infertility
Late side effects of radiation to the skin?
Telangiectasis (dialation of the capillaries causing red or purple color)
Pigmentation changes
Atrophy
Fibrosis
Late side effects of radiation to the bladder area?
Hematuria
Cystitis
Possible side effects of monoclonal antibodies?
Infusion symptoms GI (n/v/d) usu mild Cardiotoxicity Myelosuppression Pulmonary toxicity Skin problems/rash
Examples of protein targeted therapies?
Tyrosine kinase inhibitors
mTOR Inhibitors
Proteasome Inhibitors
Examples of tyrosine kinase inhibitors?
Erlotinib (Tarceva) Gefitinib (Iressa) Imatinib (Gleevec) Sorafenib (Nexavar) Sunitib (Sutent)
Examples of mTOR inhibitors?
Temsirolimus (Torisel)
Everolimus (Affinitor)
Example of a proteasome inhibitor?
Bortezomib (Velcade)
Possible side effects of protein targeted therapies?
Skin problems / rash
Cardiotoxicity
GI (n/v/d, decr appetite)
Examples of angiogenesis inhibitors?
VEGF - Bevacizumab (Avastin)
Immunomodulary Drugs - Lenalidomide (Revlimid) and
Thalidomide
Possible side effects of angiogenesis inhibitors?
HTN Cardiac (MI, stroke) Proteinuria Hemorrhage GI perforation Hypothyroidism
Examples of cytokines?
Interleukein-2 (IL-2) (Aldesleukin)
Interferon-a (Roferin or Intron A)
Possible side effects of cytokines?
Flu-like Symptoms Fatigue Anorexia Myelosuppression GI (n/v/d) Renal and cardiotoxicity
Types of hormonal agents?
SERMS, Aromatase inhibitirs, Progesterones, Antiandrogens, LHRH Agonists
Examples of SERMS
Selective Estrogen Receptor Modulators
Tamoxifen (Novaldex)
Toremifene (Fareston)
Raloxifene (Evista)
Side effects of SERMS?
Menstrual symptoms (hot flashes, sweating, n/v)
Fluid retention / peripheral edema
Increased risk for endometrial changes and cancer
Thrombembolic complications
Skin changes / rash
Joint pain
Weight gain
Examples of aromatase inhibitors?
Anastozole (Arimidex)
Letrozole (Femara)
Exemestane (Aromasin)
Side effects of aromatase inhibitors?
Joint pain Hot flashes N/V -mild Thromboembolic events High cholesterol Fever / malaise