Chemotherapy Flashcards
What is chemotherapy, and how is it commonly administered?
Chemotherapy is the use of drugs and chemical agents to fight cancer. It is often administered systemically, meaning it circulates through the bloodstream to affect the whole body.
What is the primary goal of chemotherapy in cancer treatment?
The main goal of chemotherapy is to disable cancer cells, especially by damaging them genetically so they cannot reproduce. This approach minimizes its negative impact on normal body tissues.
How does chemotherapy target cancer cells compared to normal cells?
Chemotherapy agents impair cell replication or attack cells that are actively reproducing. Cancer cells are targeted more often because they replicate constantly, whereas normal cells can usually recover.
When is chemotherapy typically used in cancer treatment?
Chemotherapy is primarily used to treat metastatic cancer. If a cancer can be addressed locally, surgery and/or radiation are preferred. Chemotherapy is employed when metastasis is identified or statistically likely.
Why is systemic chemotherapy statistically less successful?
Systemic chemotherapy often tackles cases with a poorer prognosis and is highly toxic, making it difficult for the body’s organs and systems to handle. It can also disable the immune response temporarily, posing additional risks.
What is the death rate associated with chemotherapy protocols, and what factors influence it?
The death rate in chemotherapy protocols ranges from 1-27%, depending on factors like cancer type, stage, the agents used, and the patient’s overall health. It can be higher in certain circumstances.
How does systemic chemotherapy impact the immune system, and why is this a concern?
Systemic chemotherapy can temporarily disable the immune system, making it a riskier treatment choice. This impact varies by cancer type, and targeted therapies are preferred to minimize broad-spectrum chemo use.
What are some newer categories of chemotherapeutic agents, and how do they work?
Newer chemotherapy agents include:
• Targeted molecules that exploit specific cancer cell vulnerabilities, sparing normal cells.
• Hormones that affect the growth success of certain cancers.
• Biologics that enhance the body’s natural anti-tumor defenses.
What does “antisense” mean in the context of DNA and RNA?
“Antisense” refers to a sequence of DNA or RNA that is complementary to a specific messenger RNA (mRNA). It pairs with this mRNA, blocking it from being translated into protein, thereby inhibiting gene function.
What is the primary function of cell cycle inhibitors in cancer treatment?
Cell cycle inhibitors work by slowing or stopping the progression of the cell cycle. They can induce cell cycle arrest at various stages, reducing the rate of cell division and decreasing the number of actively cycling cells.
How do angiogenesis inhibitors help fight cancer?
Angiogenesis inhibitors combat cancer by blocking the growth of blood vessels that support tumors, rather than directly targeting the tumor cells.
What is “adjuvant” chemotherapy, and what is its purpose?
Adjuvant chemotherapy is used as a supplemental treatment after surgery and/or radiation therapy. Its purpose is to attack micrometastases in a “clean up” role to reduce the risk of cancer recurrence.
What is “neoadjuvant” chemotherapy, and when is it administered?
Neoadjuvant chemotherapy is given before surgery with the goal of shrinking the tumor, making it easier to remove.
What is the purpose of “maintenance” chemotherapy, and how is it typically administered?
Maintenance chemotherapy is usually a lower-dose regimen used to prolong remission, keep an inoperable cancer from thriving, or restrain cancer activity. It aims to give the person more time by keeping the cancer under control.
What is the role of “palliative” chemotherapy in cancer treatment?
Palliative chemotherapy is used to reduce suffering and improve quality of life for the patient, especially when curative treatment is not an option.
What are the limitations of chemotherapy when used in maintenance and palliative roles?
The use of chemotherapy in maintenance and palliative roles is limited by factors such as patient tolerance and the balance of risks versus rewards.
Is oral medication a common method for delivering chemotherapy?
No, oral medication is not a common method for delivering conventional chemotherapy. However, some agents, especially newer targeted therapies and maintenance chemotherapy, are available in capsule, tablet, or liquid form.
How are oral chemotherapy agents absorbed, and what considerations are there for safety?
Oral chemotherapy agents may be swallowed and absorbed through the GI tract, or dissolved in the mouth to cross the oral mucosa. Despite being taken orally, these agents are not always safer or have fewer side effects and often require careful handling.
Why might doctors be reluctant to prescribe oral chemotherapy agents?
Doctors may be hesitant to prescribe oral chemotherapy if they are concerned that the patient may not adhere strictly to the dosage and timing required for effective treatment.
What is the most common method of chemotherapy delivery, and what are its variations?
Intravenous (IV) delivery is the most common method for administering chemotherapy. For shorter-term or less toxic treatments, standard IV methods are used. For prolonged protocols or when agents can damage blood vessels, more complex IV delivery methods are employed.
What is the purpose of tubing “lines” in intravenous chemotherapy?
Tubing “lines” allow for easier administration of intravenous chemotherapy by placing a catheter into a major vein, typically leading towards the heart. This setup enables prolonged use without needing repeated insertions.
Which veins are commonly used for chemo line placements?
Common veins for chemo line placements include the right subclavian vein, basilic vein, and brachial vein. In some cases, the femoral vein may be used.
Describe the Central Line, also known as the Hickman Line.
The Central Line, or Hickman Line, is inserted into the anterior chest and tunneled under the skin to the right subclavian vein. From there, the catheter runs through the superior vena cava to the right atrium. Needleless connectors (access ports) are attached for easy injection or infusion of chemotherapy.
What is a PICC Line, and where is it inserted?
A PICC Line (peripherally inserted central catheter) is placed in the basilic or brachial vein. It is threaded through the right subclavian vein to the superior vena cava and into the right atrium, allowing central access for chemotherapy.
How does the femoral option for a Central Line work?
In the femoral option, the line is inserted into the femoral vein and threaded up through the inferior vena cava to reach the right atrium. This approach is less common but used when other veins are unsuitable.
What are the primary hygienic precautions Registered Massage Therapists (RMTs) should take with patients who have chemo lines?
RMTs should follow standard hygienic precautions for skin openings, which include keeping dressings dry and clean, and ensuring no tugging forces are applied to the lines.
Why should RMTs be cautious about lines directly under the skin?
RMTs should be cautious of lines under the skin to avoid pressure or accidental pulling, which could dislodge or damage the lines, posing risks to the patient.
What is a chemo port, and why is it commonly used in long-term chemotherapy protocols?
A chemo port is an intravenous device with a surgically placed reservoir under the skin, reducing infection risk once healed. It connects via a line threaded into a vein leading to the right atrium and can stay in place for months.
After a chemo port incision heals, what should RMTs keep in mind during treatment?
Once the skin around the port is healed, RMTs should avoid pressing on the line under the skin but do not need additional hygienic precautions near the port.
How is medication administered through a chemo port?
A needle penetrates the port’s top, resealing material, and a butterfly clip injection set locks in place. The chemo agent then drips into the reservoir and flows through the line into the bloodstream.
What should RMTs consider if massaging a patient during a chemo session with a chemo port?
RMTs should take hygienic precautions due to a short-term skin opening at the port site and avoid creating tugging forces on any external tubing.
Describe the intrathecal method of chemotherapy delivery.
Intrathecal chemotherapy involves injecting or dripping the chemo agent into the cerebrospinal fluid (CSF) around the brain or spinal cord, often using an Ommaya reservoir placed under the scalp for brain treatments.
