Chemotherapy and Side Effects Flashcards
What does Chemotherapy target?
Targets rapidly dividing cells
What is Chemotherapy?
Drugs for treating cancer
- many different kinds and combinations
Is Chemotherapy different for everyone, if so what differs?
Yes, everyone has a different experience.
- Different combos of drugs
- Individual differences in reactions
What is Chemotherapy used for?
- Primary treatment
- Adjuvant therapy
- Neoadjuvant therapy
What is Primary treatment?
Typically for treatment when surgery is not possible
ex: if tumour is in a dangerous area where surgery would be life threatening
What is Adjuvant therapy?
After surgery to get any metastasized cells or parts of the tumour that were not excised
ex: if surgery doesn’t cure or get rid of the whole tumour.
What is Neoadjuvant therapy?
Given before surgery
Ex: shrink tumour so easier to surgically remove
What is Oral Chemotherapy?
A form of Chemotherapy inserted orally.
(Pill, capsule, liquid)
What are some advantages of Oral Chemotherapy?
- Can be taken at home
- Good for those squeamish about injections
(Easier for patients to take and for those who can’t get to the hospital)
What are some disadvantages of Oral Chemotherapy?
- Variable absorption (passes through stomach and may tackle unnecessary issues on the way)
- Variation in bioavailability (takes longer to absorb)
- Patient compliance (may not want to take it)
What is Intravenous Chemotherapy?
A single venipuncture where chemotherapy is directly delivered into the vein. Can be injected or attached to a drip bag
What is needed after Intravenous Chemotherapy?
RECOVERY!! Veins will harden if poked too often. Can’t be done as often
What is a Central Line? When is it used?
A form of intravenous chemotherapy and remains inserted through duration of chemo in the central vessel in chest. Used when chemo is required more frequently
What is a PICC? Where is this inserted and for what duration?
Peripherally inserted central catheter line. Stays in until the chemo is done and enters the body from the arm.
Disadvantages of a PICC?
- Can’t get wet
- Uncomfortable
- Difficult to exercise
- Cannot lift heavy weight
How long is a cycle (schedule of treatment)?
- Can be one day on, many days rest
- Can be everyday followed by a long rest
- Can be every other day
What are 3 goals of Chemotherapy?
- Cure - cancer goes away
- Control - Stop disease from spreading
- Managed like a chronic disease - Palliation - Improve quality of life rather than extend life (shrink a tumour that may effect the way they live, ex - colon cancer that prevents them from pooping)
What causes side effects?
Damage to normal tissues and cells due to:
- Chemo drugs target fast dividing cells (hair, bone marrow, etc)
- Chemo drugs travel around the body
What tissues are most commonly damaged?
- Bone marrow
- Mouth
- Digestive tract
- Reproductive system
- Hair follicles
What tissues can sometimes become damaged?
- Heart
- Kidneys
- Bladder
- Liver
- Lungs
- Nervous System
What are some common side effects?
- Nausea/vomiting
- Hair loss
- Fatigue
- Blood counts
- Appetite and weight changes
Who experiences nausea/vomiting?
7 to 8/10 people on chemo
What is nausea/vomiting?
A reaction to perceived poisoning
What can help nausea/vomiting?
Antiemetics (anti-nausea) drugs
What can nausea/vomiting lead to?
- Fatigue
- Difficulty concentrating
- Dehydration
- Slow wound healing
- Loss of appetite
What is Acute nausea/vomiting?
Occurs soon after chemo administration, goes away within 24 hours
What is Delayed nausea/vomiting?
Onset is at least 24 hours after chemo
What is Anticipatory nausea/vomiting?
Occurs as a person is preparing for chemo
How does chemo induced nausea affect physical activity?
Interferes with PA during chemo. No one wants to be active when they feel sick
Does PA help with nausea?
No known evidence
What is fatigue like during Chemotherapy?
- Most common side effect (90%)
- Worst during chemotherapy but can continue years after survivorship
- Different than fatigue in healthy people
What is chemo induced fatigue caused by?
- Low blood cell counts
- Sleep disruption
- Stress
- Eating too little
What is difficult to do when fatigued?
Everyday tasks
What does the American Cancer society website say to do when dealing with fatigue?
“limit your activities: do only the things that are most important to you”
How does fatigue relate to physical activity?
It is difficult to exercise but can be helpful to feel less fatigued
What is Anemia? What side effects does it cause?
Low red blood cell count
Side effects - Fatigue, dizziness, paleness, cold
What is Leukopenia? What side effects does it cause?
Low white blood cell count
Side effects - Infections can occur in mouth, lungs, skin, urinary tract, rectum, reproductive organs
What is Thrombocytopenia? What side effects does it cause?
Low platelet counts
Side effects - Bruising, more bleeding than usual, headaches
Physical activity in relation to low blood cell counts
Less red blood cells - not want to exercise
Less white and platelet counts - not recommended to exercise
What can happen to weight changes and appetite during chemo?
- Many lose appetite and weight (anorexia)
- Others (many breast cancers) gain weight
What can cause weight gain in chemo patients?
- Steroids (in chemo)
- Electrolyte imbalances
- Fluid retention
- Inactivity
How is PA related to weight changes and appetite?
- May motivate someone to lose weight
- Can promote weight loss and increase appetite
What causes heart damage?
Usually from anthracyclines (doxorubicin) that damage muscles of the heart
What Research has been done to study physical activity and cardiotoxicity?
Animal models (rats) trained on a treadmill prior to receiving doxirubicin and had less cardiotoxicity
Therefore PA can protect against acute cardiotoxicity
What is Chemobrain? What changes in the brain?
- Mental cloudiness (during and after chemo)
- Changes in brain: shrinking in areas responsible for memory, planning, putting thoughts together
How long are chemobrain changes detectable post treatment?
10 years
What study was done to observe physical activity and chemobrain?
Wheel running rats after chemotherapy injections help attenuate declines in spatial reference memory (maze) and novel object recognition
Other side effects caused by Chemotherapy?
- Diarrhea
- Constipation
- Leukemia
- Menstrual changes
- Reproductive system damage
- Nervous system
What do all side effects compromise?
Quality of Life
