Medications and Treatments

Question 1

What are the side effects of chemotherapy?

Answer 1

1) Nausea and Vomiting
2) Fatigue
3) Hair loss
4) Bone marrow suppression (low white blood cells, anaemia (low red blood cells) and bleeding and bruising (low platelet counts)
5) Mouth sores (eating is difficult)
6) Increased or decreased appetite
7) Neuropathy (numbness, tingling, weakness, pain (hands and feed peripheral neuropathy)
8) Constipation and diarrhea
9) Skin changes - dryness, itching, rash, increased sensitivity to sunlight
10) Cognitive impairment

Question 2

How can exercise improve feelings of nausea and vomiting?

Answer 2

• Improved circulation (gut motility regulated)
• Endorphin release
• Distraction from feelings

Question 3

How does exercise regulate fatigue?

Answer 3

• Stimulate release of endorphins, serotonin, and dopamine which improve well-being and fatigue
• Better sleep (circadian rhythm, reduce insomnia)

Question 4

What are the side effects of radiotherapy

Answer 4

All depend on area treated

1) Skin changes
2) Fatigue
3) Nausea and vomiting
4) Difficulty swallowing
5) Mouth and throat problems
6) Shortness of breath
7) Change in taste
8) Breathing difficulties
9) Swelling (edema)
10) Change in bowel habits
11) Urinary problems
12) Sexual side effects

Question 5

Where can exercise benefit radiotherapy patients?

Answer 5

1) Fatigue - neurotransmitters
2) Skin changes - improved circulation to promote healing (oxygen, nutrient, and immune cell delivery)
3) Deep breathing to promote lung health and aerobic exercise for lung function
4) Specific exercises for head, neck and areas where there are issues swallowing

Question 6

How does exercise improve lung capacity?

Answer 6

1) Respiratory muscle used in aerobic exercise strengthened
2) Lungs become more efficient at extracting oxygen from inhaled air and expelling CO2
3) Release of bronchodilator substances that reduce obstruction
4) Improved lung compliance (ability or chest wall and lung parenchyma to expand and contract)

Question 7

How does exercise improve respiratory efficiency?

Answer 7

1) Increased surface area in the alveoli and capillarisation for gas exchange
2) Increase ability to take in oxygen and respiratory muscles such as the diaphragm and intercostal muscles become stronger
3) Increased elasticity of lung tissue allowing for greater compliance

Question 8

What are the side effects of immunotherapy treatment?

Answer 8

1) Fatigue
2) Skin reactions - rash, itching, redness, blistering
3) Flu-like symptoms (fever, chills, muscle aches)
4) Gastro-intestinal issues (diarrhea, vomiting etc)

Question 9

How does immunotherapy cause it’s side effects?

Answer 9

1) Activation of the immune system - enhanced activity of immune cells can attack normal tissue and organs leading to inflammation and tissue damage.
2) Immune checkpoint inhibitors can disrupt immune tolerance mechanisms
3) Inflammation of gastro-intenstinal tract can cause nausea and vomiting
4) Inflammation of myocardium causing myocarditis

Question 10

What are the most common surgeries for lung cancer?

Answer 10

1) Lobectomy: This procedure involves the removal of an entire lobe of the lung affected by cancer.
2) Pneumonectomy, the entire lung affected by cancer is surgically removed. This procedure is typically reserved for larger tumors or cancers located centrally within the lung, where it may not be feasible to remove only a lobe while preserving adequate lung function.
3) Segmentectomy (Wedge Resection): Segmentectomy involves the removal of a smaller portion of the lung affected by cancer, typically a wedge-shaped segment containing the tumor. Considered when the tumor is small and located in a peripheral area of the lung, and preserving lung function is a priority.
4) Sleeve Resection: In a sleeve resection, the surgeon removes a portion of the bronchus (airway) affected by cancer and then reconnects the remaining healthy segments of the bronchus.

Question 11

What are the most common surgical procedures in hepato-pancreato-billary cancer?

Answer 11

1) Hepatectomy (Liver Resection): Hepatectomy is the surgical removal of part of the liver affected by cancer. This procedure is used to treat primary liver cancer (hepatocellular carcinoma) as well as liver metastases from other primary cancers, such as colorectal cancer.

2) Whipple Procedure: The Whipple procedure is a complex surgical operation used to treat cancers located in the head of the pancreas, as well as tumors involving the bile duct, and duodenum. During the Whipple procedure, the surgeon removes the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, a portion of the bile duct, and sometimes a portion of the stomach. The remaining structures are then reconstructed to restore continuity of the digestive tract.

3) Total Pancreatectomy: Total pancreatectomy is the complete surgical removal of the pancreas.

4) Distal Pancreatectomy: Distal pancreatectomy involves the surgical removal of the distal (left-sided) portion of the pancreas.

5) Bile Duct Resection: Surgery involving the bile ducts may include resection of a portion of the bile duct affected by cancer, followed by reconstruction of the bile ducts to restore bile flow.

6) Liver Transplantation: In select cases of liver cancer, particularly in patients with cirrhosis or end-stage liver disease, liver transplantation may be considered as a treatment option. Liver transplantation involves removing the entire diseased liver and replacing it with a healthy liver from a deceased or living donor.