Unit 5 - The Cancer Patient Flashcards
briefly outline palliative care
Uses a wide team of specialists (dietitian, physiotherapist, pharmacists, social workers to:
- Provides relief from pain
- Affirms life and regards dying as normal
- Neither to hasten or postpone death
- Integrate psychological and spiritual aspects
- Offer support to help the patient live as actively as possible, enhancing quality of life
- Offers a support system to help the family
What is the definition of palliative care?
To improve the quality of life of patients and their families by means of easing physical pain as well as other psychological and spiritual issues.
Describe some of the different ways pain can be treated in palliative care.
Convential drugs
Non-opioids (paracetamol) or opioids (codeine), anxiety (benzodiazepine)
Radiotherapy
Around 40% of radiotherapy is given for palliative care e.g., for bone metastasis for spinal cord compression. Treatment is given in short fractionated courses to minimise hospital visits
Glioblastoma multi-form – unusually high dose (60 Gy) is given to patients – so takes a lot of time (2x30days after surgery) and significant toxicity like dermatitis and somnolence syndrome, nausea – hence the length of survival period in these patients has to be worth it!!
Surgery
Toilet mastectomy in breast cancer – bleeding and secondary infection
Pining of pathological fractures (osteolytic lesion) – given that they have fairly long survival
Surgery for brain metastases – only for those who are in good healthy (can actually improve survival)
Chemotherapy
Side-effects must be minimal and manageable and the expected length of life is long enough to derive benefit – example would be bisphosphonates for breast cancer to help treat bone mets
Hormone therapy
Breast like tamoxifen or prostate orchidectomy
List some of wide-array of side-effects associated with cancer chemotherapy?
- Myelosuppression (can be given growth factors and antibiotics)
- Nausea and vomiting – can be given anti-emetics
- Fatigue
- Mucositis – affect taste
- Diarrhoea
- Hair loss
- Weight loss/gain – mentality
- Depression – ESHAP treatment
- Some will cause chronic side-effects like Tratuzumab with the heart or potentially secondary cancers (alkylating agents or radiotherapy)
- And that doesn’t even cover cost!!!!
Using prostate cancer as an example, discuss the impact of the four types of treatment available to the individual?
Surgery
Related to erectile dysfunction and incontinence – self-esteem issues which may affect relationships and fertility
Radiotherapy
Rectal inflammation, reduced fertility and erectile dysfunction
Chemotherapy
Cabazitaxel – GI problems, nausea, hair-loss, anaemia
Hormone therapy
Loss of sex drive and erectile dysfunction (in women this may be an early menopause with tamoxifen)
Can lead to financial loss leading to increased anxiety – as well as issues with relationships, fertility and self-confidence
What issues might cancer survivors face?
Anxiety about recurrence, financial issues due to lack of working, loss of autonomy, transition back to a civilian rather than a patient