WEEK 2 Oncology Nursing Flashcards
Identify the 7 forms of cancer treatment
- Chemotherapy
- Radiation Therapy
- Targeted Therapy
- Surgery
- Immunotherapy
- Hormone Transplant
- Transplant
What is targeted therapy?
Aims to target the particular cancer diagnosed e.g. Herceptin for primary breast cancer
What is immunotherapy?
Uses the body’s own immune system to fight the cancer. Challenge is that it is hard to specifically stimulate the immune system and not the rest of the body systems
What is hormone therapy?
Used to slow to growth of hormone sensitive tumours by blocking the production of a hormone e.g. oestrogen in oestrogen responsive breast cancers
What is transplant used for in cancer therapy?
E.g. stem cell transplants to increase stem cell count in order to fight the cancer to a better extent
Why is chemotherapy given in cycles?
Chemotherapy also kills healthy cells, therefore administering chemotherapy in cycles means the normal cells are given time to recover in between treatments
What are the main areas of the body most commonly affected by chemotherapy?
Hair, mouth, stomach, bowel, bone marrow, skin
Define Cell cycle SPECIFIC chemotherapy
Agents that act on cells in a specific phase. Most effective against cancers that are rapidly growing
Define Cell cycle NON SPECIFIC chemotherapy
Agents that act on cells no matter what phase of cell cycle they are in. Effective against slow growing tumours and rapidly dividing tumours
Describe cell kill hypothesis
States that a chemotherapy concentration given for a defined period of time kills a constant fraction of cells in the population, independent of the no. of cells. Because only a fraction are killed per treatment, repeated doses must be administered to reduce the tumour size
List some routes of administration for chemotherapy
Oral
Topical
IV
IM
SC
Intra arterial
Intra pleural
List some side effects of chemotherapy
Fatigue
Nausea/Vomiting
Pain
Sores in throat/mouth
Changes to skin
Diarrhoea/constipation
Hair loss
Emotional changes
Identify the 3 types of bone marrow suppression
Anaemia
Leucopenia
Thrombocytopenia
Define Anaemia
Low RBC count = Low Hb count = Decreased perfusion to body = Fatigue, tachycardia
Define Leucopenia
Low WBC count = Immunocompromised patients
Define Thrombocytopenia
Low platelet count = Decreased haemostasis (Stopping of bleeding) = Increased bruising and bleeding
Identify 3 nursing considerations within Chemotherapy
- Educate patient on what to expect/what is common/not common
- Educate on importance of taking temp each day/who and when to contact doctor
- Blood tests prior to cycle to assess bone marrow function
Define Radiation Therapy
Clinical and scientific discipline using ionizing radiation to treat neoplastic disease
Describe the effect of radiation therapy
Damages the nucleus of cells which in turn damages DNA synthesis = Cells loose the ability to reproduce
How often is Radiation therapy typically used?
Typically one fraction is given each day until the total dose is reached
What is radiation therapy typically used for?
- To shrink the tumour prior to surgery
- Destroy remaining cancer cells after surgery
- Relieve symptoms of a tumour
Identify the two types of Radiation Therapy
Internal and External
Describe External Radiation Therapy
Uses a machine to beam radiation onto the tumour. The area is precise, minimising radiation exposure to other areas. Usually given 5x per week and is painless but uncomfortable
Describe Internal Radiation Therapy
Radiation given via a needle, catheter or specialised device which stays in the person for mins-days. May require daily hospital visit/stay. Can give off small amounts of radiation to people around you
What is another name for Internal Radiation Therapy
Brachytherapy
Identify some side effects of Radiation Therapy
Skin problems e.g. dryness/itchiness
Fatigue
(Depending on place of radiation: Dental problems, nausea, stiffness in chest etc.)
Define neo-adjuvant treatment
All treatments administered before the primary cancer treatment e.g. Radiation before surgery to reduce tumour size
Define adjuvant treatment
Treatments administered after the primary treatment e.g. Chemotherapy administered after radiation when radiation is the primary treatment
Define complementary medicine
Therapies used alongside conventional therapies to enhance QOL for patients with cancer
What are 5 examples of complementary therapies?
Nutritional (Supplements, special diets)
Psychological (Mindfulness)
Physical (Massage)
Yoga
Deep breathing
Identify 3 non pharmacological measures in cancer management
Treat side effects
Education/Support/Reassurance
Referrals
Identify HCP in the interprofessional team of cancer management
Radiologists
Surgeons
Oncologists
Dieticians
Physiotherapists
Define multidisciplinary care
The development of pathways for treatment with the relevant healthcare professionals to provide highest level of care for the patient
Identify 3 benefits of an effective multidisciplinary approach
Improved team communication
Detection of emotional needs of patient
Reduction in service duplication
What is the purpose of a multidisciplinary care meeting
Deliberate face to face meeting involving a range of health professionals to facilitate best practice management of all patients with cancer
How does the patient benefit from an effective multidisciplinary approach?
They know their providers are working as a team, improved communication and understanding
Identify the role of nurses in the multidisciplinary team in cancer management
Communication between HCP
Referrals PRN
Monitor symptoms/Escalate PRN
Patient advocate
Specialist cancer nurses
Identify the 5 Oncological Emergencies
- Neutropenic Sepsis
- Spinal Cord Compression
- Tumour Lysis Syndrome
- Superior Vena Cava Obstruction
- Hypercalcemia
Describe neutropenic sepsis
Patients are immunocompromised due to treatment, therefore more susceptible to infection. Symptoms include flu like symptoms, fever, shivering
Describe spinal cord compression
Often associated with breast, lung, prostate, renal tumours causing intense localised back pain, vertebral tenderness and paraesthesia
Describe tumour lysis syndrome
Associated with tumours that are rapidly growing where intracellular components e.g. K+/DNA/RNA are released. Patient produces 4 conditions which result in weakness, muscle cramps, N&V, diarrhoea
What are the 4 conditions associated with tumour lysis syndrome
Hypocalcemia
Hyperphosphatemia
Hyperkalemia
Hyperuricaemia
Describe superior vena cava obstruction
Caused by small lung cancer, lymphoma etc. Tumour presses against SVC or tumour grows into SVC causing it to become partially blocked/compressed. Symptoms include facial oedema, distenstion of head and neck veins, mediastinal shift
Describe hypercalcemia
Caused by metastatic bone disease or parathyroid hormone like substances excreted by cancer cells causing an increase in Ca+ in blood. Occurs when Ca serum levels rise above 3mmol/L. Symptoms include fatigue, muscle weakness, polyuria/nocturia
Identify the 4 steps to respond to oncological emergencies
- Nurse in a a single room
- Recognise/Detect deterioration (Assessment)
- React/Respond (Met call/Antibitotics)
- Review (Monitoring, fluid replacement)
