Chemotherapy

CHEMOTHERAPHY: DRUG TREATMENT USES CHEMICALS TO KILL CANCER CELLS

CHEMOTHERAPHY- The use of medications to treat cancer has played a major role in cancer treatment for half a century. Years of testing and research have proved chemotheraphy to be an effective cancer treatment. It may be your only treatment, or it may be used in combination with other treatments, such as surgery and radiation theraphy. Chemotheraphy works by killing rapidly dividing cells. These cells include cancer cells, which continuously divide to form more cells, and healthy cells that also divide quickly, such as those in your bone marrow, gastrointestinal tract, reproductive system and hair follicles. Healthy cells usually usually recover shortly after chemotheraphy is complete, so for example, your hair starts growing again.

CHEMOTHERAPHY CAN SERVE VARYING GOALS

One of chemotheraphy’s main advantages is that unlike radiation , which treats only the area of the body exposed to the radiationchemotheraphy treats the entire body. As a result, any cells that may be broken away from the original cancer are treated. Depending on what type of cancer you have and whether it has spread, your doctor may use chemotheraphy to: ->Eliminate all cancer cells in your body, even when cancer is widespread ->Prolong your life by controlling cancer growth and spread ->Relieve symptoms and enhance your quality of life

In some cases, chemotherapy may be the only treatment you need. More often, it's used in conjunction with other treatments, such as surgery, radiation or a bone marrow transplant, to improve results. For example, you may receive: ->Chemotherapy before other treatments (neoadjuvant chemotherapy). The goal of neoadjuvant therapy is to reduce the size of a tumor before surgery or radiation therapy. ->Chemotherapy after other treatments (adjuvant chemotherapy). Given after surgery or radiation, the goal of adjuvant therapy is to eliminate any cancer cells that might linger in your body after earlier treatments.

FACTORS EFFECTIVENESS OF CHEMOTHERAPHY

• Size of tumor • Type of cancer • Accessibility of tumor • General health of client

CONTRAINDICATION FOR CHEMOTHERAPHY     

INFECTION- Receiving immunosuppressive drug RECENT SURGERY- Interferes with wound healing IMPAIRED RENAL- Metabolized in liver and excreted through kidney. RECENT RADIOTHERAPHY- Suppresses bone marrow cell production. PREGNANCY- First 3 weeks, bone marrow depression.

ADMINISTRATION OF CHEMOTHERAPHY AGENTS You usually receive chemotheraphy in cycles, depending on your condition and which drugs are used. Cycles may include taking the drugs daily, weekly or monthly for a few months or several months, with a recovery period after each treatment. Recovery periods allow time for your body to rest and produce new, healthy cells.

Chemotherapy drugs can be taken in a number of forms. Your doctor decides what form or forms to use primarily based on what type of cancer you have and what drug or combination of drugs will best treat your cancer. Examples of different forms of chemotherapy include:     

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ORAL- You swallow this form of chemotheraphy as a pill. TOPICAL- This type of drug is applied to your skin to treat localized skin cancers. INJECTION- Using needle, your doctor injects the drug directly into a muscle, under your skin or into a cancerous area on your skin. SUBCUTANEOUS INJECTION INTRAVENOUS (IV)-Chemotheraphy is injected into a vein, using a needle inserts through your skin. This allows rapid distribution of the chemotheraphy throughout your entire body. NON-VESICANTS- Do little damage to soft tissue. Eg. Methothexate 5-FU VESICANTS- Cause soft tissue necrosis. Eg. Nitrogen mustard IRRITANTS- Produced burning and minor inflammation. INTRA-ARTERIAL PERFUSSION- Inplantable INTRATHECAL ADMINISTRATION OMMAYA RESERVOIR- Mushroom shape self sealing silicone dome. VASCULAR PROCESS GRAFT- Use Dacron graft. INTRAPERITONEAL- Tenchoff catheter into abdominal cavity. Eg. Cancer of liver, ovary, colon

CHEMOTHERAPY Medications, regardless of how they’re given, generally travel in your bloodstream and throughout your entire body. The intravenous route is the most common, allowing chemotheraphy drugs to spread quickly through your system. In cases in which your doctor wants to direct chemotheraphy to a more confined area-for example, to ensure a tumor is exposed to more of the drug-he or she may insert a tube (catheter) directly into that area or into a blood vessel supplying the tumor.

CHEMOTHERAPHY SIDE EFECTS Because chemotheraphy drugs can affect healthy cells, one of their disadvantages is that you may experience chemotherapy side effects, some temporary and some longer term. Not every drug will cause every side effect. Your doctor can tell you what to expect from the drugs you’re receiving.

SIDE EFFECTS AND NURSING INTERVENTI0NS     

Gastrointestinal system *Nausea and vomiting -Antimetics 4-6 hrs and proophylactically (plasil or tigan) NPO Diarrhea – – – –

-anti drug clear liquid good perineal care monitor K, Na, and Cl level

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Stomatitis - Good oral hygiene - Viscous Lidocaine before meal - Gargling rinse with water - KY jelly to cracked lips - Suck popsicles Hematologic System *Thrombocytopenia- epistaxix, petechiae, ecchymoris - Avoid bumps - Avoid aspirin - Avoid IM injection - Monitor blood count - Protect physical injury

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Leukopenia - Hand washing - Note sign and symptoms of respiratory infection - Avoid crowd Anemia - Adequate rest period - H and H monitoring - Oxygen PRN Hemorrhagic Cystitis - Increase fluid (3L per day) Integumentary - Alopecia- temporary - Scalp hypothermia-ice pack - Hair grows back

LONG TERM OR LATE CHEMOTHERAPY SIDE EFFECTS

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As people with cancer live longer after treatment, doctors are discovering that some treatments cause long-lasting side effects or side effects that become apparent long after treatment ends. These long-term side effects are rare. Before you begin treatment, discuss with your doctor what long-term effects you might experience. Some chemotherapy drugs can cause: Organ damage, including problems with your heart, lungs and kidneys Nerve damage Blood in your urine (hemorrhagic cystitis) Another cancer, including Hodgkin's disease and nonHodgkin's lymphoma, leukemia and some tumors