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Cancer Treatments

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Cancer Treatments Therapies & Side Effects – PowerPoint PPT presentation

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Title: Cancer Treatments


1
Cancer Treatments
  • Therapies Side Effects

2
Goals of Therapy
  • Cure
  • refers to prolonged absence of detectable disease
  • Control
  • when cure is unrealistic
  • prevent new cancer growth

3
Goals of Therapy (cont.)
  • Palliation
  • when cure or control is impossible
  • reduce side effects/symptoms of disease

4
Types of Treatment
  • Surgery
  • Radiation Therapy
  • Chemotherapy
  • Hormone Therapy
  • Therapies can be used alone or in combination

5
Surgery
  • Removal of cancerous tissue from the body
  • Local treatment
  • Can also be used for diagnosis, staging, relief
    of side effects, or to ease pain

6
Side Effects of Surgery
  • Depends on type of surgery overall health of
    person
  • Most common side effect is Pain
  • Other side effects include bleeding,
    constipation, fatigue, wound care, and management
    of drains

7
Surgical Treatments
  • Cervical
  • Cryosurgery, laser surgery, conization,
    hysterectomy
  • Feel less womanly, incision, bleeding
  • Breast
  • Lumpectomy, mastectomy
  • Feel less womanly, balance, numbness/tingling,
    drains, lymphadema

8
Surgical Treatments
  • Colon
  • Colectomy, resection
  • Altered bowel function, colostomy
  • Lung
  • Resection, lobectomy, pneumonectomy
  • Chest tube, respirator, short of breath

9
Surgical Treatments
  • Prostate
  • Prostatectomy, orchiectomy
  • Impotence, incontinence, libido

10
Radiation Therapy
  • High energy x-rays to kill cancer cells
  • Local treatment
  • Given externally or internally
  • Skin may be marked by tattoos to direct beams
  • Daily treatments

11
Side Effects of Radiation
  • Side effects depend on targeted area
  • Skin irritation
  • Hair loss
  • Digestive problems
  • Fatigue
  • Urinary Bladder problems
  • Sexual/Fertility problems
  • Bleeding/Infection
  • Risks associated with implanted radiation source

12
Skin Changes
  • May start a few weeks after radiation begins
    last a few weeks after radiation ends
  • Redness
  • Itching
  • Dry, Peeling
  • Sores, ulcers
  • Swollen

13
Management of Skin Changes
  • Clinical
  • May hold treatment
  • Prescribe special creams
  • May prescribe medications for pain, itching, or
    infection
  • At Home
  • Use mild soap with lukewarm water
  • Do not rub or scratch area
  • Loose clothing, soft fabrics
  • Sun protection
  • Sitz baths
  • Check with Provider before using any skin products

14
Hair Loss
  • Also called alopecia
  • Only happens on the part of body being treated
  • Hair loss starts 2 to 3 weeks after first
    treatment
  • Hair may grow back 3 to 6 months after treatment
    is over
  • New hair may not look or feel the way it did
    before

15
Management of Hair Loss
  • Clinical
  • Prescription for wig
  • Look Good, Feel Better
  • At Home
  • Cut hair short or shave head
  • Buy a wig (before loss)
  • Wash hair gently
  • Avoid harsh products
  • Protect scalp
  • Stay warm

16
Digestive Changes
  • Changes depend on amount of radiation and
    concurrent chemotherapy
  • Diarrhea
  • Mouth/Throat changes
  • Nausea Vomiting

17
Diarrhea
  • Frequent bowel movements which may be soft,
    formed, loose, or watery
  • Can occur at any time
  • Radiation to the abdomen or pelvis may cause
    diarrhea

18
Management of Diarrhea
  • Clinical
  • I.V. Fluids
  • Electrolyte replacement
  • Imodium or other anti-diarrheal medications
  • At Home
  • Drink 8 to 12 cups of clear liquids per day
  • Eat 5 or 6 small meals and snacks
  • Eat foods that are low in fiber, fat, and lactose
  • Avoid spicy foods

19
Mouth Throat Changes
  • Radiation to head or neck can cause
  • Dry mouth and throat
  • Difficulty swallowing
  • Mouth sores
  • Loss or changes in taste
  • Tooth decay
  • Infections
  • Some side effects my last for months or years
    after treatment ends

20
Management of Changes to Mouth/Throat
  • Clinical
  • Dental exam
  • Prescribe special mouthwash for pain or infection
  • At Home
  • Avoid tobacco, alcohol
  • Eat moist, soft foods that are cool or room
    temperature
  • Eat 5-6 small meals high in calories protein
  • Drink 6-8 cups of fluid each day

21
Nausea Vomiting
  • Nausea and vomiting may occur 30 minutes to many
    hours after radiation therapy session ends
  • Patients are likely to feel better on days off
    from radiation
  • Those receiving radiation to the abdomen
    certain parts of the brain are at risk

22
Management of Nausea Vomiting
  • Clinical
  • I.V. fluids
  • Electrolyte replacement
  • Prescribe anti-nausea meds
  • At Home
  • Eat bland, easy-to-digest foods and drinks
  • Eat small meals and snacks (5-6 meals a day)
  • Have foods and drinks that are warm or cool

23
Fatigue
  • Feeling weak, weary, worn out, heavy, or slow
  • Possible Causes
  • Anemia
  • Anxiety
  • Depression
  • Infection
  • Lack of activity
  • Medicines
  • Fatigue may last even after therapy is over

24
Management of Fatigue
  • Clinical
  • Assess for underlying cause
  • Treat patient for anemia, anxiety, depression or
    infection as indicated
  • At Home
  • Try to sleep at least 8 hours each night
  • Plan time to rest
  • Exercise
  • Adjust work schedule
  • Let others help at home

25
Urinary Bladder Changes
  • Frequency, burning or pain
  • Trouble starting or emptying bladder
  • Incontinence
  • Blood in urine
  • Spasms
  • Starts 3-5 weeks after therapy begins
  • Most problems go away 2-8 weeks after therapy is
    over.

26
Management of Urinary Changes
  • Clinical
  • Urine sample to rule out infection
  • Prescribe meds to help with spasms, burning or
    pain
  • Refer to a therapist for exercises to improve
    bladder control
  • At Home
  • Drink 6-8 cups of fluid each day
  • Avoid coffee, black tea, alcohol, spices, and all
    tobacco products
  • Continence pads

27
Sexual Fertility Changes
  • Radiation to pelvic area
  • Can cause sexual changes loss of interest in or
    ability to have sex
  • It can also affect fertility

28
Management
  • Patients should talk to their Provider
  • Fertility Before starting radiation, let your
    doctor know if you think you might want to father
    children in the future.
  • Impotence The doctor can let you know whether
    you are likely to become impotent and how long it
    might last. Your doctor can prescribe medicine or
    other treatments that may help.
  • Sex Ask if it is okay for you to have sex during
    radiation therapy. Most men can have sex, but it
    is a good idea to ask and be sure.

29
Long-term Side Effects
  • Radiation can sometimes have long lasting
    effects
  • Second cancer
  • Fatigue
  • Infertility
  • Heart problems
  • Gastrointestinal problems
  • Lung fibrosis
  • Neurologic problems

30
Chemotherapy
  • Variety of drugs used to kill cancer cells
  • Systemic treatment damages healthy cells along
    with cancer cells
  • Given orally, IV, or by injection into various
    sites

31
Side Effects of Chemotherapy
  • Bone Marrow
  • Cardiac
  • Pulmonary
  • Nerves
  • Gastrointestinal
  • Mouth Throat
  • Kidney Bladder
  • Hair, Skin Nails

32
Myelosuppression
  • Refers to the suppression of the bone marrow
  • Bone marrow produces
  • White blood cells
  • Red blood cells
  • Platelets
  • Nadir
  • Point at which the lowest blood cell count is
    reached after chemotherapy

33
Neutropenia
  • A low number of white blood cells (neutrophils)
  • White blood cells help fight infections
  • The most common dose-limiting side effect of
    chemotherapy
  • A fever of 100.4 F or higher may be the only sign
    of infection for neutropenic patients

34
Management
  • Clinical
  • Treatment with colony stimulating factors
  • Avoid invasive procedures
  • No live vaccinations
  • At Home
  • Frequent hand washing
  • Wash fresh fruits vegetables
  • Avoid raw meats/fish
  • Avoid crowds, sick people
  • Avoid animal excreta

35
Anemia
  • A low number of red blood cells
  • Red blood cells help transport oxygen from the
    lungs to body tissues
  • Symptoms can include fatigue, shortness of
    breath, chest pain, dizziness/lightheaded

36
Management
  • Clinical
  • Blood transfusion
  • EPO administration
  • Iron supplements
  • Oxygen therapy
  • At Home
  • Plan activities to conserve energy
  • Sleep at least 8 hours each night
  • Maintain optimal level of physical activity
  • Well balanced diet (iron protein rich)

37
Thrombocytopenia
  • A low number of platelets (thrombocytes)
  • Platelets stick together to form a clot in order
    to stop bleeding
  • Overt bleeding or petechiae (a purplish red rash)
    could signify a low platelet count

38
Management
  • Clinical
  • Platelet transfusion
  • IL 11 injections
  • Avoid invasive procedures
  • Prescribe stool softeners
  • At Home
  • Avoid injuries
  • Electric razor, soft toothbrush
  • High protein diet, non-irritating foods
  • Avoid aspirin, NSAIDS

39
Heart
  • Cardiac toxicity
  • Usually dose related
  • May be irreversible
  • Symptoms fast heartbeat, shortness of breath,
    cough, ankle swelling

40
Cardiac Management
  • Clinical
  • Discontinue or reduce medication
  • Order tests EKG, MUGA, Holter monitor
  • At Home
  • Avoid alcohol and tobacco
  • Modify diet as indicated
  • Report symptoms

41
Pulmonary
  • Risk increases with chest radiation, underlying
    lung disease, patient is a smoker
  • Hypersensitivity, inflammatory, fluid retention
  • Symptoms cough, shortness of breath, fatigue,
    restlessness, rapid respirations

42
Pulmonary Management
  • Clinical
  • May discontinue medication
  • Prescribe home oxygen
  • Further tests
  • At Home
  • Refrain from smoking
  • Use a fan
  • Elevate head of bed
  • Conserve energy
  • Restrict fluids as indicated
  • Report symptoms

43
Nerves
  • Central, Peripheral, and Cranial Nerves
  • Symptoms depend on which nerves are damaged
  • Symptoms Include
  • Hearing
  • Vision
  • Touch, Sensory
  • Pain
  • Balance
  • Strength

44
Management
  • Clinical
  • May discontinue drug
  • Treat vitamin deficiency
  • Prescribe pain medication
  • Consult neurologist
  • At Home
  • Ensure safe environment
  • Report symptoms

45
Gastrointestinal
  • Nausea, Vomiting, Diarrhea
  • Acute or Delayed
  • Constipation
  • Decreased intake
  • Medications
  • Depression
  • Advanced cancer stage

46
Management of Constipation
  • Clinical
  • May suggest a fiber supplement, laxative, stool
    softener, or enema
  • At Home
  • Drink at least 8 cups of fluids each day
  • Be active every day
  • Eat high fiber foods
  • Contact Provider if not had a bowel movement in 2
    days

47
Mouth Throat
  • Dry mouth (having little or no saliva)
  • Changes in taste and smell
  • Infections of gums, teeth, or tongue
  • Increased sensitivity to hot or cold foods
  • Mucositis
  • Inflammation of the GI mucosa
  • Symptoms pain/difficulty swallowing, hoarseness,
    changes in color to oral mucosa, ulcers

48
Appetite Changes
  • Causes include
  • Nausea
  • Mouth and throat problems
  • Changes in taste
  • Feeling depressed or tired
  • Appetite loss may last for a day, a few weeks, or
    even months.

49
Management for Loss of Appetite
  • Clinical
  • Prescribe vitamins or nutrition supplements
  • Prescribe medications that increase appetite
  • receive nutrition through an IV
  • At Home
  • Eat 5 to 6 small meals each day
  • Drink milkshakes, smoothies, juice, or soup
  • Use plastic forks and spoons
  • Increase your appetite by doing something active

50
Kidneys Bladder
  • Bladder
  • burning, pain, blood
  • Kidneys
  • Impaired water excretion
  • Proteinuria
  • Weight gain
  • Little urine output

51
Management
  • Clinical
  • IV fluids
  • Bladder irrigation
  • Diuresis
  • Monitor electrolytes
  • At Home
  • Increase oral fluids
  • Empty bladder frequently
  • Call provider unable to urinate for more than 12
    hours urine dark concentrated producing only
    small amounts of urine

52
Hair Loss
  • May lose some or all hair
  • Can happen anywhere on the body
  • Starts 2 to 3 weeks after therapy begins
  • Scalp may hurt at first
  • It takes about 1 week for hair to fall out
  • Almost always, hair will grow back 2 to 3 months
    after chemotherapy is over
  • Hair may start growing back even while on therapy

53
Skin Nails
  • Itching, dryness, redness, rashes, and peeling
  • Darker veins
  • Sensitivity to the sun
  • Nail problems
  • Radiation recall
  • Allergic reactions
  • Chemotherapy leaking from IV

54
Fatigue
  • Most common and most distressing symptom
    associated with cancer treatment

55
Hormonal Therapy
  • May improve prognosis more than chemotherapy
  • If taken by mouth, must be taken everyday
  • Usually given for 5-10 years
  • In Stage IV disease, can control cancer for many
    years

56
Side Effects of Treatment
  • Usually tolerated well
  • Hot flashes
  • Joint pains
  • Blood clots
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