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 radiation-
chemotheraphy 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:

 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
 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
 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

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 non-
Hodgkin's lymphoma, leukemia and some tumors