Rosemarie Biancardi
Mammogram quality
Delayed follow up
Insurance coverage
Cancer subtype
Stage of cancer
Access quality treatments
Pneumonitis
Taxanes: Taxal or parlitaxel
o Microtubule stabilizing agents
Mechanism is cancer cells: destabilizing
of microtubule lattice during cell
division
Radiation Recall
Pneumonitis
A reaction that can occur when irradiated
pulmonary tissue has a reaction to a triggering
agent (chemo).
Common symptoms
o
o
o
o
o
o
Dyspnea
Shortness of breath
Low grade fever
Cough
ground glass opacity
Infiltrates in lungs
Radiation Recall
Pneumonitis
Mechanism behind chemotherapy induced
pneumonitis is unknown
No relationship between duration of chemotherapy
and occurrence
Reactions are usually more sever if time between
radiation and the beginning of chemotherapy are short
Patient History
Stage IV ER/PR positive breast cancer with bone
mets.
Palliative radiation for bone mets.
Endocrine therapy (Faslodex and Ibrance)
Chemotherapy (Taxol) since February 2016
Compression fracture to spine (kyphoplasty)
Hyperglycemia
Right mastectomy
Hypertension
Hypercholesterolemia
Anthropometrics
163.56cm or 5 feet 4 inches
Initial weight 75.8kg or 166.8lbs
BMI 28
Adjusted body weight 62.3kg or 131.7lbs
Patents weight range: 66.8kg (146lbs) - 85.7kg
(188lbs)
Labs
Nutrition Related
Medications
Reglan
Fentanyl
Levophed (Norepinephrine)
Acyclovir
Intubation/ Extubation
X-rays
Chest CT
Bronchoscopy
Tracheotomy
Blood transfusion
Video swallow study
Nutrition Diagnosis
Inadequate oral intake related to inability to take
PO and increased metabolic needs as evidenced
by NPO/ need for nutrition support and metastatic
breast cancer.
Altered nutrition related lab values (glucose)
related to endocrine dysfunction as evidenced by
elevated blood glucose with no diabetes history.
Complications
Sedation and vent needed due to respiratory
distress
Health care associated pneumonia
Herpes Zoster on right leg
High Blood glucose levels
Iatrogenic right pneumothorax
Tracheostomy
C-Diff
Sinusitis
Nutrition Intervention
Nutrition support
o Jevity 1.5
o Vital HP
o Promod
o Glucerna 1.5
o Clinimix 5%/15% and 150ml lipids
References
http://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid= 507554
1. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer
statistics, 2015: Convergence of incidence rates between black and white women:
Breast Cancer Statistics, 2015. CA: A Cancer Journal for Clinicians. 2016;66:31-42.
2. CamachoRivera M, Kalwar T, Sanmugarajah J, Shapira I, Taioli E. Heterogeneity of
Breast Cancer Clinical Characteristics and Outcome in US Black WomenEffect of Place
of Birth. The Breast Journal. 2014;20:489-495.
3. Alushin GM, Lander GC, Kellogg EH, Zhang R, Baker D, Nogales E. High-resolution
microtubule structures reveal the structural transitions in -tubulin upon GTP
hydrolysis. Cell. 2014;157:1117-1129.
4. Ding X, Ji W, Li J, Zhang X, Wang L. Radiation recall pneumonitis induced by
chemotherapy after thoracic radiotherapy for lung cancer. Radiation oncology (London,
England). 2011;6:24-24.
5. Kim S, Tannock I, Sridhar S, Seki J, Bordeleau L. Chemotherapy-induced infiltrative
pneumonitis cases in breast cancer patients. Journal of Oncology Pharmacy Practice.
2012;18:311-315.
6. Storaas E, Holmaas G, Gravdal K, Brretzen A, Eikesdal HP. Lethal pneumonitis after
docetaxel chemotherapy: Case report and review of the literature. Acta Oncologica.
2013;52:1034-1038.