Side effects chemotherapy pdf

However, it is a key component of the role place. Cancer has developed a comprehensive tool for providing such information. The focus of the consultation is to initial clinic visit and commencing chemotherapy, because determine the presence of any toxicities of treatment.

Side this gives patients an opportunity to digest the informa- effects, if any, have often resolved by the time the patient tion and ask questions prior to commencing treatment.

Nursing: Research and Reviews submit your manuscript www. This is an excellent example of adherence to care Neutropenic sepsis pathways improving outcomes. Many patients on chemotherapy will be means eradicated. As noted in the triage tool, a single episode of Given that this survey addressed patient-reported outcomes, fever prompts a red response, meaning contact the hospital the issue of chemotherapy-induced nausea and vomiting immediately.

Others symptoms, such as breathlessness or remains current. However, other fac- escalated to a red situation which again means contacting tors, including age, gender, comorbid conditions, concurrent the hospital immediately.

Neutropenic deaths still occur in practice and motherapy-induced nausea and vomiting, and most recently, submit your manuscript www. Accessed February Octreotide can be tried for persis- that it is okay to abstain from food intake for 24 hours as long tent diarrhea.

Patients are Prevention of chemotherapy-induced nausea and vomit- reluctant to attend hospital when suffering from diarrhea ing remains the goal of antiemetic therapy, as a syndrome because it is difficult to travel and embarrassing. In addition, of anticipatory nausea is well documented if prevention is patients are often reluctant to contact help lines a second time not successful. This syndrome involves learned anticipa- if their symptoms resolved during a previous cycle.

This powerful response is unpleas- ensuring medicines are stored and administered safely. Some ant and difficult to treat, although lorazepam has be used to individuals start to doubt their ability to complete treatment.

Updated but its causes are multifactorial Table 3. Direct damage to the mucosa lining the gastrointestinal tract is often thought to be the cause, but overuse of anti- Alopecia biotics, underuse of antidiarrheal agents, malabsorption Chemotherapy affects the growth of both cancerous and syndromes, concurrent radiotherapy, and infection are also noncancerous cells. Hair can be lost from Untreated diarrhea can be fatal, and the mainstay of all over the body and not just the head, a fact that is often management is early control using agents such as loperamide overlooked.

The duration is short, but can be debilitating that, contrary to common belief, men also have negative and painful for the patient. A patient with stomatitis can suffer feelings about hair loss. It can also leave the patient feeling from isolation, nutrition problems, and infection.

Wigs can be obtained through the National patients, with a return to normal health within a few days. A patient information commencing any chemotherapy treatment and good attention booklet provides practical advice for patients regarding hair to oral hygiene is recommended thereafter.

Oral assessments loss, choice of wig, and caring for their hair when it regrows should be done by the nurse at each visit. Comprehensive following chemotherapy.

One aspect that ultimately lead to weight loss and malnutrition. Stomatitis Taste changes affect approximately half of all patients receiv- Stomatitis is a common side effect of chemotherapy, and ing chemotherapy, indicating a need for discussion with the is characterized by pain and inflammation of the surface of patient before starting treatment. It develops as a The nurse has a role in suggesting possible strategies to direct result of chemotherapy destroying healthy cells in the minimize the detrimental impact of chemotherapy.

Part of this process should include undertaking both clinical and nutritional assessments Table 4 Common toxicity criteria NCI and monitoring changes during the course of treatment.

Accessed February of fatigue in patients undergoing chemotherapy is unknown, In this instance, Fatigue is a common subjective complaint associated with restarting the infusion even cautiously is not appropriate.

There is a desensitization procedure can be attempted. This involves increasing evidence of the benefit of exercise during treatment administering sequential doses of the drug and building up to maintain muscle bulk.

Ensuring adequate calorie intake tolerance very slowly. This is not without clinical risk, and and correcting anemia are other measures to consider, along is both time-consuming and resource-intensive, so should with determining if depression is present.

Patients with Whilst the potential for hypersensitivity reactions is present previous severe reactions should be referred back to the in all patients receiving chemotherapy, it is more common oncologist. In particular, there is an increased risk with taxanes docetaxel and paclitaxel and many of the Peripheral neuropathy targeted monoclonal antibody therapies, eg, trastuzumab, Peripheral neuropathy is becoming a challenging clinical rituximab, and cetuximab. Minor reactions, eg, flushing, mild to the nerve endings.

Once resolved, considerable distress and difficulty to the patient in terms of cautiously restarting the infusion may result in comple- activities of daily living. However, Symptoms of peripheral neuropathy are variable Table 8. In this situation, full resuscitative support is age, resulting in changes in sensation, along with numbness and burning.

Both hands and feet can be affected, and the degree of Table 6 Common toxicity criteria NCI damage is worsened with increasing duration of treatment. It is Grade 1 2 3 4 for this reason that nursing assessment of fine motor function is Fatigue Fatigue Fatigue not relieved Fatigue not relieved — crucial at every cycle of treatment.

A simple history can pinpoint relieved by rest and limiting by rest, limiting a problem. Asking searching questions, eg, regarding ability to by rest instrumental ADL self-care ADL fasten buttons or send text messages can offer clues.

Unfortunately there is no treatment available for peripheral agents that have extravasated and the possible antidotes neuropathy. Management strategies include preventing further available. There are three main classification groups, ie, The nurse in the clinic has an ongoing responsibility to nonvesicant, irritant, and vesicant72 with the latter potentially carry out vein assessments to ensure no signs of extravasation causing the most harm.

Management of extravasation remains and to determine if administration of chemotherapy is causing controversial, and depends on the chemotherapy agent or veins to become fragile. The nurse must assess the need for Table 8 Common toxicity criteria NCI Grade 1 2 3 4 Peripheral motor Asymptomatic, clinical or Moderate symptoms limiting Severe symptoms limiting Life-threatening neuropathy diagnostic observations only, instrumental ADL self-care ADL, assistive consequences, urgent intervention not indicated device indicated intervention indicated Peripheral sensory Asymptomatic, loss of deep Moderate symptoms limiting Severe symptoms limiting Life-threatening neuropathy tendon reflexes, or paresthesia instrumental ADL self-care ADL consequences, urgent intervention indicated Note: Data from National Cancer Institute.

An excellent example of this initiative in action is the Other side effects implementation of a nurse-led, integrated acute oncology Nurses need a full awareness of the toxicities associated with service in Pan Birmingham Cancer Network and Sandwell chemotherapy regimens including for any new drugs.

Evaluation has small sample has been given above, and readers are directed been three-fold, with a focus on reducing bed days, using the to the full common toxicity criteria for a complete guide.

Despite thorough assessments to determine fitness to receive A reduction in the mean length of stay from 10 days to chemotherapy, urgent situations do occur because of the toxic 6. Therefore, it is important to chemotherapy-related emergency admissions were achieved. This means that acute oncol- to advise in a timely manner. Patients who appropriate advice to patients. Confidential Enquiry into Perioperative Deaths report that In addition, early interventions for grade 1 and 2 toxicities examined deaths within 30 days of receiving chemotherapy.

Conclusion Acute oncology services now offer timely and appropriate Chemotherapy nurses have been much respected for their advice to patients and are beginning to have a noticeable technical, information-giving, and communication skills.

Integrating the hour che- Most recently, chemotherapy nurses have been developing motherapy help lines into acute oncology services means assessment and management skills for supporting patients patients can be reassured and kept at home or fast tracked into through their chemotherapeutic pathway. This trend will the hospital. To assist nurses for consistency. Nurses have a real opportunity to add value in triage and management of these patients, UKONS has to the patient pathway by undertaking this exciting new role, submit your manuscript www.

National Cancer Survivorship Initiative. Concerns checklist. Accessed February 16, Support Care Cancer. The authors report no conflicts of interest in this work. Department of Health. The Nursing Contribution to Cancer Care. September 20, MacMillan Cancer Support. London, UK: Her www. The Cancer Reform Strategy.

London, UK: Her 19, Cancer Research UK. How chemotherapy works. Manual of Cancer Services; Chemotherapy cancerresearchuk. National Cancer Action Team; The hidden price of getting treatment. Accessed September 20, Farrell C, Lennan E.

Nurse-led chemotherapy clinics: issues for the org. Nurse Prescribing. Pain can make it harder to do your normal activities, and lower your quality of life. Pain control is an important part of your cancer treatment plan. Talk to your doctor if you have pain.

Your doctor will figure out what is causing the pain and the best way to control it. For more information, visit Pain in People with Cancer. Deep vein thrombosis DVT is when a blood clot forms in a deep vein. These clots usually form in the lower leg, thigh, or pelvis, but they can also occur in the arm.

Sometimes the DVT will break off and go to the lungs. Cancer patients, especially cancer patients who are receiving chemotherapy, have a much higher risk of DVT than other people. Learn about the symptoms of DVT and how to lower your risk.

Cancer treatments can cause many other side effects, including tiredness, trouble eating, and depression. The National Cancer Institute external icon and the American Cancer Society external icon describe many of these problems and offer tips for preventing or coping with them. Cancer treatments can cause many side effects. Learn about some of the most common from CDC.

Skip directly to site content Skip directly to page options Skip directly to A-Z link. Cancer Survivors. Section Navigation. Facebook Twitter LinkedIn Syndicate. Side Effects of Cancer Treatment. Minus Related Pages. On This Page. Note : Please refer to the Passport to Whole Health , Chapter 15 on Dietary Supplements for more information about how to determine whether or not a specific supplement is appropriate for a given individual. Supplements are not regulated with the same degree of oversight as medications, and it is important that clinicians keep this in mind.

Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer. Fatigue is experienced by almost every patient undergoing cancer treatment.

There are numerous contributing causes including anemia, nutritional deficiencies, endocrine dysfunction, cardiopulmonary dysfunction, mood disturbance, pain, sleep disturbance, deconditioning, treatment-related effects, and the underlying malignancy. The following therapeutic approaches are supported by recent studies:. Cancer pain can be described as nociceptive or neuropathic.

Nociceptive pain results from damage to tissue, while neuropathic pain is caused primarily by nerve injury. Refer to the Whole Health overview Chronic Pain for a more detailed approach to pain management. Cancer is a difficult diagnosis to receive and the treatment can be prolonged.

Many patients experience depression, anxiety, mental stress, and anguish at the time of diagnosis or during various stages of the treatment. Coping can be very difficult, and at times, medications are necessary. Refer to Depression and Anxiety Whole Health overviews for more information on Whole Health approaches for these conditions.

Quality of sleep is a major indicator of well-being. Consider the following in cancer patients, as these show promise in the research:. For more information, refer to the Whole Health overview Recharge.

Peripheral neuropathy is a potentially debilitating side effect caused by a number of chemotherapeutic agents, especially the platinum-based drugs and taxanes. Therapies that have shown potential benefit for neuropathy include the following:.

Mucositis is a common side effect of chemotherapy, local radiation, and bone marrow transplant, and is often the dose-limiting side effect for treatment. Mucositis involves inflammation and ulceration of the mucosal lining in the oral cavity, which causes pain, discomfort, and difficulty eating and swallowing, increasing the risk for hospitalization.

Mucositis is painful inflammation and ulceration of the lining of the digestive tract. To help with it, consider the following:. Xerostomia is dry mouth caused by salivary gland damage due to head and neck radiation therapy. Decreased salivation can lead to dental caries, tooth decay, periodontal disease, inflammation, and ulceration, causing difficulty eating, swallowing, and speaking.

Patients experience taste sensation changes, increased thirst, and tongue pain. Acute radiation-induced xerostomia is associated with an inflammatory reaction. Delayed radiation-induced xerostomia can occur up to one year after treatment from fibrosis of the salivary gland and is typically permanent. Lymphedema is swelling that occurs in a limb.