ONS ONCC CHEMO RENEWAL
QUESTIONS WITH CORRECT ANSWERS
Neoadjuvantatherapyadoesanotaincreaseasurvivalawhenacomparedatoaadjuvantatherapy.aIta
onlyachangesatheatimingaofatreatmentaandacanachangeasurgicalaoptionsaifatheatumoraisashr
unkaenough.aIfathisaoccurs,atheapatientamayaonlyarequireaaalumpectomyaplusaradiationathe
rapyainsteadaofaneedingaaamastectomya-aans--
Mainabenefitaofaneoadjuvantachemotherapya(breastacancerapatient)
Aacomprehensiveageriatricaassessmenta(CGA)aisaaamultidisciplinaryaevaluationatoaassess
alifeaexpectancyaandariskaofamorbidityaandamortalityainatheaolderapatient.aThisaassessmenta
toolawouldaevaluateaandaincludeatheafollowingaareas:afunctionalastatus,asocioeconomicais
sues,apsychosocialadistress,acomorbidities,acognitiveafunction,anutritionalastatus,apolypha
rmacy,aandaaamedicationareviewa(NCCNaOlderaAdultaOncologyaGuidelines,aversiona1.201
5).a-aans--
DueatoaMrs.aTurner'saageaandacomorbidities,aheraoncologistaperformsaaacomprehensiveag
eriatricaassessment.aYouaknowathatathisaassessmentacoversaallabutawhichaofatheafollowing
:
65a-aans--
TheaNCCNaOlderaAdultaOncologyaGuidelinesa(versiona1.2015)aprovidesainformationaonaw
hataisaincludedainaaacomprehensiveageriatricaassessment.aCurrently,amoreathana60%aofac
ancersainatheaUnitedaStatesaoccurainapeopleaagea______andaolderaandaasatheaoncologya
worldaages,anearlyahalfa(46%)aofacancerasurvivorsaarea70ayearsaofaageaoraolder
Twoaofatheaagentsa(docetaxelaandacarboplatin)athataMrs.aTurnerawillareceiveaareacategoriz
edaasairritants.aDocetaxelacanacauseaaasignificantareactionaifaitaextravasates.aItacanaleadat
oaedema,aerythema,aoccasionalapainaandablisteraformationa(ONSaChemo/Bioaguidelines,a
2014).aThataisatheamostalikelyareasonathataMrs.aTurnerawasagivenaaaportaforaheratreatment
s.aSomeapatientsawillareceiveatheiratreatmentsathroughaaaperipheralaIVawithoutaincident.aJ
ustabecauseatheyaareaintravenousaagentsadoesanotameanathataaaportaisarequiredaandanee
dingaaaportahasanothingatoadoawithaherabeingaolderainaage.aSinceanoneaofatheseaagentsaar
eavesicants,atheyalikelyacouldahaveabeenagivenasafelyaviaaperipheralarouteabutahavingaaap
ortaplacedaisaOKaasawell.a-aans--
WhataisayourabestaexplanationaforawhyaMrs.aTurnerawasagivenaaaportatoareceiveaherachem
otherapy?
Irrirtantsa-aans--
_____________canacauseainflammation,apain,aandaburningabutararelyacauseatissueanecr
osisacomparableatoaaavesicanta(unlessaaalargeaamountaoraaaveryahighaconcentrationaofath
eairritantaisaextravasated).
, Vesicantsa-aans--
_____________canacauseablisteringaandasignificantapainaandatissueadamageaandadestru
ction,aleadingatoatissueadeath.
Non-DNA-
bindingasolutionsaremainainathealocalaareaaofatheaextravasation,awhichaimprovesatheapossi
bilityaofadrugadeactivation.
DNA-
bindingaagentsaattachatoaDNAanucleicaacids,acausingatheaantagonistatoabeaingestedacellul
arly,aleadingatoaprogressiveatissueadestructiona-aans--
Aafurtheraclassificationaofaanaantineoplasticaagent'sapotentialatoacauseadamageaisawhether
aitsamechanismaofaactionaincludesaDNAabinding.
Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycina-aans--DNAaBindingaIrritants
Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbinea-aans--DNAaNonbindingavessicants
Sodiumathiosulfate
Injecta2amlaofasodiumathiosulfateaforaeachamilligramaof
mechlorethamineaextravasated.
Injectasubcutaneouslyaintoaextravasationasiteausingaaa25
gaugeaorasmalleraneedlea(changeaneedleawithaeachainjection).
Monitoraextravasationasiteaaccordingatoatheainstitution's
policiesaandaprocedures.a-aans--ExtravasciationaAlkylatinga/aMechlorethamineatx
Applyawarmacompresses.a
Dexamethasone
8amgatwiceadaily
fora14adaysa-aans--ExtravasciationaAlkylating:aOxaliplatin
Totect
Applyaiceapacka(removea15
QUESTIONS WITH CORRECT ANSWERS
Neoadjuvantatherapyadoesanotaincreaseasurvivalawhenacomparedatoaadjuvantatherapy.aIta
onlyachangesatheatimingaofatreatmentaandacanachangeasurgicalaoptionsaifatheatumoraisashr
unkaenough.aIfathisaoccurs,atheapatientamayaonlyarequireaaalumpectomyaplusaradiationathe
rapyainsteadaofaneedingaaamastectomya-aans--
Mainabenefitaofaneoadjuvantachemotherapya(breastacancerapatient)
Aacomprehensiveageriatricaassessmenta(CGA)aisaaamultidisciplinaryaevaluationatoaassess
alifeaexpectancyaandariskaofamorbidityaandamortalityainatheaolderapatient.aThisaassessmenta
toolawouldaevaluateaandaincludeatheafollowingaareas:afunctionalastatus,asocioeconomicais
sues,apsychosocialadistress,acomorbidities,acognitiveafunction,anutritionalastatus,apolypha
rmacy,aandaaamedicationareviewa(NCCNaOlderaAdultaOncologyaGuidelines,aversiona1.201
5).a-aans--
DueatoaMrs.aTurner'saageaandacomorbidities,aheraoncologistaperformsaaacomprehensiveag
eriatricaassessment.aYouaknowathatathisaassessmentacoversaallabutawhichaofatheafollowing
:
65a-aans--
TheaNCCNaOlderaAdultaOncologyaGuidelinesa(versiona1.2015)aprovidesainformationaonaw
hataisaincludedainaaacomprehensiveageriatricaassessment.aCurrently,amoreathana60%aofac
ancersainatheaUnitedaStatesaoccurainapeopleaagea______andaolderaandaasatheaoncologya
worldaages,anearlyahalfa(46%)aofacancerasurvivorsaarea70ayearsaofaageaoraolder
Twoaofatheaagentsa(docetaxelaandacarboplatin)athataMrs.aTurnerawillareceiveaareacategoriz
edaasairritants.aDocetaxelacanacauseaaasignificantareactionaifaitaextravasates.aItacanaleadat
oaedema,aerythema,aoccasionalapainaandablisteraformationa(ONSaChemo/Bioaguidelines,a
2014).aThataisatheamostalikelyareasonathataMrs.aTurnerawasagivenaaaportaforaheratreatment
s.aSomeapatientsawillareceiveatheiratreatmentsathroughaaaperipheralaIVawithoutaincident.aJ
ustabecauseatheyaareaintravenousaagentsadoesanotameanathataaaportaisarequiredaandanee
dingaaaportahasanothingatoadoawithaherabeingaolderainaage.aSinceanoneaofatheseaagentsaar
eavesicants,atheyalikelyacouldahaveabeenagivenasafelyaviaaperipheralarouteabutahavingaaap
ortaplacedaisaOKaasawell.a-aans--
WhataisayourabestaexplanationaforawhyaMrs.aTurnerawasagivenaaaportatoareceiveaherachem
otherapy?
Irrirtantsa-aans--
_____________canacauseainflammation,apain,aandaburningabutararelyacauseatissueanecr
osisacomparableatoaaavesicanta(unlessaaalargeaamountaoraaaveryahighaconcentrationaofath
eairritantaisaextravasated).
, Vesicantsa-aans--
_____________canacauseablisteringaandasignificantapainaandatissueadamageaandadestru
ction,aleadingatoatissueadeath.
Non-DNA-
bindingasolutionsaremainainathealocalaareaaofatheaextravasation,awhichaimprovesatheapossi
bilityaofadrugadeactivation.
DNA-
bindingaagentsaattachatoaDNAanucleicaacids,acausingatheaantagonistatoabeaingestedacellul
arly,aleadingatoaprogressiveatissueadestructiona-aans--
Aafurtheraclassificationaofaanaantineoplasticaagent'sapotentialatoacauseadamageaisawhether
aitsamechanismaofaactionaincludesaDNAabinding.
Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycina-aans--DNAaBindingaIrritants
Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbinea-aans--DNAaNonbindingavessicants
Sodiumathiosulfate
Injecta2amlaofasodiumathiosulfateaforaeachamilligramaof
mechlorethamineaextravasated.
Injectasubcutaneouslyaintoaextravasationasiteausingaaa25
gaugeaorasmalleraneedlea(changeaneedleawithaeachainjection).
Monitoraextravasationasiteaaccordingatoatheainstitution's
policiesaandaprocedures.a-aans--ExtravasciationaAlkylatinga/aMechlorethamineatx
Applyawarmacompresses.a
Dexamethasone
8amgatwiceadaily
fora14adaysa-aans--ExtravasciationaAlkylating:aOxaliplatin
Totect
Applyaiceapacka(removea15
