Ques ons and answers With complete solu on new!!
Main benefit of neoadjuvant chemotherapy (breast cancer pa ent) - Ans Neoadjuvant therapy
does not increase survival when compared to adjuvant therapy. It only changes the ming of
treatment and can change surgical op ons if the tumor is shrunk enough. If this occurs, the
pa ent may only require a lumpectomy plus radia on therapy instead of needing a mastectomy
Due to Mrs. Turner's age and comorbidi es, her oncologist performs a comprehensive geriatric
assessment. You know that this assessment covers all but which of the following: - Ans A
comprehensive geriatric assessment (CGA) is a mul disciplinary evalua on to assess life
expectancy and risk of morbidity and mortality in the older pa ent. This assessment tool would
evaluate and include the following areas: func onal status, socioeconomic issues, psychosocial
distress, comorbidi es, cogni ve func on, nutri onal status, polypharmacy, and a medica on
review (NCCN Older Adult Oncology Guidelines, version 1.2015).
The NCCN Older Adult Oncology Guidelines (version 1.2015) provides informa on on what is
included in a comprehensive geriatric assessment. Currently, more than 60% of cancers in the
United States occur in people age ______and older and as the oncology world ages, nearly half
(46%) of cancer survivors are 70 years of age or older - Ans 65
What is your best explana on for why Mrs. Turner was given a port to receive her
chemotherapy? - Ans Two of the agents (docetaxel and carbopla n) that Mrs. Turner will
receive are categorized as irritants. Docetaxel can cause a significant reac on if it extravasates.
It can lead to edema, erythema, occasional pain and blister forma on (ONS Chemo/Bio
guidelines, 2014). That is the most likely reason that Mrs. Turner was given a port for her
treatments. Some pa ents will receive their treatments through a peripheral IV without
incident. Just because they are intravenous agents does not mean that a port is required and
needing a port has nothing to do with her being older in age. Since none of these agents are
vesicants, they likely could have been given safely via peripheral route but having a port placed
is OK as well.
, _____________can cause inflamma on, pain, and burning but rarely cause ssue necrosis
comparable to a vesicant (unless a large amount or a very high concentra on of the irritant is
extravasated). - Ans Irrirtants
_____________can cause blistering and significant pain and ssue damage and destruc on,
leading to ssue death. - Ans Vesicants
A further classifica on of an an neoplas c agent's poten al to cause damage is whether its
mechanism of ac on includes DNA binding. - Ans Non-DNA-binding solu ons remain in the
local area of the extravasa on, which improves the possibility of drug deac va on.
DNA-binding agents aBach to DNA nucleic acids, causing the antagonist to be ingested cellularly,
leading to progressive ssue destruc on
DNA Binding Irritants - Ans Bendamus nea
Dac nomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin
DNA Nonbinding vessicants - Ans Amsacrine
Paclitaxel
Vinblas ne
Vincris ne
Vindesine
Vinorelbine
, Extravascia on Alkyla ng / Mechlorethamine tx - Ans Sodium thiosulfate
Inject 2 ml of sodium thiosulfate for each milligram of
mechlorethamine extravasated.
Inject subcutaneously into extravasa on site using a 25
gauge or smaller needle (change needle with each injec on).
Monitor extravasa on site according to the ins tu on's
policies and procedures.
Extravascia on Alkyla ng: Oxalipla n - Ans Apply warm compresses.
Dexamethasone
8 mg twice daily
for 14 days
Extravasa on Tx: Anthracyclines --- Daunorubicin,
doxorubicin, epirubicin,
idarubicin - Ans Totect
Apply ice pack (remove 15
minutes prior to Totect
treatment).
Infusion should be ini ated within six hours of extravasa on.
Infused over 1-2 hours for three days in an area other
than the extravasa on site