ONS ONCC CHEMO RENEWAL EXAM
Questions and Answers
1. Neoadjuvant therapy does not increase survival when compared
to adjuvant therapy. It only changes the timing of treatment and
can change surgical options if the tumor is shrunk enough. If this
occurs, the patient may only require a lumpectomy plus radiation
therapy instead of needing a mastectomy: Main benefit of neoadjuvant
chemotherapy (breast cancer patient)
2. A comprehensive geriatric assessment (CGA) is a multidisciplinary
evaluation to assess life expectancy and risk of morbidity and
mortality in the older patient. This assessment tool would evaluate
and include the following areas: functional status, socioeconomic
issues, psychosocial distress, comorbidities, cognitive function,
nutritional status, polypharmacy, and a medication review (NCCN
Older Adult Oncology Guidelines, version 1.2015).: Due to Mrs. Turner's age
and comorbidities, her oncologist performs a comprehensive geriatric assessment. You know that this
assessment covers all but which of the following:
3. 65: The NCCN Older Adult Oncology Guidelines (version 1.2015) provides information 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
4. Two of the agents (docetaxel and carboplatin) that Mrs. Turner
will receive are categorized as irritants. Docetaxel can cause a
significant reaction if it extravasates. It can lead to edema,
erythema, occasional pain and blister formation (ONS Chemo/Bio
guidelines, 2014). That is the most likely reason that Mrs. Turner
was given a port for her treatments. Some patients 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.: What is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy?
5. Irrirtants: can cause inflammation, pain, and burning but rarely
cause tissue necrosis com-parable to a vesicant (unless a large amount or a very high concentration
of the irritant is extravasated).
6. Vesicants: can cause blistering and significant pain and
tissue damage and destruction, leading to tissue death.
7. Non-DNA-binding solutions remain in the local area of the
extravasation, which improves the possibility of drug
, deactivation.
DNA-binding agents attach to DNA nucleic acids, causing the
antagonist to be ingested cellularly, leading to progressive tissue
destruction: A further classification of an antineoplastic agent's potential to cause
damage is whether its mechanism of action includes DNA binding.
8. Bendamustin
ea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethami
ne
Mitomycin: DNA Binding Irritants
9. Amsacri
ne
Paclitaxel
Vinblastin
e
Vincristine
Vindesine
Vinorelbine: DNA Nonbinding vessicants
Questions and Answers
1. Neoadjuvant therapy does not increase survival when compared
to adjuvant therapy. It only changes the timing of treatment and
can change surgical options if the tumor is shrunk enough. If this
occurs, the patient may only require a lumpectomy plus radiation
therapy instead of needing a mastectomy: Main benefit of neoadjuvant
chemotherapy (breast cancer patient)
2. A comprehensive geriatric assessment (CGA) is a multidisciplinary
evaluation to assess life expectancy and risk of morbidity and
mortality in the older patient. This assessment tool would evaluate
and include the following areas: functional status, socioeconomic
issues, psychosocial distress, comorbidities, cognitive function,
nutritional status, polypharmacy, and a medication review (NCCN
Older Adult Oncology Guidelines, version 1.2015).: Due to Mrs. Turner's age
and comorbidities, her oncologist performs a comprehensive geriatric assessment. You know that this
assessment covers all but which of the following:
3. 65: The NCCN Older Adult Oncology Guidelines (version 1.2015) provides information 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
4. Two of the agents (docetaxel and carboplatin) that Mrs. Turner
will receive are categorized as irritants. Docetaxel can cause a
significant reaction if it extravasates. It can lead to edema,
erythema, occasional pain and blister formation (ONS Chemo/Bio
guidelines, 2014). That is the most likely reason that Mrs. Turner
was given a port for her treatments. Some patients 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.: What is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy?
5. Irrirtants: can cause inflammation, pain, and burning but rarely
cause tissue necrosis com-parable to a vesicant (unless a large amount or a very high concentration
of the irritant is extravasated).
6. Vesicants: can cause blistering and significant pain and
tissue damage and destruction, leading to tissue death.
7. Non-DNA-binding solutions remain in the local area of the
extravasation, which improves the possibility of drug
, deactivation.
DNA-binding agents attach to DNA nucleic acids, causing the
antagonist to be ingested cellularly, leading to progressive tissue
destruction: A further classification of an antineoplastic agent's potential to cause
damage is whether its mechanism of action includes DNA binding.
8. Bendamustin
ea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethami
ne
Mitomycin: DNA Binding Irritants
9. Amsacri
ne
Paclitaxel
Vinblastin
e
Vincristine
Vindesine
Vinorelbine: DNA Nonbinding vessicants
