Cancer treatment goals
Cure (greatest chance of disease eradication)
Control (treatment plan for cancer that cannot be completely eradicated
but are responsive to anticancer therapies)
Palliation (relief or control of symptoms and the maintenance of a
satisfactory quality of life are the primary objectives).
Surgical therapy
Biopsy to diagnose a malignancy, the anatomical tissue from which the
tumour arises (histology) and the degree of cell differentiation.
If for cure and control: resection of tumour
If for supportive care: feeding tube to maintain bodily function, CVAD for
chemotherapy,
Chemotherapy
mainstay of cancer treatment for most solid tumours and haematological
malignancies
cytotoxic > principle of safe handling
Radiation therapy
High energy waves or beams are used when absorbed into tissue
produce irons in the cells.
The energy in ionising radiation acts to break chemical bonds in DNA >
DNA damaged > necrosis.
Stomatitis, mucositis and oesophagitis management
Assess oral mucosa daily and educate the patient to do this > Keep oral
cavity clean and moist by performing frequent oral rinses with saline or
salt solution.
Encourage nutritional supplements and soft/moist/bland food > Avoid
spicy, acidic foods.
Be aware that eating, swallowing and talking may be difficult (may
, require analgesics)
Encourage pt to use artificial saliva to manage dryness
Apply topical anaesthetics (lignocaine)
Anorexia
• Release of TNF and IL-1 from macrophages has appetite-suppressant
effect.
Therapy-induced GI effects (mucositis, nausea and vomiting, bowel
disturbances) and anxiety reduce appetite.
Management:
• Monitor weight.
• Encourage patient to eat small, frequent meals of high-protein, high-
kilojoule foods.
Hepatoxicity
Toxic effects from chemotherapy medications (usually transient and
resolve when medication is stopped).
Management: Monitor liver function tests.
Anaemia management
• Monitor haemoglobin and haematocrit levels.
• Administer iron supplements and erythropoietin.
• Encourage intake of foods that promote RBC production
Leucopoenia management
• Monitor WBC count, especially neutrophils.
• Tell patient to report temperature elevation and any other symptoms of
infection.
• Teach patient to avoid large crowds and people with infections.
• Administer WBC growth factor
Thrombocytopenia management
• Observe for signs of bleeding (e.g. petechiae, ecchymosis).
• Monitor platelet counts.
• For patient teaching
Alopecia management
• Destruction of hair follicles by chemotherapy or radiation to scalp.
Mangement: .
• Suggest ways to cope with hair loss (e.g. hair pieces, scarves, wigs).
Cure (greatest chance of disease eradication)
Control (treatment plan for cancer that cannot be completely eradicated
but are responsive to anticancer therapies)
Palliation (relief or control of symptoms and the maintenance of a
satisfactory quality of life are the primary objectives).
Surgical therapy
Biopsy to diagnose a malignancy, the anatomical tissue from which the
tumour arises (histology) and the degree of cell differentiation.
If for cure and control: resection of tumour
If for supportive care: feeding tube to maintain bodily function, CVAD for
chemotherapy,
Chemotherapy
mainstay of cancer treatment for most solid tumours and haematological
malignancies
cytotoxic > principle of safe handling
Radiation therapy
High energy waves or beams are used when absorbed into tissue
produce irons in the cells.
The energy in ionising radiation acts to break chemical bonds in DNA >
DNA damaged > necrosis.
Stomatitis, mucositis and oesophagitis management
Assess oral mucosa daily and educate the patient to do this > Keep oral
cavity clean and moist by performing frequent oral rinses with saline or
salt solution.
Encourage nutritional supplements and soft/moist/bland food > Avoid
spicy, acidic foods.
Be aware that eating, swallowing and talking may be difficult (may
, require analgesics)
Encourage pt to use artificial saliva to manage dryness
Apply topical anaesthetics (lignocaine)
Anorexia
• Release of TNF and IL-1 from macrophages has appetite-suppressant
effect.
Therapy-induced GI effects (mucositis, nausea and vomiting, bowel
disturbances) and anxiety reduce appetite.
Management:
• Monitor weight.
• Encourage patient to eat small, frequent meals of high-protein, high-
kilojoule foods.
Hepatoxicity
Toxic effects from chemotherapy medications (usually transient and
resolve when medication is stopped).
Management: Monitor liver function tests.
Anaemia management
• Monitor haemoglobin and haematocrit levels.
• Administer iron supplements and erythropoietin.
• Encourage intake of foods that promote RBC production
Leucopoenia management
• Monitor WBC count, especially neutrophils.
• Tell patient to report temperature elevation and any other symptoms of
infection.
• Teach patient to avoid large crowds and people with infections.
• Administer WBC growth factor
Thrombocytopenia management
• Observe for signs of bleeding (e.g. petechiae, ecchymosis).
• Monitor platelet counts.
• For patient teaching
Alopecia management
• Destruction of hair follicles by chemotherapy or radiation to scalp.
Mangement: .
• Suggest ways to cope with hair loss (e.g. hair pieces, scarves, wigs).
