Minimizing the Side Effects Of Chemotherapy. Atif Hussein, MD, MMM, FACP Memorial Cancer Institute Hollywood, FL

Minimizing the Side Effects Of Chemotherapy Atif Hussein, MD, MMM, FACP Memorial Cancer Institute Hollywood, FL The Cell Cycle The Cell Cycle Canc...
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Minimizing the Side Effects Of Chemotherapy Atif Hussein, MD, MMM, FACP Memorial Cancer Institute Hollywood, FL

The Cell Cycle The Cell Cycle

Cancer Cell Characteristics • • • • • • •

Unchecked & Uncontrolled Growth Loss of contact inhibition Loss of capacity to differentiate Increased growth fraction Chromosomal Instability Capacity to metastasise Altered biochemical properties

Chemotherapy Side Effects • Chemotherapy targets cells which are dividing rapidly. • Chemotherapy cannot distinguish between normal cells and cancer cells • Healthy Cells which have a high rate of growth and multiplication include cells of the bone marrow, hair, GI mucosa and skin.

Chemotherapy Side effects • Side effects may be drug specific e.g. anthracyclines and cardiotoxicity, vinca alkaloids and neuropathy/constipation, bleomycin and pulmonary fibrosis • Severity of side effects varies between drugs. • Side effects often occur 7-14 days post treatment.

COMMON CONCERNS WITH CHEMOTHERAPY • • • • • • • • • •

Nausea and Vomiting Infection Bleeding Peripheral neuropathy Diarrhea Constipation Mucositis Fatigue Fluids Nutrition

• Skin care

• Hand-Foot syndrome • Emotional needs • Stress • When to call the nurse

Side Effects: Gastro-Intestinal • • • • •

Nausea & Vomiting Diarrhea & constipation Loss of appetite Taste Changes Mucositis

Everyone Worries About Nausea and Vomiting • Not everyone experiences nausea. • Nausea and vomiting can occur before, during or for several days after receiving treatment. • Take anti-nausea medication as prescribed. • Let your nurse or doctor know if you’re unable to keep medications down, drink fluids, or your anti-nausea medication doesn’t work.

Nausea and Vomiting: Patient-specific risk factors • Higher-risk groups: – Young – Female – High pretreatment expectation of nausea

• Negative risk factor: high alchohol consumption

Nausea and Vomiting: Stratification • High (level 4) – >90% risk of emesis without treatment

• Moderate (level 3) – 31-90%

• Low (level 2) – 10-30%

• Minimal (level 1) –

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