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Understanding chemotherapy
 

Understanding chemotherapy

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guide for cares of children on chemotherapy

guide for cares of children on chemotherapy

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    Understanding chemotherapy Understanding chemotherapy Presentation Transcript

    • UNDERSTANDING CHEMOTHERAPY Managing Side Effects by MARIA SUGA A. DIOKO, MD
    • What is Cancer?
      • CANCER: A disease of the body’s cells
      • Normal: body constantly making new cells- to enable us to grow , to replace worn out cells or to heal damaged cells after an injury
      • Cells grow uncontrolled- tumor/leukemias
    • Treatment of Cancer
      • Surgery
      • Chemotherapy
      • Radiotherapy
    • Chemotherapy
      • Use of drugs to kill or slow the growth of cancer cells
      • Many different types of chemotherapy drugs
      • Commonly used drugs in ALL
        • Prednisone
        • Vincristine
        • Doxorubicin
        • L-asparaginase
        • Cytarabine
        • Cyclophosphamide
        • Methotrexate
        • 6 mercaptopurine
    • Why have chemotherapy?
      • Cure
        • Sometimes in combination with surgery and radiotherapy
      • Adjuvant
        • To make the cancer smaller so the other treatment can be more effective
      • Palliative
        • Relief of symptoms
        • For people with advanced cancer who cannot be cured but want to live comfortable and without undue pain
    • How chemotherapy works
      • Stop cancer cells from growing and multiplying
      • Affects also normal cells that multiply rapidly – hair cells, cells lining the mouth and blood cells
    • Fear of Chemotherapy
      • Natural to be worried
      • Terrible stories
      • BUT!!!
      • Everyone is different and reacts differently to chemotherapy
      • Tailored therapy
    • How chemotherapy is given
      • Intravenous
      • By mouth (tablets
      • Injection into a muscle (IM)
      • Injection under the skin (SQ)
      • Injection into the fluid around the spine (IT)
    • Intrathecal Chemotherapy
    • Does it hurt?
      • IV chemotherapy- Like having blood taken
      • It should not hurt after the initial injection
    • Chemotherapy is time consuming
      • Waiting and waiting
      • Read a book or magazine
      • Listen to music
      • Talk to a companion
      • Write in a journal
      • Do crafts
    • Managing Side Effects
      • Most important effect of chemotherapy: it kills cancer cells
      • Can also affect normal cells - cause unwanted side effects
      • Usually start during the first few weeks of treatment
      • Most can be managed and go away in time
    • Side Effects of Chemotherapy
      • Vary greatly
      • Some will have no side effects
      • Complimentary/Alternative medicine?
    • Common Side Effects of Chemotherapy
      • Feeling tired and lacking energy
      • Feeling sick or vomiting
      • Constipation or diarrhea
      • Mouth sores
      • Hair loss and scalp problems
      • Itchy skin and other skin problems
      • Nerve and muscle effects
      • Change in hearing
      • Effects on the blood and immune system
      • Fertility problems
    • Feeling tired and lacking energy
      • Exhausted, tired, sleepy, drowsy, confused, impatient
      • TIPS:
        • Plan your day
        • Save energy. Don’t do more than you can comfortably do
        • Take short naps or breaks
        • Take short walks or do light exercise
        • Let other people help you
    • Feeling sick or vomiting
      • Not everyone
      • Usually starts a few hours after treatment and may last many hours
      • If continues for a few days – go to your doctor
      • Changes to eating pattern
    • Feeling sick or vomiting
      • TIPS
        • Eat a light meal before the treatment
        • Drink small but frequent fluids.
        • Small but frequent food
        • Avoid food that usually upset stomach
        • Eat slowly and chew well
    • Feeling sick or vomiting
      • TIPS
        • Jellies, weak tea, fresh fruit juices, ice cubes
        • Eat dry toast or crackers
        • Avoid odors – cooking smell, perfume, alcohol
      X
    • Feeling sick or vomiting
      • Don’t do anything strenuous after a meal
      • Elevate head after eating
      • Try breathing thru the mouth when you feel sick
      • Ask for medications
      • Let your child wear loose clothing
      • Bring plastic bags
      • Use distractions – TV, music, games
    • Constipation
      • Eat more high-fibre foods such as wholegrain bread and pasta, fruit and vegetables
      • Drink plenty of fluids
      • Get some light exercise
      • Eat small, frequent snacks instead of big meals
    • Diarrhea
      • May need admission
      • Drink plenty of fluids
      • Take: clear broth and toast, biscuits and cheese or cooked rice
      • Avoid: spicy foods, fatty or fried foods, rich gravies and sauces, raw fruit or vegetables with skins or seeds
      X
    • Mouth Sores
      • Soft toothbrush.
      • Mouthwash without alcohol
      • Gargle 4 x a day: 1 teaspoon of salt + 1 glass of water
      • Dry mouth: Sip fluids, eat soft foods, blend food, soups, ice cream, moisten foods with butter
    • Hair Loss and Scalp Problems
      • Varies from person to person
      • Usually starts 2 to 3 weeks after the first treatment
      • Wear a wig or a scarf
    • Hair Loss and Scalp Problems
      • Keep it clean
      • Use mild shampoo – baby shampoo
      • Comb using a large comb or brush with soft bristles
      • Use hat or scarf to protect head from the sun
      • Use cotton pillowcase
      • Avoid hair perms and dyes
      • Limit use of dryers
    • Hair Loss and Scalp Problems
      • Emphasize that it temporary and that it will grow back
      • Hair loss is quite variable
      • Separate your feelings from your child’s
      • Let it okay to be bald
    • Itchy skin and other skin problems
      • Skin may darken, peel or become dry and itchy
      • May be sensitive to the sun
      • Protect your skin from the sun
      • Dust cornflour over the itchy part
      • Use lotion or cream to stop the dryness
    • Effects on the Immune Blood and Immune System
      • The bone marrow makes 3 kinds of blood cells
        • White blood cells
        • Red blood cells
        • Platelets
      • Chemotherapy can lower your blood count
        • Infection
        • Bleeding
        • Anemia
    • What is ANC?
      • This provides an indication of the child’s ability to fight infection
      • To get ANC, multiply percentage of neutrophils by the total WBC
      • Example
        • Total WBC = 1000
        • Neutrophils = 50%
        • ANC = 500
    • How to protect the child with a low ANC?
      • Thorough hand washing for every member of the family
      • Make sure all medical personnel wash their hands before touching your child
      • Keep child’s diaper area clean and dry
      • Whenever your child needs a needle stick, make sure the technician cleans the skin thoroughly with alcohol
    • How to protect the child with a low ANC?
      • Small cuts – wash with soap and water and rinse with hydrogen peroxide
      • No rectal thermometers, no rectal suppositories
      • No routine immunizations
      • Siblings should not be give live vaccines
      X
    • Urgent!
        • Fever over 38 C or chills
        • Sweating esp at night
        • Easy bruising or any unusual bleeding
        • Sore throat
        • Mouth ulcers
        • Persistent or severe vomiting more than 24 hours after treatment
    • Urgent!
        • Severe constipation, diarrhea or abdominal pain
        • Burning or stinging on passing urine
        • Tenderness, redness, or swelling in the injection site
        • Any unexpected side effects of sudden deterioration in health
    • Thank You