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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