Cancer is a global issue majorly affecting developing countries. According to a survey, 63% of deaths due to cancer are reported from developing countries. There are different conventional treatment modalities that are available to treat and manage cancer. However, new cancer treatment options are being explored continuously as over 60% of all current experimental trials worldwide are focusing on tumor cure. The success of treatment depends upon the type of cancer, locality of tumor, and its stage of progression. Surgery, radiation-based surgical knives, chemotherapy, and radiotherapy are some of the traditional and most widely used treatment options. Some of the modern modalities include hormone-based therapy, anti-angiogenic modalities, stem cell therapies, and dendritic cell-based immunotherapy.
A standout among the best cancer treatment modalities is the gene therapy which is direct in situ insertion of exogenous genes into the tumors which could give a powerful remedial way for the treatment of benign tumors. Similarly, hormonal treatments are also widely used for cancer malignancies and generally considered as cytostatic. Hormonal treatment restricts tumor development by limiting hormonal growth factors. It most likely acts via the down direction of hypothalamic-pituitary-gonadal axis, blockage of hormone receptor, and restraint of adrenal steroid synthesis.
2. INTRODUCTION
The method of treatment depends up on the type of malignancy,
the specific histologic cell type, stage, presence of metastasis
and condition of the patient .
4. CHEMOTHERAPY
Chemotherapy is the use of drugs to kill tumor cell by interfering
with cellular functions and reproduction. In Chemotherapy
Anti neoplastic agents are used in an attempt to destroy tumor
cells by interfering with cellular functions. The purpose of
treating cancer cells with chemotherapy is to prevent these cells
from multiplying, invading and metastasizing to distant sites.
Chemotherapy may be combined with surgery or radiation
therapy or both.
6. Cure : Total elimination of cancerous cells.
Control: To extend the life of patient when cure not
possible.
Palliation: When the cancer is at an advanced stage,
chemotherapy drugs may be used to relieve symptoms
caused by the cancer.
7. CLASSIFICATION OF CHEMOTHERAPEUTIC
DRUGS
Alkylating agents: Common drugs Chlorambucil,
Cyclophosphamide, Cisplatin, Carboplatin.
Anti metabolite agents: 5-Flurouracil , hydroxyurea
Anti tumor antibiotics: Bleomycin, mitomycin,
Doxorubicin.
Plant alkaloids: Plant alkaloids are cytotoxic agents derived
from plant extracts
Vinblastine, vincristine.
10. PLANNING DRUG DOSE AND SCHEDULES
Dose – Most of the chemodrugs are measured in milligrams
(Mg). The overall dose is sometimes based on persons body
weight.
Schedule- Chemotherapy is generally given at regular
intervals called cycles.
11. NURSING MANAGEMENT FOR PATIENT
UNDERGOING CHEMOTHERAPY
Patient should be protected from infection
Wash hands regularly with antibacterial agent
Avoid crowds and people with cold
Maintain good nutritional status
Antiemetics should be administered one hour prior to
chemotherapy
Body weight should be measured at least twice a week
Patient should be clearly assessed for side effects .
12. BONE MARROW TRANSPLANTATION
A bone marrow transplant involves taking cells that are
found in the bone marrow, filtering those cells, and
giving them back either to the patient or to another
person.
13. NURSING MANAGEMENT FOR PATIENT
UNDERGOING BONE MARROW THERAPY
Monitor vital signs and observe for dyspnea, chest pain, chills
Monitor patient for signs of infection
Observe patient for signs of bleeding
Balanced fluid and electrolyte status has to be maintained.
14. RADIATION THERAPY
Radiation therapy is the use of certain type of energy to kill
cancer cells and shrink tumors. Radiation therapy injures or
destroys cells in the area being treated by damaging their
genetic material.
16. EXTERNAL RADIATION THERAPY
External radiation therapy also called teletherapy, is administered
by a machine at a certain distance from the specific area of
body.
External radiation therapy is used to treat most types of cancer,
including cancer of the bladder, brain, breast, cervix, larynx,
lung, prostate and vagina. In addition external radiation maybe
used to relieve pain.
17. INTERNAL RADIATION THERAPY
Internal radiation therapy also called brachytherapy, is a
radiation technique in which the specific radioisotopes placed
directly near the tumor.
The radiation source is usually sealed in a small holder called an
implant. Implant may be in the form of thin wires, plastic tube
called catheters, capsule.
For internal radiation therapy, the patient says in the hospital for
a few days. The implant may be temporary or permanent. Once
an implant is removed, there is no radioactivity in the body
18. MOST COMMON SIDE EFFECTS OF
RADIATION THERAPY
Skin reaction- Common side effect of radiation is skin
irritation in the area of the body being treated.
Skin reaction can range from mild redness and dryness to
severe peeling.
19. PRECAUTIONS THAT MAY MINIMIZE SKIN
IRRITATION
Keep the treated area dry
Wash the skin in the treatment area only with mild soap
Use a mild shampoo, such as baby shampoo, if the head is
being treated
Do not use perfumes, deodorants
Wear loose fitting clothing that does not rub the skin in the
treated area.
20. FATIGUE
Feeling of tiredness, weakness. Fatigue is typically more severe
two to four hours after treatment
Following suggestions may help you to manage fatigue
Limit your activities
Exercise each day to maintain your strength
Drink three litres of fluid each day to prevent the buildup of
cellular waste products
Increase rest by getting more sleep at night .
21. Nausea and vomiting
Loss of appetite
Taste changes.
22. NURSING MANAGEMENT OF PATIENT
UNDERGOING RADIATION THERAPY
Reassure the patient by clearing all the fears about the effects of
radiotherapy.
Explain procedure to the patient like equipment to be used,
duration of procedure.
If radio-implant is used for radiotherapy, patient should be
informed about restriction of movements.
Oral mucosa and skin of the patient assessed frequently to rule
out side effects.
Skin is protected from radiation.