Chemo101

1.  
Continuing Education

2.  Identify classifications of chemotherapy.
 Discuss side effects and toxicities of chemotherapy.
 Verbalize an understanding of safe chemotherapy
handling in the home.
 Discuss safe administration of chemotherapy in the
home.
 Identify patient teaching points relating to home
chemotherapy.

3.  Chemotherapy is a category of cancer treatment that
uses chemical substances that are given as part of a
regimen. Most often, the treatment plan will also include
surgery and/or radiation.
 Chemotherapy may be given with the following intent:
o Curing the Cancer
o Slowing the cancer’s growth
o Preventing the cancer from spreading
o Relieving symptoms caused by cancer

4.  The chemotherapy treatment plan is most often given in
cycles, which is determined by the physician.
 The cycle will vary depending on the type of cancer and
type of chemotherapy agent used.
 There is usually a rest period in between the cycles to
allow the body and blood counts to recover before the
next dose of chemotherapy is given.

5.  Depending on the type of cancer and where it is found,
chemotherapy may be given via different routes
including the following:
o Oral
o Subcutaneous
o Intravenous
o Intra-arterial
o Intrathecal/Intraventricular
o Intraperitoneal
o Intrapleural
o Intravesicular
o Intralesional

6.  Some treatment regimes may include the chemotherapy
to be administered via multiple routes simultaneously.
When the route of chemotherapy is not specified or
unclear, clarification of the order is necessary to prevent
a medication error.
 When chemotherapy is given via intravenous route for
an extended period of time, a vascular access device will
be placed. The following are examples of the types of
catheters placed for chemotherapy:
o Mediport
o Peripherally Inserted Central Catheter (PICC)
o Central Venous Catheter (Tunneled or Non-tunneled)

7.  Chemotherapy can be administered in the hospital, out-
patient oncology clinic or in the patient’s home. The setting
will be determined by the type of chemotherapy agent used,
physician preference, patient’s insurance and safety profiles
of the chemotherapy agents needing to be administered.

8.  Besides being classified as cell cycle-specific
(chemotherapy kills cells that are in a specific phase
and actively dividing) or non-specific agents, cytotoxic
drugs are also classified based on their biochemical
structure and mechanism of action.
 Classifications of cytotoxic drugs include the following:
o Alkylating Agents
o Antimetabolites
o Antitumor Antibiotics
o Plant Alkaloids
o Hormone Therapy
o Biological Cancer Therapies

9.  Interfere with DNA replication to prevent cancer cells
from reproducing
 Most alkylating agents are cell cycle non-specific
 Alkylating agents can produce major toxicities affecting
the hematopoietic, gastrointestinal and reproductive
systems
 These drugs are active against chronic leukemia, non-
Hodgkin’s lymphoma, Hodgkin’s lymphoma, multiple
myeloma and some cancers of the lung, breast and
ovary
 Examples of alkylating agents include the following:
carboplatin, cisplatin and ifosfamide

10.  Interfere with DNA and RNA growth.
 Most antimetabolites are cell cycle specific.
 Antimetabolites can produce major toxicities affecting the
hematopoietic and gastrointestinal systems.
 Antimetabolites are used to treat chronic leukemias as
well as tumors of the breast, ovary and gastrointestinal
tract
 Examples of antimetabolites include the following: 5-
fluorouracil, capecitabine and methotrexate

11.  Interfere with DNA by stopping enzymes needed for cell
division or by altering the membranes that surround
cells.
 Antitumor Antibiotics are cell cycle non-specific.
 Antitumor Antibiotics can produce major toxicities
affecting the hematopoietic, gastrointestinal,
reproductive, and cardiovascular systems.
 Examples of antitumor antibiotics include the following:
mitomycin-C, doxorubicin and daunorubicin

12.  Inhibit cancer cell growth by preventing cellular mitosis
or division.
 Most plant alkaloids are cell cycle specific
 Plant Alkaloids can produce major toxicities affecting the
hematopoietic, integumentary, neurologic and
reproductive systems.
 Examples of plant alkaloids include the following:
vincristine, vinblastine, and vinorelbine.

13.  A systemic therapy that works to add, block or remove
hormones from the body to slow or stop the growth of
cancer cells.
 There are two types of hormonal agents: corticosteroids
and sex hormones
 Corticosteroids are used to treat leukemia, multiple
myeloma and lymphoma and are used to reduce
swelling around tumors of the brain and spinal cord. Ex:
Prednisone & Dexamethosone
 Sex hormones are used to control the growth of breast,
uterine and prostate cancer. Ex: Tamoxifen & Leuprolide
 Can have a range of side effects depending on type of
cancer involved (hot flashes, decreased sex drive, mood
changes, joint/muscle pain and osteoporosis).

14.  Strengthen the body’s immune system to fight the growth
of cancer.
 Various biological response modifiers include
monoclonal antibodies, immunotherapy, oncolytic viral
therapy, cytokines.
 These drugs are active against breast cancer, non-
Hodgkin’s lymphoma, leukemia, renal cell carcinoma and
malignant melanoma.
 The side effects can often include the following: flu-like
symptoms (chills, fever, muscle aches, weakness), loss
of appetite, nausea, vomiting and diarrhea.
 Some patients develop a rash and some bleed or bruise
easily.
 Examples include Herceptin, Avastin, Erbitux and
Rituxan.