by: Mrs. Theresa Margarita Marivee L. Saldevar RADIATION THERAPY
also called radiotherapy, X-ray therapy, or
irradiation is the use of ionizing radiation to kill cancer cells and shrink tumors may be used to treat almost every type of solid tumor, including cancers of the brain, breast, cervix, larynx, lung, pancreas, prostate, skin, stomach, uterus, or soft tissue sarcomas Types of Radiation Therapy External Beam Radiation Therapy (EBRT) - also known as teletherapy - utilizes X-rays, electron beams and beta or gamma radiation produced by radioactive isotopes - uses ionizing radiation to destroy malignant tissue and/or slow down the development of abnormal cells Internal Radiation Therapy - involves placement of specially prepared radioisotopes directly into or near the tumor itself or into the systemic circulation Brachytherapy or Sealed Source - involves using a sealed source of radioactivity in the form of isotope rods that can be implanted directly into a tumor or body cavity delivering radiation to a localized area - radioactive needles or wires are implanted into tumors of the tongue, floor of the mouth and breast, vagina, cervix, lower uterus, rectum or anus and prostate Unsealed Sources or Systemic Radionuclide Therapy involves injecting radioactive isotopes either into a vein or into an organ one of the most common types of systemic radiation therapy is radioactive iodine given to treat cancers of the thyroid and bones Side Effects of Radiation Therapy Area of the Effect Body Head and Neck Irritation of the mucous membranes, stomatitis, oral pain and infection, loss of taste, increased ICP Skin Change in color or texture, alopecia, erythema, pruritus Chest Inflammation, infection, tissue destruction Abdomen Anorexia, N/V, diarrhea Pelvis Cystitis, urethral and rectal stenosis, diarrhea, sexual dysfunction Blood Bone marrow depression, anemia, leucopenia, thrombocytopenia, compromised immune function General Fatigue Radiation Safety Precautions Place the client in a private room. Plan care well so minimal time is spent in direct contact with client with implant. Provide care for client standing at client’s shoulder or at foot of bed. Use lead aprons/shield. The room should be marked with appropriate signs stating the presence of radiation. Carefully check all linens or other materials removed from the bed for the presence of foreign bodies. Keep long-handled forceps and a lead-lined container available on the nursing unit. Nursing Responsibilities Carefully assess client and take medical history Provide education: common side effects, skin changes, effects on bone marrow, procedure Maintain good nutrition Provide rest and sleep Monitor blood counts Prevent skin irritation Prevent injury and infection BONE MARROW TRANSPLANTATION Also known as Hematopoietic stem cell transplantation
Involves taking cells
that are normally found in the bone marrow (stem cells), filtering those cells, and giving them back either to the patient or to another person Bone Marrow Transplantation Indications: leukemias, severe aplastic anemia, lymphomas, multiple myeloma, immune deficiency disorders, solid-tumor cancers, such as breast or ovarian Types of bone marrow transplants: autologous bone marrow transplant allogeneic bone marrow transplant umbilical cord blood transplant Nursing Responsibilities Discuss special preparation Describe the harvest procedure Explain what happens after recovery: 1. Pain in harvest sites 2. Application of pressure dressings 3. Keep surgical sites clean and covered for 3 days IMMUNOTHERAPY Also known as Biologic Response Modifiers (BRM) Biotherapy a diverse set of therapeutic strategies designed to induce the patient's own immune system to fight the tumor Types of Immunotherapy: Interferons: activate NK cells
Interleukins: activate production of NK cells,
cytotoxic T cells Tumor Necrosis Factor (TNF): attaches to tumor cell membrane, causing cell damage Growth Factors: Granulocyte-colony stimulating factor: promotes growth of neutrophils Granulocyte-macrophage colony stimulating factor : promotes growth of macrophages and monocytes Erythropoietin (EPO): enhances erythrocyte growth Monoclonal Antibodies (MoAb): bind only to cancer cell-specific antigens and induce an immunological response against the target cancer cell Hormonal Therapy Androgens Testosterone Replacement therapy for Have some antiestrogen Males:Impotence, gynecomastia, propionate males, treat properties, making it epididymitis, bladder dysmenorrheal and useful to treat estrogen- irritation menopause in dependent breast cancers Females: hirsutism, amenorrhea, women, inoperable masculinization breast cancer in Both: N/V, fluid retention women Anti-androgens Flutamide To treat metastatic Antagonizes androgen effects at Diarrhea, nausea, vomiting, loss of (Eulexin) prostate cancer cellular level libido, impotence, gynecomastia, hot flushes, edema, hypertension Estrogens Diethylstilbestrol Postmenopausal Supplements estrogen N/V, anorexia, abdominal (DES) syndrome, distention, spotting, amenorrhea due to menstrual changes, fluid ovarian failure, retention, breast tenderness prostatic cancer Anti-estrogens Tamoxifen citrate Treat estrogen receptor Act as estrogen antagonist Rare bone marrow depression, (Nolvadex) positive breast menstrual irregularity, hot cancer flashes Synthetic Leuprolide Prostate cancer, used in Initially stimulates but then Dizziness, headache, decreased lutenizing acetate clients who cannot inhibits release of follicle- libido, impotence, anorexia, hormone (Leupron) tolerate an stimulating hormone and bone pain, paresthesias orchiectomy or luteinizing hormone estrogen therapy Miscellaneous Paclitaxel (Taxol) Metastatic breast and Inhibits microtubular function, Bone marrow depression, antineoplastic ovarian cancer causing cell death hypersensitivity reactions, peripheral neuropathy, N/V Angiogenesis Inhibitors prevent the extensive growth of blood vessels (angiogenesis) that tumors require to survive Example of drugs: bevacizumab Symptom Control/Palliative Care Pain management Reconstructive interventions Supportive care Shift your problems to challenges. When you have problems, you worry about them. When you have challenges - you are working, applying, and attacking thank you very much… your plan to get results. This shift in thinking from