Chemotherapy Of Malignancy

Mr.B.CHAKRAPANI M.pharm (ph.D) ASSISTANT PROFESSOR DEPARTMENT OF PHARMACOLOGY

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BHARAT INSTITUTE OF TECNOLOGY

MANGALAPALLY,IBRAHIMPATNAM(M), R.R Dist.

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Chemotherapy is a common treatment for a variety of cancers.

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It has proven to be safe and effective.

An understanding of this treatment helps patients better recognize and tolerate side effects, if they occur
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Antineoplastic agents are used in an attempt to destroy tumor cells by interfering with cellular functions including replication.
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Chemotherapy is used primarily to treat systemic disease rather than localized lesions that are amenable to surgery or radiation.
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Working

To understand how chemotherapy works as a treatment, it is helpful to understand the normal life cycle of a cell in the body.
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All living tissue is composed of cells. Cells grow and reproduce to replace cells lost during injury or normal "wear and tear." The cell cycle is a series of steps that both normal cells and cancer cells go through in order to form new cells.
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Assess fluid and electrolyte status (Anorexia, nausea & vomiting, altered taste and diarrhea put patient at risk) Modifying risk for infection and bleeding (suppression of the bone marrow and immune system)

Administering Chemotherapy patient is observed for extravasation (particularly of vesicant agents, which may produce necrosis if deposited in subcutaneous tissues Protect caregivers
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Nursing Management in Chemotherapy

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CELL CYCLE

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The cell cycle phases are: resting (G0; nothing is happening), G1 (or gap 1; a growth phase), S (synthesis; the replication of DNA occurs), G2 (gap 2; another growth phase), and M (mitosis; the actual division from 1 cell into 2).

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Cell Cycle
G2 3-4 h M 1h

S 6-8 h

G1 6-12 h

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S PHASE

S phase the s phase is the phase during Out of sight of most peoples ability to see, the

which dna replication is occurring.

dna is undergoing replication so, at the end of the s phase, there would be two complete sets of dna in the nucleus of that cell.

In the s phase the cell has copied the contents

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G2 PHASE

G2 Phase- In this phase, the cell makes copies of the important organelles found in the cytoplasm. If a cell is going to divided, it needs enough mitochondria, (power plants) endoplasmic reticulum, (highways) and so on to support itself after cell division. If there are not enough mitochondria in one of the new cells, that cell will die and the main purpose of cell division, to make two cells out of one cell, will be for nothing. In G2 phase, the important organelles in the cytoplasm are copied to ensure that the two new cells will have enough organelles each to survive.
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G1 PHASE

G1 Phase This is the phase in which the cell It is the normal phase of the cell. The cell is doing what ever that cell was designed to do. For example: a skin cell would function as a skin cell during G1 and a liver cell would function as a liver cell during G1.
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spends almost all of its time.

PROPHASE

Prophase Spindle fibers form, Chromosomes shorten, thicken and become visible (under a microscope) and the nuclear membrane begins to dissolve.

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METAPHASE

Spindle fibers move the chromosomes, which have their copies wrapped around themselves, to the middle of the nucleus and line them up.

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M-PHASE

M Phase- This phase is the phase during There are four parts to this phase; PROPHASE, METAPHASE, ANAPHASE , TELOPHASE.

which the nucleus divides into two nuclei.

1) 2) 3) 4) )

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ANAPHASE

Spindle fibers shorten and pull the identical chromosomes away from each other to the opposite side of the nucleus.

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TELOPHASE

Spindle fibers dissolve, chromosomes lengthen out and become invisible again, nuclear membrane reforms around both sets of separated chromosomes.

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CYTOKINESIS

The cytoplasm divides leaving you with two identical cells, each with one nucleus.

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NEUROLOGIC SYSTEM Peripheral neuropathies Loss of deep tendon reflexes Paralytic ileus
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MISCELLANEOUS Fatigue Alopecia

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REPRODUCTIVE SYSTEM
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Take effective contraceptive precautions when having chemotherapy, as the chemotherapy drugs might harm the baby if pregnancy occurs.

In some women, chemotherapy brings on an early menopause. This may cause symptoms such as dryness of the vagina and a decreased interest in sex.

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Cancer of Buccal mucosa invading extra-oral tissues following tobacco quid habit

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Second years II-I

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Dr Suwas Darvekar

Cancer of Tongue following tobacco consumption

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Dr Suwas Darvekar

Alveolar cancer after tobacco quid habit

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Dr Suwas Darvekar

ORAL LEUCOPLAKIA PATCH

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Diarrhea can also be a side effect of chemotherapy. Caused by the destruction of normal, dividing cells of the gastrointestinal (GI) tract, diarrhea varies from patient to patient. It is better managed if treated early RENAL SYSTEM Rapid tumor cell lysis- increased urinary excretion of uric acid, which can cause renal damage Myelosuppression- depression of bone marrow function, resulting in decreased production of blood cells. - Decreases the number of RBCs (anemia), WBCs (leukopenia) and platelets (thrombocytopenia)
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Nausea & Vomiting- most common side effects of chemotherapy and may persist for as long as 24-48 hrs. after its administration. Mucositis inflammation of the mucosal lining

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GASTROINTESTINAL SYSTEM
It can cause irritation which can eventually lead to inflammation of the mouth, a condition known as stomatitis .
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A stinging sensation in the throat may develop and lead to dysphagia (difficulty in swallowing).
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Management: qGood oral hygiene

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What are the side effects of Chemotherapy?

SKIN Alopecia q Hair loss occurs because chemotherapy can sometimes damage healthy cells.
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It is so common because hair follicle cells multiply very quickly like cancer cells and chemotherapy drugs have difficulty in discerning the difference.

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Sequence of treatments:
Adjuvant therapy: Therapy given after surgery to reduce the likelihood of the cancer returning.
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Neo-adjuvant therapy: Therapy given before surgery to shrink the tumor, allowing the surgery to be more successful.
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Concurrent therapy: When 2 or more therapies are given together, such as chemotherapy and radiation.
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How is chemotherapy given?

Orally (by mouth, in pill form) qIntravenously (IV, through a vein, either as a short infusion or continuously for one or more days)
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As an injection or needle qDirectly into a body cavity (i.e.: the bladder, abdominal cavity) qIntra-arterially (in special cases, such as limb perfusion treatment for melanoma)
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Rand 50.3

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