Ch. 32-Drugs Used in the Treatment of Cancer

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CHAPTER
32
Drugs Used in the
Treatment of Cancer
 cells reproduce for tissue growth and repair, cells divide
in an orderly way.
 cell division and growth can be out of control, a mass or
clump of cells develops
 this new growth of abnormal cells is called a tumor
 tumors are benign or malignant
 malignant tumors (cancer): invade and destroy nearby
tissue (fig 32-2), can spread to other body parts, may be
life-threatening, sometimes will grow back after removal
 benign tumors: do NOT spread to other body parts, can
grow to a large size but rarely threaten life, usually do not
grow back when removed
 metastasis: spread of cancer to other body parts (fig 32-3),
cells break off of tumor and travel to other part of body,
new tumors grow in other body parts, this occurs if cancer
is not treated and controlled
 cancer can occur almost anywhere
 common sites: skin, lung, bronchus, colon, rectum,
breast, prostate, uterus, ovary, urinary bladder, kidney,
mouth, pharynx, pancreas, thyroid gland (fig 32-4)
 cancer is 2nd leading cause of death in United States
 certain factors increase risk of cancer:
 growing older: cancer occurs at all ages, most occur in
persons 65 years or older
 tobacco: includes smoking, snuff, chewing tobacco, and
being around tobacco smoke.
 sunlight: sun, sunlamps and tanning booths cause early
aging of skin and skin damage, these can lead to skin
cancer. Time in sun should be limited
certain factors increase risk of cancer cont….
 ionizing radiation: can cause cell damage that leads to
cancer, X-rays are one source, so is radon gas that forms in
soil and some rocks, people who work in mines are at risk,
radon is found in homes in parts of the country.
Radioactive fallout is another source, it can come from
nuclear power plant accidents, also from
producing/testing or use of atomic weapons
 certain chemicals and other substances: painters,
construction workers, and those in chemical industry are
at risk. Household substances also contain risk- paint,
pesticides, used oil
 some viruses and bacteria: infection from viruses
increases the risk of these cancers-cervical, liver,
lymphoma, leukemia, Kaposi’s sarcoma, stomach
certain factors increase risk of cancer cont….
 certain hormones: hormone replacement therapy for menopause
may increase risk of breast cancer. Diethystilbestrol (DES), a form of
estrogen, was given to pregnant women between 1940-1971. women
who took this are at risk for breast cancer, their daughters are at risk
for a certain type of cervical cancer
 family history of cancer: certain cancers tend to occur in families,
including: melanoma, and cancers of breast, ovary, prostate and
colon
 alcohol: risk of certain cancers increases with more than 2
drinks/day. Cancers include: mouth, throat, esophagus, larynx, liver
and breast. Women should have no more than 1 drink/day
 poor diet, lack of physical activity, being overweight: high-fat diet
increases the risk of cancers of colon, uterus, prostate. Lack of
activity and being overweight increase risk of : breast, colon,
esophagus, kidney, uterine cancers
 if detected early cancer can be treated and controlled (box
32-1, signs/symptoms of cancer)
 treatment depends on type of tumor, its site and size, and
if it has spread
 goal of cancer treatment:
 cure cancer
 control disease
 reduce symptoms as long as possible
 cancer treatments also damage healthy cells and tissues
 side effects depend on type and extent of treatment
 surgery: removes tumors, done to cure or control cancer,
can relieve pain from advanced cancer, some surgeries are
disfiguring, self-esteem and body image are affected
 radiation therapy: kills cells, x-ray beams are aimed at
tumor, sometimes radioactive material is implanted in or
near tumor, cancer cells and normal cells receive radiation
and both are destroyed
 radiation therapy:
 destroys certain tumors
 shrinks a tumor before surgery
 destroys cancer cells that remain in area after surgery
 controls tumor growth to prevent/relieve pain
 side effects depend on area being treated
 fatigue is common, extra rest is needed
 discomfort, nausea, vomiting, diarrhea and loss of
appetite are other side effects
 chemotherapy: involves drugs that are used to kill cells
 it’s used to:
 shrink a tumor before surgery
 kill cells that break off the tumor, goal is to prevent
metastasis
 relieve symptoms caused by cancer
 cancer cells and normal cells affected
 side effects depend on drug used:
 hair loss (alopecia)
 GI irritation, poor appetite, nausea, vomiting, diarrhea,
stomatitis: inflammation of mouth, may occur
 bone marrow depression (decreased production of blood
cells) bleeding and infection are risks
 person may feel weak and tired
 hormone therapy: prevents cancer cells from getting or
using hormones needed for their growth
 drugs are given to prevent the production of certain
hormones, organs or glands that produce a certain
hormone are removed
 side effects of hormone therapy:
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fatigue
fluid retention
weight gain
hot flashes
nausea
vomiting
appetite changes
blood clots
fertility can be effected in men and women
men may experience impotence and loss of sexual desire
 biological therapy: (immuno-therapy)
 helps immune system fight the cancer
 protects body from the side effects of treatment
 side effects include:
 flu-like symptoms
 chills
 fever
 muscle aches
 weakness
 loss of appetite
 nausea
 vomiting
 diarrhea
 bleeding, bruising and swelling may occur
 Drug therapy for Cancer:
 chemotherapy is most effective when tumor is small and
when cells rapidly divide
 agent used depends of type of tumor cells, rate of growth
and tumor size
 see pgs 390-396 for chemotherapeutic
Delegation Guidelines
Drugs Used in the Treatment of Cancer:
Some drugs used to treat cancer are given parenterally- by
subcutaneous, intramuscular or intravenous injection. Because
you do NOT give parenteral dose forms, they are NOT
included in this chapter. Should a nurse delegate the
administration of such to you, you must:
- remember that parenteral dosages are often very different
from dosages other routes
-Refuse the delegation. Make sure to explain why. Do NOT just
ignore the request. Make sure the nurse knows that you cannot
give drug and why
Your state and agency may allow you to give some oral dose
forms. Make sure you receive the necessary education about
any chemotherapy agents that you will give
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