Chemotherapy treatment

The anxiety or fears the patient may have regarding chemotherapy treatments... 

The performance status of the patient represents an important aspect of chemotherapy treatment decisions. Patients with a performance status of 0 to 1 maybe treated with chemotherapy. Patients with a performance status of 2 maybe treated with less aggressive regimens that have a decreased risk of major toxici-ties, whereas performance status 3 and 4 patients should be treated with supportive care only. 

Judicious selection of treatment options to avoid long-term toxicity because patients may require several different chemotherapy treatment regimens over a period of years for low-grade NHL... 

Recommend the appropriate surgical and chemotherapy treatment options for newly diagnosed and relapsed ovarian cancer patients. 

FIGURE 91-3. Summary of chemotherapy treatment algorithm for epithelial ovarian cancer. CR, complete response PR, partial response PD, progressive disease. 

This 67-year-old patient was optimally debulked and completed six cycles of paclitaxel/carboplatin after her surgery. HerCA-125 normalized (12 U/mL, 12 kU/L) on completion of her chemotherapy treatment, and her CT scan was negative. This patient returns to your clinic for her first 3-month follow-up appointment. Her CA-125 is (45 U/mL, 45 kU/L), and she reports some mild bloating. CT scan report states mild fluid accumulation in the pelvic cavity. 

List the possible chemotherapy treatment options for this patient... 

Treatment of anaemia associated with chronic disease Treatment of anaemia associated with cancer/chemotherapy Treatment of anaemia associated with prematurity To facilitate autologous blood donations before surgery To reduce transfusion requirements after surgery To prevent anaemia after bone marrow transplantation... 

Cancer patients on chemotherapy Treatment of patients with grossly elevated serum erythropoietin levels (eg, greater than 200 milliunits/mL) is not recommended. Monitor hemoglobin on a weekly basis in patients receiving epoetin alfa therapy until... 

Pegram MD, Lipton A, Hayes DF, et al. Phase II study of receptor-enhanced chemosensitivity using recombinant humanized anti-pl 85HER2/neu monoclonal antibody plus cisplatin in patients with HER2/ neu-overexpressing metastatic breast cancer refractory to chemotherapy treatment. J Clin Oncol 1998 16 2659-2671. 

Indications Treatment of anemia associated with chronic renal failure. Treatment of anemia related to therapy with zidovudine. Treatment of anemia in cancer patients on chemotherapy. Treatment of anemic patients scheduled to undergo elec-... 

If chemotherapy-associated nausea and vomiting are not well controlled, some patients develop nausea and vomiting in anticipation of their next chemotherapy treatment. This conditioned response, once it occurs, is often difficult to treat. Adequate early antiemetic treatment, particularly with regimens that include a benzodiazepine, may prevent this reaction. 

Chronic gout can be caused by (1) a genetic defect, for example, one resulting in an increase in the rate of purine synthesis, (2) renal deficiency, (3) Lesch-Nyhan Syndrome,4 or (4) excessive synthesis of uric acid associated with cancer chemotherapy. Treatment strategies for chronic gout include the use of uricosuric drugs that increase the excretion of uric acid, thereby reducing its concentration in plasma, and the use of allopurinol, which is a selective inhibitor of the terminal steps in the biosynthesis of uric acid. 

Mrs KT, a 52-year-old hospital cleaner, is admitted as an inpatient to your oncology ward with symptoms from advanced colon cancer. Her GP referred her to the hospital oncology team three weeks ago for investigations (including colonoscopy and subsequent biopsy of a colonic mass, as well as whole body computerised tomography (CT) scan) that revealed stage IV metastatic colon cancer. Her consultant oncologist has now admitted her for FOLFOX systemic cytotoxic chemotherapy treatment. 

Apart from basic information such as name of drug, its purpose (laxative) and the dose and frequency it should be taken, it is important to impress on Mrs CR the necessity to not increase the dose beyond that prescribed unless recommended by her GP or hospital doctor. Unless she was to develop diarrhoea (which is possible while on chemotherapy treatment), she should be counselled to continue taking senna while on morphine treatment. 

It is also important to educate and counsel Mrs CR on the chemotherapy treatment she is receiving and the possible side-effects, as well as how to manage them. It is imperative, however, to ensure that any communication from the clinical pharmacist is in line with that already provided by other health professionals, especially clinicians and nurses. Briefly, this advice should include ... 

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