Question

Tom has cancer and is undergoing chemotherapy. He is 5 foot 8 inches tall and weighs 160 pounds. After his chemotherapy treatments, Tom feels nauseated and has loss of appetite. He also complains of his tongue being red, swollen, and sore.

1. Is this an expected effect of antineoplastics? Explain why or why not.

2. What suggestions do you have to help with his dietary intake?

3. Can Tom expect alopecia from all types of chemotherapy? Why or why not?

4. How do you explain to Tom what stage II carcinoma indicates?

5. The physician has ordered Tom to receive vincristine 1.2 mg/m2. Using the nomogram below, or on page 161 of your textbook, calculate the dose of vincristine that is to be given.

Answer 1

Cancer chemotherapy use wide range of group of drugs which have a lot of side effects on the patient body systems. Antineoplastic agents are drugs used kill the cancer cells and prevent the multiplication of the cells.Sometimes these drugs can affect the normal cells also and cause various side effects in the patient.

1.  Chemotherapy-induced nausea and vomiting is one of the common side effects in patients during cancer treatment because cells in the gastrointestinal tract are fast-growing, so these normal cells most likely to be destroyed by chemotherapy. A loss of appetite is also seen as a result of the antineoplastic drug effect on the gastrointestinal lining cells and from the metabolic changes caused by the cancer in the body. Thus nausea and vomiting experiencing by the patient can be an expected effect of antineoplastic drugs.

2. The patients with nausea and loss of appetite following chemotherapy can be supported by scheduled eating times with high calorie, high protein food which can help them with gain energy, repair cell damage and reduce fatigue. A bland or diet with appealing food items can be given,Avoid smells that trigger nausea and decrease appetite can be advised for patients with increased nausea and other gastrointestinal symptoms.Additional supplements that contain fish oil or eicosapentaenoic acid, or EPA can be provided to correct and maintain altered metabolism due to cancer and its treatment.

3. Tom can expect alopecia from all types of chemotherapy because hair follicles are fast growing cells,so the cancer drugs can accidentally kill these cells along with abnormally proliferating cancerous cells which can cause hair loss.

4. Stages of cancer indicate the size of the tumor and the extent of spread of cancer in the body according to TNM classification of tumor. There are five stages of cancer stage 0( pre cancerous cells) , stage 1(Small tumor without spread), stage 2, stage 3, and stage 4. Lower stages where the disease is more localized, and higher stages where cancers spread to other parts of the body.

Stage two cancer tumor are bigger in size than stage 1 tumors and it is localized in the organ of origin and not spread to surrounding tissue or lymph nodes. According to the type of the cancer, some can involve few cells of the surrounding muscles and tissues and nearby lymph nodes but not spread to distant parts of the body.