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

Antineoplastic agents are the group of drugs used to destroy the fast proliferating cancer cells in the body. They are not specific to the cancer cells and sometimes can kill the normal cells of the body like cells of digestive tract, hair follicles etc and can leads to unpleasant side effects.

1. Nausea, loss of appetite and sore mouth can be expected in patients followed by antineoplastic drugs because they can destroy the normal cells of oral mucosa and gastrointestinal tract along with the cancer tumor cells This can be also induced due to the metabolic changes occur in the body by the cancer progression.

2. As the patients under treatment for cancer has altered metabolism due to the disease condition and the treatment involves lots of side effects due to increased cell damage, the patients need to consume a diet with high calories and high protein. This diet pattern will helps to reduce weigh loss and repair the damaged tissues in the body. They need to avoid high spicy, high fatty and high fiber containing food and should consume protein rich food like eggs, low-fat dairy, beans, and fish along with other additional supplements and multivitamin supplements.Plan the diet menu with small frequent meals, avoid bland flavors, and try appealing food which reduce nausea and improve appetite.

3. Patients under chemotherapy treatment with antineoplastic agents can experience alopecia. The chance of destruction of hair follicles by the drug is the reason because the hair follicle cells are highly proliferating leading to hair fall.

4. The standard classification of malignant tumor is known as TNM classification in which the tumor is classified according to the size, involvement of lymph nodes and metastasis or extant of spread to other parts of the body. According to this classification tumor classified into stage 0 to stage IV. The Stage 2 tumor can be described as bigger than stage 1 cancer tumors. It is localized and has few surrounding tissue involvement. It may or may not spread to the nearby lymph nodes( depending on the type of cancer) but not to other part of the body.