Question

1. Study the targeted anticancer agents, chemo protective agents, and bone marrow stimulants to identify the major indications for use.

2. What are the goals of chemotherapy when using drug therapy for cancer?

3. How can hormones affect chemotherapy?

4. Describe the physical assessment of chemotherapy care.

5. What would be the patient education you would use for someone using a Hickman catheter?

Answer 1

Ans)1) The major groups currently used are classified as alkylating agents, antimetabolites, natural products, antineoplastic antibiotics, and hormones. Newer developed cancer fighting agents are targeted anticancer agents, chemoprotective agents, and bone marrow stimulants.

- Chemotherapeutic agents, also referred to as antineoplastic agents, are used to directly or indirectly inhibit the proliferation of rapidly growing cells, typically in the context of malignancy.

- Plant alkaloids are chemotherapy treatments derived made from certain types of plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents.

2) If cure is not possible, the goal may be to control the disease. Chemo is used to shrink tumors and/or stop the cancer from growing and spreading. This can help the person with cancer feel better and live longer.

3) Breast and prostate tumors frequently require estrogen/androgen for growth/survival.

- Tumor cell growth/survival can be inhibited by lowering hormone levels or antagonizing hormone function.

- Relatively minor side effects (no myelosuppression, mucositis etc). Decrease amount of circulating hormone or antagonizes the inhibition of growth or survival
- Once hormone gets to tumor cell it gets to androgen or estrogen receptor, translocated to nucleus and brings about gene expression and proliferation of survival, antagonizes synthesis and binding of hormone to receptor, or translocation that Inhibit gene expression.

4) A physical exam is often done as part of a regular checkup, but it can be done at any time. It may be done to:

- check for possible diseases and medical conditions, including cancer
- find medical issues that may become problems in the future
- allow your doctor to notice and keep track of any changes in your physical health
- check your health during and after cancer treatment
- ensure you maintain a healthy lifestyle
help your doctor decide if more tests are needed

A physical exam is usually done in a doctor’s office or an exam room in a medical clinic or hospital.

A health history is usually taken at the same time as the physical exam. A health history is a record of present symptoms, risk factors and all the medical events and problems a person has had in the past. The doctor or healthcare professional will ask you about:

- past and current diseases, medical conditions and illnesses
- surgeries you have had
- immunizations you have had
medicines, vitamins, minerals and herbal remedies you are taking (prescription and over-the-counter drugs)
- current signs and symptoms of diseases such as cancer
- lifestyle, such as eating and exercise habits, tobacco and alcohol use and sexual and reproductive history
- family history of cancer and other diseases
The physical exam includes a review of the person’s body systems that is tailored to their age. During a physical exam, your doctor may:

- measure your height and weight
- examine your skin and eyes
- look into your nose, mouth, throat and ears
- feel pulses in your neck, groin and feet
- check your body’s reflexes
- listen to your heart and lungs
- take your blood pressure and pulse
- feel lymph nodes in your neck, armpits or groin to check if they are enlarged
feel your abdomen to check for abnormalities or growths on organs such as the liver, spleen and kidneys
Depending on your age and sex, a physical exam may also include:

- a skin exam
- a clinical breast exam (CBE) to feel for lumps in the breasts
- a digital rectal exam (DRE) to feel for abnormalities in the lower part of the rectum and to check the prostate in men
- a Pap test and pelvic exam in women to check organs in the pelvis such as the vagina, cervix and uterus
- an exam of the scrtum and testicles in men to check for lumps, swelling or tenderness.