Question

Case 1 Chapter 14: Antineoplastic Agents An older adult patient has recently been diagnosed with prostate and kidney cancer. The patient has a lot of concerns and questions about antineoplastic agents that he is going to be receiving following surgery 3 months ago. What are the anticipated changes the patient's body undergoes when cancer occurs? What is the goal of cancer chemotherapy? Why are antineoplastic agents often given in combination? What are the key points that the nurse needs to review with the patient receiving cancer-specific agents?

Answer 1

1. Anticipated changes the patient's body undergoes when cancer occurs are:

• Surgery scars.
• Hair loss from chemotherapy or radiotherapy
• Surgical modification of body parts
• Weight gain/loss
• Skin changes like itching, redness, more sensitivity etc.
• Pain due to cancer or cancer treatment.
• Loss of muscle mass and/or muscle weakness
• Gynecomastia in men
• Lymphedema
• Sexual dysfunction
• Mouth sores
• Fever
• Fatigue
• Nausea and vomiting
• Loss of appetite
• Small red spots (petechiae) on the arms and legs
• Easy bruising
• Bleeding from the gums when brushing teeth
• Lower leg edema

2. The goals of chemotherapy depend on the patient’s condition, i.e., the type and the stage of cancer. These goals are:

• Cancer cure: When possible, chemo is used to destroy cancer cells until they are no longer detected in the patient’s body.
• Cancer control: Chemo may be used to keep cancer from spreading, slow its growth, or destroy cancer cells that have spread to other parts of the body.
• To ease symptoms of cancer as a palliative. In the advanced stage of cancer, chemo is used to shrink the tumors that cause pain or pressure.
• The goal of adjuvant chemotherapy, given after surgery or radiation, is to kill any remaining cancer in the body after surgery or radiation therapy.
• The goal of neoadjuvant chemotherapy, given before surgery, is to shrink the cancer tumor so that it can be removed easily surgically.

3. Antineoplastic agents are often given in combination because antineoplastic agent combination treatment is more effective than single antineoplastic drug treatment. This is because of the fact that each agent targets and affects cancer growth in a different manner. In combination treatment, antineoplastic agents that work by different mechanisms are used to decrease the likelihood of developing resistant cancer cells. The antineoplastic combination has two or more drugs, each one with a different action. Combination therapy increases tumor response, survival rates, and prolongs the time before cancer progression.

4. Key points that the nurse needs to review with the patient receiving antineoplastic agents include:

a. The side effects:

• Increased risk of infectious diseases like influenza.
• Fatigue.
• Hair loss
• Weight loss
• Nausea, vomiting, and other digestive problems.
• Localized and whole-body pain.

b. Management of side effects.

c. Explain the safe administration of antineoplastic drugs

d. Discuss the psychological and social impact of chemotherapy and measures to overcome these.

e. Discuss the importance of compliance.