Care of patients receiving chemotherapy | Causes,Symptoms,Diagnosis,Treatment,Options,Types

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Sunday, 26.05.2013, 12:26


Patients receiving chemotherapy


Chemotherapy of malignant tumors based on the use of substances that damage and kill cells in their division. The younger and less differentiated tissue (tumor) than the gain share her cell, so ruinous to her chemotherapy drugs. Mechanism of Action of modern chemotherapeutic agents is similar to the action of radiant energy. Both methods kill the cell during its division. The difference is that the beam of radiant energy can be directed to the center of disease - the tumor or its metastases, and the chemotherapy drug getting into the bloodstream directly, by absorption after intramuscular injection or oral administration, acting on all tissues and organs of the patient.


Chemotherapy is used a significant number of cases of malignant tumors as the primary method of treatment and many more patients in combination with surgery or radiation methods.


Feature of the chemotherapy treatment is its duration and frequency. Separate repeated courses of chemotherapy administration are carried out over several years, sometimes throughout the life of the patient. Many patients re-assigned to outpatient chemotherapy, especially with ongoing prophylactic.


The introduction of modern anti-cancer drugs in precisely defined for each single and total dose to avoid toxic effects of the healthy tissues and organs. However, to completely eliminate their negative impact on healthy tissue is not always possible. Are important individual features in the reactivity of the patients. Distinguish local and general, early and late complications of chemotherapy.


Under the supervision of oncologists performed intramuscular injections of chemotherapy and intravenous infusions They monitor the timely attendance of patients to treatment, give direction to the necessary control blood, watching patients after drug administration, and organize consultative examinations of patients by specialists and keep a record of injections, infusions, and reactions to the introduction of drugs.



The earliest complication of chemotherapy are repeated painful vomiting, occurring frequently immediately after the intravenous administration of chemotherapy or a few hours later. In some patients, this complication is so natural that the reflex is produced not only a drug but also on the type of drug-filled syringe before injection. The most effective way to deal with this complication - the use of sleeping pills. When receiving a chemotherapeutic drug inside the sleeping pill is given after 2 h. The ineffectiveness of sleeping pills given neuroleptics. Before the first infusion of cytostatic drug to the patient explaining the observed sometimes nausea and vomiting do not pose any danger, they pass quickly and easily disposed of by special pills or sleeping pills.


By the early complications also include sharp pain, burning sensation, followed by some limited areas of necrosis of subcutaneous tissue, if it has got even a small amount of cytostatics. This is, in fact, not a specific complication of chemotherapy, but a consequence of the error injection techniques.


This sort of complications include phlebitis and more fleboskleroz vein elbow and shoulder pain after repeated administration of cytotoxic drugs or antitumor antibiotics. From prevention to recommend the drugs be administered intravenously slowly and end up passing through the infusion of nevynutuyu vein needle syringe full 5% glucose solution.


Appears relatively early toxic effects of chemotherapy on the skin. Unpleasant complications, especially for women who are balding and baldness. It is necessary to explain the sick, that after treatment the hair grow back, and sure it does not require special treatment. In the treatment of some drugs are observed early complications in the form of itching, increased sensitivity of the skin, which disappear at the end of treatment.


Often in the middle of chemotherapy, there are complaints of tooth pain, pain in the lower jaw. Of these complaints must be made aware of the doctor-oncologist, as some anticancer drugs give complications: toxic neuritis and polyneuritis. This complication requires cessation of chemotherapy treatment in B vitamins, aminalona, neostigmine and consult a neurologist.


As well as in radiation therapy of cancer patients, a common complication of chemotherapy is suppression of hematopoiesis. Most sensitive to cytotoxic agents lymphoblastic elements follicles of lymph nodes, spleen, intestines, tonsils and thymus. Less sensitive erythro blastycs granulocytes of bone marrow tissue. Already on the third day after initiation of treatment can be detected decrease in the number of leukocytes in peripheral blood. The number of red blood cells does not change significantly. Leukopenia occurs after the administration of almost all cytotoxic drugs. After chemotherapy, some drugs there is a delayed leukopenia, when the decrease in the number of white blood cells continues for several more weeks. Therefore, systematic blood tests should be performed and after completion of outpatient chemotherapy for a month.


Reducing the number of platelets in the blood during chemotherapy less frequently leukopenia in a few times, but often it comes in time before the radiation.


Hematopoietic system in our body has a tremendous capacity to recover their functions in full after the termination of chemotherapy treatment. After a while, comes a full recovery of white blood cells or platelets without any special events.


Prolonged leukopenia and thrombocytopenia poses a real threat to the emergence of infectious complications, hemorrhage. Patients may develop weakness, loss of the mouth and throat.


Observation of patients by oncologists permanently, may require the production of clinical studies, bone marrow puncture, ie, hospitalization. The best prevention of complications from the blood system is the systematic control over the composition of peripheral blood and timely break in chemotherapy.


The defeat of the oral mucosa - ulcerative stomatitis - sometimes complicates chemotherapy. In these cases astringent mouthwash solutions, with pain that prevents a normal diet - 1-2% solution of novocaine.


In the middle or the end of treatment with cytostatics without a noticeable decrease in the number of white blood cells or platelets in some patients, pain in abdomen spastic character, loose stools with mucus, usually without blood. It enterocolitis, which appeared due to the cytostatic irritating the intestinal mucosa. These phenomena are generally overcome by the appointment of sparing diet, rest after 2-3 days. Patients are subject to medical supervision. If abdominal cramping accompanied by tenesmus, false desires, and the patient receives chemotherapy, should be suspected toxic recto. Necessary medical examination for purposes of treatment and further chemotherapy tactics.


In the treatment can be observed holetsistopatii with pain in the right hypochondrium biliary colic type. Patients subject to examination and medical research for its intended purpose. Holetsistopatii can occur, and one month after completion of chemotherapy. The tactic is similar to that in the first case: examination of the doctor-oncologist research.


Patients receiving certain cytotoxic agents, by the end of treatment sometimes complain about the appearance of frequent painful urination. This may be a sign of incipient aseptic cystitis. The patient should be directed to consult a urologist.


In women, chemotherapy may cause disruption of the menstrual cycle. It is advisable to consult the direction of the patient to a gynecologist appointment for corrective therapy.


Complications from chemotherapy are not observed frequently, but the patient and his relatives should be aware of them and inform them of the oncologist.


The effectiveness of chemotherapy depends on the precision of the term prescribed by a doctor of drug administration, and prevention of complications - the regularity of the produced tests.


Contact with patients, positive effect on the healing process, manifested in the friendly attitude toward him, a sincere interest in his recovery.


Nutrition of patients during outpatient chemotherapy treatment usually without any restrictions, except for alcohol, which is strictly prohibited. Should be recommended more often included in the diet fresh fruits and vegetables, do not forget the fresh air.