Question

Give two examples of common chemotherapeutic agents that are considered vesicants and what is your nursing responsibility in preventing and treating vesicant type events.

Explain the significance of growth fraction and the cell cycle to the success of chemotherapy.

Explain the three primary therapies for cancer: surgery, radiation, and chemotherapy. please send appropriate references

Answer 1

ANSWER 1) The two common chemotherapeutic agent that are considered to be vesicants are Cisplatin, Docetaxel.

The nursing responsibility in preventing and treating vesicant type events are:

1. Assess for a good and patent intravenous line. The intravenous line should be proper placed to prevent extravasation of the medication in the surrounding area to the venous system.
2. Usually a vesicants is infused through central venous line so the proper placement of CVP line is important.
3. Veins that are thin and fragile, veins over the flexion area, over the joints, veins in the limbs with impaired arterial, venous or lymphatic drainage should be avoided for intravenous cannulation.
4. All the staff members in the chemotherapy department should be trained.
5. While administering a vesicants, monitor the site for redness, pain and swelling.
6. Stop infusion if any such symptoms are noted.
7. If patient has to receive more drugs then the vesicant medication should be administered first.
8. If an extravasation occurs,stop the infusion and aspirate as much vesicant as possible.
9. Adequate antidote should be administered. For example: Sodium thiosulphate for cisplatin, hyaluronidase for docetaxel for topical cooling.

ANSWER 2) Every cell whether cancerous or normal cell have to complete the cell cycle to replicate. The cell cycle is a sequence of cellular events that is regulated by certain chemical signals produced by genes.The study of cell cycle have helped the researchers to develop such treatment which will act on these phases to stop the proliferation of certain cells and also causes cells to self destruct. The growth fraction refers to the percentage of cells engaged in proliferation verus the GO phase at any given point of time. The GO phase is the resting phase of a cell during which it carries out its normal metabolic functions. The growth fraction indicates the dividing cells that are potentially sensitive to chemotherapy. It meanse the tumor which has high growth fraction, can be cured easily be drugs.

ANSWER 3) Surgery: Surgery is one of the oldest method of treating cancer. It is the removal of the tumor and the surrounding structures. The surgery can be diagnostic or can be curative.

Radiation: It is method of treatment for cancer patients that uses the Xray or other radiations to destroy cancer cells. It consist of specific number of treatment given over a period of time. In some cases the radiation therapy is considered as the primary treatment but in other its used after surgery or chemotherapy called adjuvant therapy. There are various types of radiation therapy but mainly its of two types called external radiation and internal radiation therapy.

In external radiation therapy the radiation is given by a machine outside the body to the patients. A large area can be treated. In internal radiation therapy an implants that is permanent or temporary is placed within the tumor or in the surrounding area. This continues to emit radiation. All type of radiation therapy requires safe handling as it has risk of developing radiational hazards for both therapist and the patient.

Chemotherapy: Its the treatment of cancer with use of drugs that will destroy cancer cells. These drugs reduces the growth and division of the cancer cells as it grows faster than normal cells. The chemotherapy drugs causes harm to even the healthier cells which leads to its side effects.The drug,dose and treatment schedule depends on the size and location of tumor, tgype of tumors, age, general health and other medical conditions of the patients. Chemotherapy is usually given orally and intravenously. Some of the chemotherapeutic drugs are cisplatin, daunorubicin, oxiplatin, docetaxel etc. The nurse or the care provider who is administering the chemotherapeutic drugs should be well trained and should be aware about the care to be taken while preparing and adminstering these drugs.

REFERENCES:

1. ALPF medical research, Pharmacology, "Tumor growth and growth fraction" May 2018
2. RnCeus.com, " The cell cycle".
3. Cancer.net, Doctor approved patient information from ASCO " Navigating cancer care".