CANCER NURSING

by:
Mrs. Theresa Margarita
Marivee L. Saldevar
 RADIATION THERAPY

 also called radiotherapy, X-ray therapy, or

irradiation
 is the use of ionizing radiation to kill cancer cells
and shrink tumors
 may be used to treat almost every type of solid
tumor, including cancers of the brain, breast,
cervix, larynx, lung, pancreas, prostate, skin,
stomach, uterus, or soft tissue sarcomas
 Types of Radiation Therapy
External Beam Radiation Therapy (EBRT)
- also known as teletherapy
- utilizes X-rays, electron beams and beta or gamma
radiation produced by radioactive isotopes
- uses ionizing radiation to destroy malignant tissue
and/or slow down the development of abnormal cells
 Internal Radiation Therapy
- involves placement of specially prepared radioisotopes directly
into or near the tumor itself or into the systemic circulation
Brachytherapy or Sealed Source
- involves using a sealed source of radioactivity in the form of
isotope rods that can be implanted directly into a tumor or body
cavity delivering radiation to a localized area
- radioactive needles or wires are implanted into tumors of the
tongue, floor of the mouth and breast, vagina, cervix, lower uterus,
rectum or anus and prostate
Unsealed Sources or Systemic Radionuclide Therapy
 involves injecting radioactive isotopes either into a vein or
into an organ
 one of the most common types of systemic radiation therapy is
radioactive iodine
 given to treat cancers of the thyroid and bones
Side Effects of Radiation Therapy
Area of the Effect
Body
Head and Neck Irritation of the mucous membranes,
stomatitis, oral pain and infection, loss of
taste, increased ICP
Skin Change in color or texture, alopecia,
erythema, pruritus
Chest Inflammation, infection, tissue destruction
Abdomen Anorexia, N/V, diarrhea
Pelvis Cystitis, urethral and rectal stenosis, diarrhea,
sexual dysfunction
Blood Bone marrow depression, anemia,
leucopenia, thrombocytopenia,
compromised immune function
General Fatigue
 Radiation Safety Precautions
 Place the client in a private room.
 Plan care well so minimal time is
spent in direct contact with client
with implant.
 Provide care for client standing at
client’s shoulder or at foot of bed.
 Use lead aprons/shield.
 The room should be marked with
appropriate signs stating the presence
of radiation.
 Carefully check all linens or other
materials removed from the bed for
the presence of foreign bodies.
 Keep long-handled forceps and a
lead-lined container available on the
nursing unit.
 Nursing Responsibilities
 Carefully assess client and take medical
history
 Provide education: common side effects, skin
changes, effects on bone marrow, procedure
 Maintain good nutrition
 Provide rest and sleep
 Monitor blood counts
 Prevent skin irritation
 Prevent injury and infection
BONE MARROW TRANSPLANTATION
 Also known as
Hematopoietic stem
cell transplantation

 Involves taking cells

that are normally
found in the bone
marrow (stem cells),
filtering those cells,
and giving them back
either to the patient
or to another person
 Bone Marrow Transplantation
Indications: leukemias, severe aplastic anemia,
lymphomas, multiple myeloma, immune deficiency
disorders, solid-tumor cancers, such as breast or
ovarian Types of bone marrow
transplants:
autologous bone marrow
transplant
allogeneic bone marrow
transplant
umbilical cord blood transplant
 Nursing Responsibilities
 Discuss special preparation
 Describe the harvest procedure
 Explain what happens after recovery:
1. Pain in harvest sites
2. Application of pressure dressings
3. Keep surgical sites clean and covered for 3
days
 IMMUNOTHERAPY
 Also known as Biologic
Response Modifiers
(BRM)
 Biotherapy
 a diverse set of
therapeutic strategies
designed to induce the
patient's own
immune system to fight
the tumor
Types of Immunotherapy:
 Interferons: activate NK cells

 Interleukins: activate production of NK cells,

cytotoxic T cells
 Tumor Necrosis Factor (TNF): attaches to tumor
cell membrane, causing cell damage
 Growth Factors:
Granulocyte-colony stimulating factor:
promotes growth of neutrophils
Granulocyte-macrophage colony stimulating factor
: promotes growth of macrophages and monocytes
Erythropoietin
(EPO): enhances erythrocyte growth
 Monoclonal Antibodies (MoAb): bind only to
cancer cell-specific antigens and induce an
immunological response against the target cancer cell
 Hormonal Therapy
Androgens Testosterone Replacement therapy for Have some antiestrogen Males:Impotence, gynecomastia,
propionate males, treat properties, making it epididymitis, bladder
dysmenorrheal and useful to treat estrogen- irritation
menopause in dependent breast cancers Females: hirsutism, amenorrhea,
women, inoperable masculinization
breast cancer in Both: N/V, fluid retention
women
Anti-androgens Flutamide To treat metastatic Antagonizes androgen effects at Diarrhea, nausea, vomiting, loss of
(Eulexin) prostate cancer cellular level libido, impotence,
gynecomastia, hot flushes,
edema, hypertension
Estrogens Diethylstilbestrol Postmenopausal Supplements estrogen N/V, anorexia, abdominal
(DES) syndrome, distention, spotting,
amenorrhea due to menstrual changes, fluid
ovarian failure, retention, breast tenderness
prostatic cancer
Anti-estrogens Tamoxifen citrate Treat estrogen receptor Act as estrogen antagonist Rare bone marrow depression,
(Nolvadex) positive breast menstrual irregularity, hot
cancer flashes
Synthetic Leuprolide Prostate cancer, used in Initially stimulates but then Dizziness, headache, decreased
lutenizing acetate clients who cannot inhibits release of follicle- libido, impotence, anorexia,
hormone (Leupron) tolerate an stimulating hormone and bone pain, paresthesias
orchiectomy or luteinizing hormone
estrogen therapy
Miscellaneous Paclitaxel (Taxol) Metastatic breast and Inhibits microtubular function, Bone marrow depression,
antineoplastic ovarian cancer causing cell death hypersensitivity reactions,
peripheral neuropathy, N/V
 Angiogenesis Inhibitors
 prevent the extensive growth of blood
vessels (angiogenesis) that tumors require to
survive
 Example of drugs: bevacizumab
Symptom Control/Palliative Care
 Pain management
 Reconstructive interventions
 Supportive care
 Shift your problems to
challenges. 
When you have problems,
you worry about them. 
When you have challenges -
you are working,
applying, and attacking
thank you very much…
your plan to get results.
This shift in thinking from