| Preface |
ix |
| Abbreviations Used in This Manual |
x |
| Generic Medications and Brand-Name Equivalents |
xii |
| I. Introduction |
1 |
| A. Definition of cancer |
1 |
| B. Treatment modalities |
2 |
| C. The drug development process |
4 |
| D. Ethical issues related to cancer therapy |
11 |
| E. Legal issues related to cancer therapy |
12 |
| II. Cancer Therapy Goals and Response |
17 |
| A. Goals of cancer therapy |
17 |
| B. Factors affecting response to treatment |
17 |
| C. Treatment strategies |
18 |
| D. Measuring response |
19 |
| III. Principles of Antineoplastic Therapy |
25 |
| A. Life cycle of cells |
25 |
| B. Chemotherapeutic agents |
26 |
| C. Actions of the immune system |
26 |
| D. Types of immune response |
26 |
| E. Cells of the immune system |
28 |
| F. Tumor escape mechanisms |
29 |
| G. Principles of biotherapy |
30 |
| H. Categories of biotherapy |
30 |
| I. Principles of radioimmunotherapy |
32 |
| J. Toxin-conjugated molecules |
33 |
| K. Therapeutic uses for biotherapeutic agents |
33 |
| L. Supportive uses for biotherapeutic agents |
33 |
| M. Biotherapeutic strategies |
33 |
| N. Angiogenesis and antiangiogenic agents |
34 |
| IV. Fundamentals of Administration |
73 |
| A. Safe handling |
73 |
| B. Verification and maintenance of treatment as planned |
84 |
| C. Pretreatment |
93 |
| D. Treatment |
95 |
| V. Immediate Complications of Cytotoxic Therapy |
105 |
| A. Extravasation |
105 |
| B. Irritation |
110 |
| C. Flare reaction |
111 |
| D. Acute infusion reactions |
111 |
| E. Patient and family education |
114 |
| VI. Care of the Patient Receiving Cancer Therapy |
117 |
| A. Patient education |
117 |
| B. Adherence to therapy |
118 |
| C. Toxicity management |
118 |
| VII. Side Effects of Cancer Therapy |
121 |
| A. Myelosuppression |
121 |
| B. GI and mucosal side effects |
146 |
| C. Cutaneous toxicity |
182 |
| D. Alopecia |
197 |
| E. Cardiovascular toxicity |
200 |
| F. Pulmonary toxicity |
231 |
| G. Hemorrhagic cystitis |
255 |
| H. Hepatotoxicity |
259 |
| I. Nephrotoxicity |
266 |
| J. Neurotoxicity |
274 |
| K. Cancer treatment–related cognitive changes |
284 |
| L. Ocular toxicity |
300 |
| M. Pancreatitis |
310 |
| N. Fatigue |
311 |
| O. Alterations in sexuality |
315 |
| P. Reproductive alterations |
320 |
| VIII. Post-Treatment Care |
325 |
| A. General principles |
325 |
| B. Types of effects |
326 |
| C. Secondary malignancies |
326 |
| D. Collaborative management |
339 |
| E. Preventive screening recommendations |
340 |
| F. Patient and family education |
340 |
| G. Professional education |
340 |
| H. Nursing assessment |
340 |
| IX. Nursing Education and Management |
343 |
| A. The clinical practicum |
343 |
| B. Policy and procedure |
344 |
| C. Issues in antineoplastic administration |
344 |
| D. Documentation |
345 |
| Appendices |
347 |
| Appendix 1. Nursing Flow Sheet |
347 |
| Appendix 2. Chemotherapy Flow Sheet |
351 |
| Appendix 3. Safe Management of Chemotherapy in the Home |
353 |
| Appendix 4. Progression of Intravenous Extravasation |
355 |
| Appendix 5. Clinical Practicum Evaluation: Part I |
356 |
| Appendix 6. Clinical Practicum Evaluation: Part II |
357 |
| Appendix 7. Oncology Nursing Society Position on the Education of the RN Who Administers and Cares for the Individual Receiving Chemotherapy and Biotherapy |
358 |
| Appendix 8. Consent Document |
359 |
| Appendix 9. Extravasation Flow Sheet |
360 |
| Index |
361 |