| Preface..................................................................................................................
|
ix |
| |
|
| Abbreviations Used in This Manual......................................................................... |
xi |
| |
|
| Generic Medications and Brand-Name Equivalents................................................ |
xii |
| |
|
| I. Introduction....................................................................................................... |
1 |
| A. Definition of cancer............................................................................................. |
1 |
| B. Treatment modalities.......................................................................................... |
2 |
| C. The drug development process.......................................................................... |
3 |
| D. Ethical issues related to cancer therapy............................................................. |
8 |
| E. Legal issues related to cancer therapy............................................................... |
9 |
| |
|
| II. Cancer Therapy Goals and Response........................................................... |
13 |
| A. Goals of cancer therapy..................................................................................... |
13 |
| B. Factors affecting response to treatment............................................................. |
13 |
| C. Measuring response........................................................................................... |
14 |
| |
|
| III. Principles of Chemotherapy.......................................................................... |
18 |
| A. Life cycle of cells................................................................................................. |
18 |
| B. Chemotherapeutic agents................................................................................... |
18 |
| |
|
| IV. Principles of Biotherapy................................................................................ |
36 |
| A. Theory of immune surveillance........................................................................... |
36 |
| B. Methods of biotherapeutic action........................................................................ |
36 |
| C. Categories of biotherapy.................................................................................... |
36 |
| D. Therapeutic uses for biotherapeutic agents....................................................... |
36 |
| E. Supportive uses for biotherapeutic agents......................................................... |
36 |
| F. Uses for biotherapeutic agents in research........................................................ |
36 |
| G. Biotherapeutic strategies.................................................................................... |
44 |
| H. Actions of the immune system............................................................................. |
44 |
| I. Types of immune response.................................................................................. |
44 |
| J. Cells of the immune system................................................................................. |
46 |
| K. Tumor escape mechanisms................................................................................ |
48 |
| L. Angiogenesis and antiangiogenic agents............................................................
|
49 |
| M. Principles of radioimmunotherapy (RIT)............................................................. |
49 |
| N. Toxin-conjugated molecules............................................................................... |
49 |
| |
|
| V. Fundamentals of Administration.................................................................... |
53 |
| A. Safe handling......................................................................................................
|
53 |
| B. Treatment schedule............................................................................................ |
63 |
| C. Pretreatment....................................................................................................... |
68 |
| D. Treatment........................................................................................................... |
70 |
| |
|
| VI. Immediate Complications of Cytotoxic Therapy..........................................
|
78 |
| A. Extravasation ..................................................................................................... |
78 |
| B. Flare reaction..................................................................................................... |
83 |
| C. Hypersensitivity and anaphylaxis........................................................................ |
83 |
| D. Patient and family education............................................................................... |
86 |
| |
|
| VII. Care of the Patient Receiving Cancer Therapy.................................................................................................................. |
89 |
| A. Patient education................................................................................................ |
89 |
| B. Toxicity management.......................................................................................... |
89 |
| |
|
| VIII. Side Effects of Cancer Therapy.................................................................. |
93 |
| A. Myelosuppression............................................................................................... |
93 |
| B. Gastrointestinal and mucosal side effects........................................................... |
109 |
| C. Alopecia.............................................................................................................. |
139 |
| D. Fatigue............................................................................................................... |
140 |
| E. Cardiac toxicity.................................................................................................... |
144 |
| F. Pulmonary toxicity............................................................................................... |
167 |
| G. Hemorrhagic cystitis........................................................................................... |
180 |
| H. Hepatotoxicity...................................................................................................... |
182 |
| I. Nephrotoxicity....................................................................................................... |
186 |
| J. Neurotoxicity........................................................................................................ |
192 |
| K. Pancreatitis......................................................................................................... |
197 |
| L. Alterations in sexuality and reproductive function............................................... |
198 |
| M. Cutaneous toxicity.............................................................................................. |
206 |
| N. Ocular toxicity..................................................................................................... |
206 |
| O. Secondary malignancies.................................................................................... |
213 |
| |
|
| IX. Post-Treatment Care...................................................................................... |
219 |
| A. General principles............................................................................................... |
219 |
| B. Classification of effects....................................................................................... |
219 |
| C. Nursing assessment........................................................................................... |
219 |
| D. Collaborative management................................................................................. |
225 |
| |
|
| X. The Clinical Practicum..................................................................................... |
226 |
| A. Course description.............................................................................................. |
226 |
| B. Course objectives............................................................................................... |
226 |
| C. Clinical activities................................................................................................. |
226 |
| D. Evaluation........................................................................................................... |
226 |
| |
|
| Appendices........................................................................................................... |
227 |
| Appendix 1. Nursing Flow Sheet.............................................................................. |
227 |
| Appendix 2. Chemotherapy Flow Sheet.................................................................. |
231 |
| Appendix 3. Safe Management of Chemotherapy in the
Home............................... |
233 |
| Appendix 4. Progression of Intravenous Extravasation........................................... |
235 |
| Appendix 5. Clinical Practicum Evaluation: Part I..................................................... |
236 |
| Appendix 6. Clinical Practicum Evaluation: Part II....................................................
|
237 |
| |
|
| Index...................................................................................................................... |
239 |