Cancer modalities

Cancer is a global issue majorly affecting developing countries. According to a survey, 63% of deaths due to cancer are reported from developing countries. There are different conventional treatment modalities that are available to treat and manage cancer. However, new cancer treatment options are being explored continuously as over 60% of all current experimental trials worldwide are focusing on tumor cure. The success of treatment depends upon the type of cancer, locality of tumor, and its stage of progression. Surgery, radiation-based surgical knives, chemotherapy, and radiotherapy are some of the traditional and most widely used treatment options. Some of the modern modalities include hormone-based therapy, anti-angiogenic modalities, stem cell therapies, and dendritic cell-based immunotherapy.
A standout among the best cancer treatment modalities is the gene therapy which is direct in situ insertion of exogenous genes into the tumors which could give a powerful remedial way for the treatment of benign tumors. Similarly, hormonal treatments are also widely used for cancer malignancies and generally considered as cytostatic. Hormonal treatment restricts tumor development by limiting hormonal growth factors. It most likely acts via the down direction of hypothalamic-pituitary-gonadal axis, blockage of hormone receptor, and restraint of adrenal steroid synthesis.

1. CANCER
MODALITIES
By
Mr B Kalyan kumar
Msc (N) Dept Of MSN

2. INTRODUCTION
Themethodoftreatmentdependsuponthetypeofmalignancy,
thespecifichistologiccelltype,stage,presenceofmetastasis
andconditionofthepatient.

3. CANCER TREATMENT MODALITIES
Surgical
intervention
Chemotherapy
Radiation
therapy
Biotherapy
Hormonal
therapy
Bone marrow
transplantation

4. CHEMOTHERAPY
Chemotherapyistheuseofdrugstokilltumorcellbyinterfering
withcellularfunctionsandreproduction.InChemotherapy
Antineoplasticagentsareusedinanattempttodestroytumor
cellsbyinterferingwithcellularfunctions.Thepurposeof
treatingcancercellswithchemotherapyistopreventthesecells
frommultiplying,invadingandmetastasizingtodistantsites.
Chemotherapymaybecombinedwithsurgeryorradiation
therapyorboth.

5. GOALSOFCHEMOTHERAPY

6. Cure:Totaleliminationofcancerouscells.
Control:Toextendthelifeofpatientwhencurenot
possible.
Palliation:Whenthecancerisatanadvancedstage,
chemotherapydrugsmaybeusedtorelievesymptoms
causedbythecancer.

7. CLASSIFICATION OFCHEMOTHERAPEUTIC
DRUGS
Alkylatingagents: Common drugs Chlorambucil,
Cyclophosphamide, Cisplatin, Carboplatin.
Anti metabolite agents: 5-Flurouracil , hydroxyurea
Anti tumorantibiotics: Bleomycin, mitomycin,
Doxorubicin.
Plant alkaloids: Plant alkaloids are cytotoxicagents derived
from plant extracts
Vinblastine, vincristine.

8. ROUTEOFCHEMOTHERAPY
ADMINISTRATION

9. Oral route
Intravenous
route
Intra thecal
route
Intra-arterial
route
Intra pleural
route

10. PLANNING DRUGDOSEANDSCHEDULES
Dose–Mostofthechemodrugsaremeasuredinmilligrams
(Mg).Theoveralldoseissometimesbasedonpersonsbody
weight.
Schedule-Chemotherapyisgenerallygivenatregular
intervalscalledcycles.

11. NURSINGMANAGEMENT FORPATIENT
UNDERGOING CHEMOTHERAPY
Patientshouldbeprotectedfrominfection
Washhandsregularlywithantibacterialagent
Avoidcrowdsandpeoplewithcold
Maintaingoodnutritionalstatus
Antiemeticsshouldbeadministeredonehourpriorto
chemotherapy
Bodyweightshouldbemeasuredatleasttwiceaweek
Patientshouldbeclearlyassessedforsideeffects.

12. BONEMARROW TRANSPLANTATION
Abonemarrowtransplantinvolvestakingcellsthatare
foundinthebonemarrow,filteringthosecells,and
givingthembackeithertothepatientortoanother
person.

13. NURSINGMANAGEMENT FORPATIENT
UNDERGOING BONEMARROWTHERAPY
Monitorvitalsignsandobservefordyspnea,chestpain,chills
Monitorpatientforsignsofinfection
Observepatientforsignsofbleeding
Balancedfluidandelectrolytestatushastobemaintained.

14. RADIATION THERAPY
Radiationtherapyistheuseofcertaintypeofenergytokill
cancercellsandshrinktumors.Radiationtherapyinjuresor
destroyscellsintheareabeingtreatedbydamagingtheir
geneticmaterial.

15. TYPESOFRADIATION THERAPY
External radiation therapy
Internal radiation therapy

16. EXTERNAL RADIATION THERAPY
Externalradiationtherapyalsocalledteletherapy,isadministered
byamachineatacertaindistancefromthespecificareaof
body.
Externalradiationtherapyisusedtotreatmosttypesofcancer,
includingcancerofthebladder,brain,breast,cervix,larynx,
lung,prostateandvagina.Inadditionexternalradiationmaybe
usedtorelievepain.

17. INTERNAL RADIATION THERAPY
Internal radiation therapy also called brachytherapy, is a
radiation technique in which the specific radioisotopes placed
directly near the tumor.
The radiation source is usually sealed in a small holder called an
implant. Implant may be in the form of thin wires, plastic tube
called catheters, capsule.
For internal radiation therapy, the patient says in the hospital for
a few days. The implant may be temporary or permanent. Once
an implant is removed, there is no radioactivity in the body

18. MOSTCOMMON SIDEEFFECTSOF
RADIATIONTHERAPY
Skinreaction-Commonsideeffectofradiationisskin
irritationintheareaofthebodybeingtreated.
Skinreactioncanrangefrommildrednessanddrynessto
severepeeling.

19. PRECAUTIONS THATMAYMINIMIZE SKIN
IRRITATION
Keepthetreatedareadry
Washtheskininthetreatmentareaonlywithmildsoap
Useamildshampoo,suchasbabyshampoo,iftheheadis
beingtreated
Donotuseperfumes,deodorants
Wearloosefittingclothingthatdoesnotrubtheskininthe
treatedarea.

20. FATIGUE
Feelingoftiredness,weakness.Fatigueistypicallymoresevere
twotofourhoursaftertreatment
Followingsuggestionsmayhelpyoutomanagefatigue
Limityouractivities
Exerciseeachdaytomaintainyourstrength
Drinkthreelitresoffluideachdaytopreventthebuildupof
cellularwasteproducts
Increaserestbygettingmoresleepatnight.

21. Nausea and vomiting
Loss of appetite
Taste changes.

22. NURSING MANAGEMENT OFPATIENT
UNDERGOING RADIATIONTHERAPY
Reassurethepatientbyclearingallthefearsabouttheeffectsof
radiotherapy.
Explainproceduretothepatientlikeequipmenttobeused,
durationofprocedure.
Ifradio-implantisusedforradiotherapy,patientshouldbe
informedaboutrestrictionofmovements.
Oralmucosaandskinofthepatientassessedfrequentlytorule
outsideeffects.
Skinisprotectedfromradiation.