Guidelines for the management of hypersensitivity reactions are available from the Resuscitation Council (Table 7).69. Volume 2014:4 Pages 103—115, Helen Roe,1 Elaine Lennan2 1Department of Clinical Oncology, North Cumbria University Hospitals NHS Trust, Carlisle, 2Chemotherapy Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK Abstract: Chemotherapy services in the UK have been the subject of national policy directives for the past decade. Effectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy: a randomized, controlled trial. There is increasing evidence of the benefit of exercise during treatment to maintain muscle bulk. A patient with stomatitis can suffer from isolation, nutrition problems, and infection.57,58 Severely compromised oral mucosa will result in reduction in the chemotherapy dose, with possible consequences in terms of optimal treatment outcome, although the mouth repairs quickly in most patients, with a return to normal health within a few days. The NHS Cancer Plan. This site is owned and operated by Informa PLC ( “Informa”) whose registered office is 5 Howick Place, London SW1P 1WG. Extravasation is a potential consequence of receiving intravenous chemotherapy, and is defined as occurring when the chemotherapy agent accidently leaks into the surrounding tissue instead of the intended intravenous or intra-arterial administration site.72 Although extravasations are more likely to occur when a peripheral cannula is being used, they can also occur when using central venous access devices, and have the potential to cause further damage.73 It is therefore vital that nurses involved in administering intravenous chemotherapy have the knowledge and skills to minimize the risk of an extravasation, detect signs early should they occur, and manage the incident effectively.74 Distinguishing cutaneous reactions which are not extravasations, ie, flare reactions, is also important.75. The focus of the consultation is to determine the presence of any toxicities of treatment. As already discussed, nurses are supported by the DOH to develop nurse-led chemotherapy clinics. This work is published and licensed by Dove Medical Press Limited. 2009;17:437–444. Br J Nurs. Accessed November 13, 2013. Hickok JT, Roscoe JA, Morrow GR, King DK, Atkins JN, Fitch TR. The nurse must assess the need for a central access device, counsel the patient accordingly, and refer to the appropriate service for placement. Taste changes affect approximately half of all patients receiving chemotherapy, indicating a need for discussion with the patient before starting treatment.63,60, The nurse has a role in suggesting possible strategies to minimize the detrimental impact of chemotherapy.63 The carer is often an essential part of these discussions, given that they are usually responsible for the cooking. Understanding anticipatory nausea. Side effects of cancer treatment: “chemo head” chemotherapy causes chemo brain. Cancer Therapy Evaluation Program. Support Care Cancer. You can learn about what data of yours we retain, how it is processed, who it is shared with and your right to have your data deleted by reading our Privacy Policy. Molassiotis A, Brearley S, Saunders M, et al. Hilton S, Hunt K, Emslie C, Salinas M, Ziebland S. Have men been overlooked? Broeckel JA, Jacobsen PB, Horton J, Balducci L, Lyman GH. J Clin Oncol. Docetaxel-related side effects and their management. Concerns checklist. The individual’s perception of self is challenged, and a transition to a new self is needed.15 An assessment framework known as the holistic needs assessment can be used to identify and address these issues. In addition, patients are often reluctant to contact help lines a second time if their symptoms resolved during a previous cycle. Recommended guidelines for the treatment of cancer treatment-induced diarrhea. Table 9 Common toxicity criteria (NCI 2012)Abbreviation: NCI, National Cancer Institute. Manual of Cancer Services; Acute Oncology Services. 2009;27:1899–1905. J Clin Oncol. Octreotide can be tried for persistent diarrhea.47 It is important for the patient to understand their own baseline bowel habits before treatment and feel comfortable in discussing and describing their motions. In the clinic, the nursing assessment establishes the presence of any toxicities and determines the need for intervention. Ensuring that the patient has understood the information provided, particularly in relation to oncological emergencies, is vitally important. The duration is short, but can be debilitating and painful for the patient. A recent survey involving ten cancer centers reported the incidence of moderate to severe nausea as 3%–40% and moderate to severe vomiting as 23%–66%. Eur J Oncol Nurs. This means that acute oncology services is on track to save £247,000 in its first year based on bed savings of £221 per day, but more importantly, the service has demonstrated an ability to provide timely and appropriate advice to patients.78, The particular focus of these services includes early recognition and treatment of neutropenic sepsis, metastatic spinal cord compression, and cancer of unknown primary. Nurses need a full awareness of the toxicities associated with chemotherapy regimens including for any new drugs. Based on this assessment, adjustments can be made to their chemotherapy and supportive medicines as necessary, including potentially delaying treatment for a few days to allow full recovery from a particular symptom. Available from: http://connect.qualityincare.org/oncology/patient_safety/case_studies/acute_oncology_service_implementation_of_a_nurse_led,_integrated_acute_oncology_service_pan_birmingham_cancer_network_and_sandwell_and_west_birmingham_hospitals_nhs_trust. Accessed Sep 2013. Department of Health. Many of these services are nurse-led (although not in isolation from the multidisciplinary team) and work in tandem with the chemotherapy nurses. We offer real benefits to our authors, including fast-track processing of papers. 2013;22:797–806. Gibson RJ, Keefe DM. http://www.cancerresearchuk.org/cancer-help/about cancer/treatment/chemotherapy/about/how-chemotherapy-works. If you have previously obtained access with your personal account, please log in. Nurse-led chemotherapy clinics in practice. Department of Health. • software development by maffey.com Dibble SL, Luce J, Cooper BA, et al. The primary purpose of the clinic is to assess the patient’s ongoing suitability to receive chemotherapy. Certainly left untreated, the sequelae of diarrhea include renal failure, perforation, infection, and death.48,49 Anyone presenting with grade 3 and 4 diarrhea needs admission to hospital for hydration and investigation of cause. 2008. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms. This involves administering sequential doses of the drug and building up tolerance very slowly. The Viviscal Report; the hidden impact of hair loss. Accessed February 15, 2014. However, severe reactions can result in stridor, bronchospasm, and angioedema. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. The most important risk factor for the development of chemotherapy-induced nausea and vomiting is the emetic potential of the chemotherapy regimen. Qualitative and quantitative assessment of taste and smell changes in patients undergoing chemotherapy for breast and gynecologic malignancies. Nurses are well placed to play a pivotal role in chemotherapy management and lead interventions such as a specialist oncology nursing roles that provide information and support to guide patients through their chemotherapy cycles. Risks of incorrect dosing of oral anti-cancer medicines. Available from http://www.resus.org.uk/pages/reaction.pdf#search=%E2%80%9Danaphylaxis2. How chemotherapy works. In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content. Available from: http://www.asco.org/guidelines/chemotherapyinducednauseaandvomiting/. A longitudinal qualitative interview study to understand need for support in family members of people having chemotherapy. Miller M, Kearney N. Chemotherapy-related nausea and vomiting – past reflections, present practice and future management. N Engl J Med. Semin Oncol Nurs. 2012. Schlairet M, Heddon M, Griffis M. Piloting a needs assessment to guide development of a survivorship program for a community cancer center. • Associations & Partners Chemotherapy-induced nausea and vomiting: prevention, detection, and treatment – how are we doing? Acute oncology services now offer timely and appropriate advice to patients and are beginning to have a noticeable impact on patient outcomes. Register your specific details and specific drugs of interest and we will match the information you provide to articles from our extensive database and email PDF copies to you promptly. Steinback S, Hummel T, Böhner C, et al. In addition, early interventions for grade 1 and 2 toxicities arising from treatment can sometimes prevent escalation of symptoms and consequent morbidity.10.
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