ONS ONCC Chemo Renewal 2026
• A comprehensive geriatric assessment (CGA) is a multidisciplinary evaluation to
assess life expectancy and risk of morbidity and mortality in the older patient. This
assessment tool would evaluate and include the following areas: functional status,
socioeconomic issues, psychosocial distress, comorbidities, cognitive function,
nutritional status, polypharmacy, and a medication review (NCCN Older Adult
Oncology Guidelines, version 1.2015). -✓✓Due to Mrs. Turner's age and
comorbidities, her oncologist performs a comprehensive geriatric assessment. You
know that this assessment covers all but which of the following:
• 65 -✓✓The NCCN Older Adult Oncology Guidelines (version 1.2015) provides
information on what is included in a comprehensive geriatric assessment.
Currently, more than 60% of cancers in the United States occur in people age
______and older and as the oncology world ages, nearly half (46%) of cancer
survivors are 70 years of age or older
• Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive are
categorized as irritants. Docetaxel can cause a significant reaction if it extravasates.
It can lead to edema, erythema, occasional pain and blister formation (ONS
Chemo/Bio guidelines, 2014). That is the most likely reason that Mrs. Turner was
given a port for her treatments. Some patients will receive their treatments through
a peripheral IV without incident. Just because they are intravenous agents does not
mean that a port is required and needing a port has nothing to do with her being
older in age. Since none of these agents are vesicants, they likely could have been
given safely via peripheral route but having a port placed is OK as well. -✓✓What
is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy?
• Irrirtants -✓✓_____________can cause inflammation, pain, and burning but
rarely cause tissue necrosis comparable to a vesicant (unless a large amount or a
very high concentration of the irritant is extravasated).
• Vesicants -✓✓_____________can cause blistering and significant pain and tissue
damage and destruction, leading to tissue death.
• Non-DNA-binding solutions remain in the local area of the extravasation, which
improves the possibility of drug deactivation.
, DNA-binding agents attach to DNA nucleic acids, causing the antagonist to be
ingested cellularly, leading to progressive tissue destruction -✓✓A further
classification of an antineoplastic agent's potential to cause damage is whether its
mechanism of action includes DNA binding.
• Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin -✓✓DNA Binding Irritants
• Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine -✓✓DNA Nonbinding vessicants
• Sodium thiosulfate
Inject 2 ml of sodium thiosulfate for each milligram of
mechlorethamine extravasated.
Inject subcutaneously into extravasation site using a 25
gauge or smaller needle (change needle with each injection).
Monitor extravasation site according to the institution's
policies and procedures. -✓✓Extravasciation Alkylating / Mechlorethamine tx
• Apply warm compresses.
Dexamethasone
8 mg twice daily
for 14 days -✓✓Extravasciation Alkylating: Oxaliplatin
• Totect
Apply ice pack (remove 15
minutes prior to Totect
• A comprehensive geriatric assessment (CGA) is a multidisciplinary evaluation to
assess life expectancy and risk of morbidity and mortality in the older patient. This
assessment tool would evaluate and include the following areas: functional status,
socioeconomic issues, psychosocial distress, comorbidities, cognitive function,
nutritional status, polypharmacy, and a medication review (NCCN Older Adult
Oncology Guidelines, version 1.2015). -✓✓Due to Mrs. Turner's age and
comorbidities, her oncologist performs a comprehensive geriatric assessment. You
know that this assessment covers all but which of the following:
• 65 -✓✓The NCCN Older Adult Oncology Guidelines (version 1.2015) provides
information on what is included in a comprehensive geriatric assessment.
Currently, more than 60% of cancers in the United States occur in people age
______and older and as the oncology world ages, nearly half (46%) of cancer
survivors are 70 years of age or older
• Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive are
categorized as irritants. Docetaxel can cause a significant reaction if it extravasates.
It can lead to edema, erythema, occasional pain and blister formation (ONS
Chemo/Bio guidelines, 2014). That is the most likely reason that Mrs. Turner was
given a port for her treatments. Some patients will receive their treatments through
a peripheral IV without incident. Just because they are intravenous agents does not
mean that a port is required and needing a port has nothing to do with her being
older in age. Since none of these agents are vesicants, they likely could have been
given safely via peripheral route but having a port placed is OK as well. -✓✓What
is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy?
• Irrirtants -✓✓_____________can cause inflammation, pain, and burning but
rarely cause tissue necrosis comparable to a vesicant (unless a large amount or a
very high concentration of the irritant is extravasated).
• Vesicants -✓✓_____________can cause blistering and significant pain and tissue
damage and destruction, leading to tissue death.
• Non-DNA-binding solutions remain in the local area of the extravasation, which
improves the possibility of drug deactivation.
, DNA-binding agents attach to DNA nucleic acids, causing the antagonist to be
ingested cellularly, leading to progressive tissue destruction -✓✓A further
classification of an antineoplastic agent's potential to cause damage is whether its
mechanism of action includes DNA binding.
• Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin -✓✓DNA Binding Irritants
• Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine -✓✓DNA Nonbinding vessicants
• Sodium thiosulfate
Inject 2 ml of sodium thiosulfate for each milligram of
mechlorethamine extravasated.
Inject subcutaneously into extravasation site using a 25
gauge or smaller needle (change needle with each injection).
Monitor extravasation site according to the institution's
policies and procedures. -✓✓Extravasciation Alkylating / Mechlorethamine tx
• Apply warm compresses.
Dexamethasone
8 mg twice daily
for 14 days -✓✓Extravasciation Alkylating: Oxaliplatin
• Totect
Apply ice pack (remove 15
minutes prior to Totect
