ONS ONCC Chemo Renewal | 59 Questions And Answers
Neoadjuvant therapy does not increase survival when compared to adjuvant
therapy. It only changes the timing of treatment and can change surgical options
if the tumor is shrunk enough. If this occurs, the patient may only require a
lumpectomy plus radiation therapy instead of needing a mastectomy
Main benefit of neoadjuvant chemotherapy (breast cancer patient)
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
treatment).
Infusion should be initiated within six hours of extravasation.
Infused over 1-2 hours for three days in an area other
than the extravasation site
The dose recommended is based on the patients' body
surface area.
• Day 1: 1,000 mg/m2
• Day 2: 1,000 mg/m2
• Day 3: 500 mg/m
Neoadjuvant therapy does not increase survival when compared to adjuvant
therapy. It only changes the timing of treatment and can change surgical options
if the tumor is shrunk enough. If this occurs, the patient may only require a
lumpectomy plus radiation therapy instead of needing a mastectomy
Main benefit of neoadjuvant chemotherapy (breast cancer patient)
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
treatment).
Infusion should be initiated within six hours of extravasation.
Infused over 1-2 hours for three days in an area other
than the extravasation site
The dose recommended is based on the patients' body
surface area.
• Day 1: 1,000 mg/m2
• Day 2: 1,000 mg/m2
• Day 3: 500 mg/m
