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LEARNING OBJECTIVES

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LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Describe the etiology of cancer.

  2. Define the tumor, nodes, metastases (TNM) system of cancer staging.

  3. Classify each drug used in the treatment of cancer and compare and contrast the mechanisms of action, uses, and side effects.

  4. Outline actions for all health care providers to prevent medication errors with cancer treatments.

  5. Describe the role of health care practitioners in the care of cancer patients.

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KEY CONCEPTS

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  • Image not available. The word cancer covers a diverse array of tumor types that affect a significant number of Americans and individuals worldwide and are a significant cause of mortality.

  • Image not available. Numerous cellular changes occur in the genetic material of the cancer cell so that programmed cell death, or apoptosis, does not occur. Proliferation of cancer cells goes unregulated.

  • Image not available. Most solid tumors are staged according to the tumor, nodes, metastases (TNM) classification system. The size of the primary tumor, extent of nodal involvement, and presence of metastases are used to determine the stage. Metastases are cancer cells that have spread to sites distant from the primary tumor site and have started to grow. The most frequently occurring sites of metastases of solid tumors are the brain, bone, liver, and lungs. After TNM staging, most cancers types are then classified by a more simplified staging (i.e., stages I to IV), which indicates disease severity.

  • Image not available. Traditional chemotherapy agents have some similar side effects, usually manifested on the most rapidly proliferating cells of the body. However, various pharmacological categories of antineoplastic agents do possess unique toxicities. Anthracyclines (e.g., doxorubicin) have the potential to cause cardiac toxicity, which is related to the cumulative dose. Microtubule-targeting agents (e.g., vincristine) are associated with various forms of neurotoxicity. Alkylating agents (e.g., melphalan) are associated with secondary malignancies.

  • Image not available. Because of the risk of severe toxicities associated with many of the chemotherapy agents, safety and handling precautions must be in place to prevent chemotherapy errors and/or accidental chemotherapy exposures to health care professionals or patients.

  • Image not available. Clinicians should play a role in ensuring chemotherapy safety, patient education, and monitoring patient response to therapy. For example, cumulative doses of anthracyclines should be monitored along with signs and symptoms of heart failure. Clinicians should also monitor for drug interactions between other current medications and chemotherapy agents.

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EPIDEMIOLOGY

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Image not available. The word cancer covers a diverse array of tumor types that affect a significant number of Americans and individuals worldwide and are a significant cause of mortality. The term cancer actually refers to more than 100 different diseases. What is common to all cancers is that the cancerous cell is uncontrollably growing and has the potential for invading local tissue and spreading to other parts of the body, a process called metastases.Cancer is now the leading cause of death in Americans younger than the age of 85 years of age.1 In 2011, it was ...

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